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TRANSACTIONS  OF  THE  SECOND  INTERNA- 
TIONAL SANITARY  CONVENTION  OF  THE 
AMERICAN  REPUBLICS 


HELD  AT  THE  NEW  WILLARD 
HOTEL,  WASHINGTON,  D.  C, 
OCTOBER  9,  10,  12, 13,  and  14,  1905, 
UNDER  THE  AUSPICES  OF  THE 
GOVERNING  BOARD  OF  THE 
INTERNATIONAL  UNION  OF 
THE  AMERICAN   REPUBLICS 


WASHINGTON,  D.  C.  ■  -  GOVERNMENT  PRINTING  OFFICE  -  -  1906 


f  1-1 

1^  Ob' 


OFFICERS  OF  THE  CONVENTION. 


President, 
Surgeon-General  Wyman,  United  States  Public  Health  and  Marine-HospitallService. 

Vice-presidents. 

Señor  Don  Eduardo  Moore,  M.  D.,  Chile. 
Señor  Don  Juan  J.  Ulloa,  M.  D.,  Costa  Rica. 
Señor  IJmilio  Joubert,  Dominican  Republic. 
Señor  Don  Serafín  S.  Whither,  Ecuador. 
Señor  Don  JoAQmN  Yela,  M.  D.,  Guatemala. 
Señor  Don  Eduardo  Licéaga,  M.  D.,  Mexico. 
"  Señor  Don  J.  L.  Medina,  M.  D.,  Nicaragua. 
Señor  Don  Daniel  E.  Lavorería,  M.  D.,  Peru. 
Mr.  H.  L.  E.  Johnson,  M.  D.,  United  States. 
Señor  Don  Nicolás  Veloz  Goiticoa,  Venezuela. 

Permanent  secretary. 

Señor  Don  Juan  J.  Ulloa,  M.  D.,  Costa  Rica. 

Advisory  council. 

^  Señor  Don  Eduardo  Moore,  M.  D.,  ChUe,  Chairman. 

Señor  Don  Eduardo  Licéaga,  M.  D.,  Mexico. 
^     .  Asst.  Surg.  Gen.  H.  D.  Geddings,  United  States. 

Maj.  Walter  D.  McCaw,  U.  S.  Army. 
^  Señor  Don  Juan  Guiteras,  M.  D.,  Cuba. 

^  Dr.  J.  D.  Gatewood,  Surgeon,  U.  S.  Navy. 

^  3 


^ 
•C 


436628 


CONVOCATION   OP   THE   SECOND   GENERAL   INTERNATIONAL 
SANITARY  CONVENTION. 


In  accordance  with  the  mode  of  procedure  authorized  by  the 
Second  International  Conference  of  American  States,  held  in  the  City 
of  Mexico  in  1901-2,  the  date  of  October  9,  1905,  was  fixed  for  the 
assembling  of  the  Second  General  International  Sanitary  Convention 
in  "Washington,  D.  C. 

The  following  official  communications  were  promulgated  as  neces- 
sary preliminaries: 

Treasury  Department, 

Washington,  April  29,  1905. 
Mr.  W.  C.  Fox, 

Director  of  tJie  Bureau  of  the  American  Republics,  Washington,  D.  C. 
Dear  Sir:  I  inclose  herewith  a  call  for  the  Second  General  International  Sanitary  Con- 
vention of  the  American  Eepublics,  summoned,  by  direction  of  the  International  Sanitary 
Bureau,  to  meet  in  Washington,  D.  C,  on  October  9,  1805,  at  11  o'clock  a.  m. 

This  call  is  issued  in  accordance  with  the  resolutions  relating  to  international  sanitary 
poUcy  and  sanitary  conventions  adopted  by  the  Second  International  Conference  of  the 
American  States,  held  in  the  City  of  Mexico  October  22,  1901,  to  January  22,  1902. 

In  accordance  with  paragraph  7  of  said  resolutions,  I  have  to  request  that  you  will  take 
such  measures  as  you  deem  advisable  to  make  announcement  of  this  call. 
Respectfully, 

Walter  Wtman, 
Surgeon-General,  Chairman  International  Sanitary  Bureau. 


Treasury  Department, 

Washington,  April  29, 1905. 

the     second     general    international   sanitary     convention     of     the     AMERICAN 

REPUBLICS. 

By  direction  of  the  International  Sanitary  Bureau,  the  Second  General  International 
Sanitary  Convention  of  the  American  Republics  will  be  held  at  the  New  Willard  Hotel, 
Washington,  D.  C,  on  October  9,  1905,  at  11  a.  m.  The  programme  for  the  meeting  wiU 
be  furnished  in  a  short  time,  and  announcements  of  any  changes  therein  will  appear  from 
time  to  time  in  the  Monthly  Bulletin  of  the  Bureau  of  the  American  Republics. 
Respectfully, 

Walter  Wyman, 
Chairman,  International  Sanitary  Bureau. 

In  consequence  of  the  foregoing,  the  Bureau  of  the  American 
Republics  caused  the  following  to  be  transmitted  to  the  accredited 
representatives  in  the  United  States  of  the  countries  composing  the 
International  Union  of  American  Republics : 

I^Iay  1, 1905. 
Sir:  I  have  the  honor  to  transmit  herewith  copy  of  a  letter  received  from  Surg.  Gen. 
Walter  Wyman,  chairman  of  the  International  Sanitary  Bureau,  forwarding  a  call  for  the 
Second  General  International  Sanitary  Convention  of  the  American  Eepublics  to  meet  in 
Washington,  D.  C,  on  October  9,  1905,  at  11  o'clock  a.  m. 
I  am,  sir,  your  obedient  servant, 

Williams  C.  Fox,  Director. 


b  SECOND    INTEKNATIONAL    SANITARY    CONVENTION. 

The  programme  submitted  for  the  work  of  the  convention  was  as 
follows : 

Secx)nd  International  Sanitary  Convention  of  American  Republics, 

Washington,  D.  C,  October  9, 1905. 

scientific  programme. 

1.  Reports  by  a  delegate  from  each  Republic.  These  reports  should  include  (a)  reports 
on  prevaleúce  of  diseases,  with  special  reference  to  plague,  yellow  fever,  and  malaria  since 
January  1,  1904,  being  approximately  the  date"  of  adjournment  of  the  last  convention; 
(b)  a  summary  of  all  quarantine  and  sanitary  laws  enacted  since  the  first  convention;  (c) 
special  sanitary  work  in  progress  or  in  contemplation.  Tliese  reports  are  to  be  rendered 
in  behalf  of  each  Republic,  or  each  division  of  the  subject  may  be  committed  to  a  delegate 
for  presentation.     A  written  report  is  requested  for  publication. 

2.  Plague:  (a)  Diagnosis;  (b)  Prophylaxis  and  therapeusis;  (3)  Maritime  quarantine; 
(d)  Land  quarantine ;  (e)  Local  measures  for  the  eradication  of  the  disease. 

3.  The  mosquito  in  its  relation  to  yellow  fever  and  malarial  fevers.  Prevention  of  the 
spread  of  yellow  fever  and  malarial  fever  by  the  destruction  and  elimination  of  the  mosquito. 

4.  Discussions  on  sanitation  of  cities,  with  special  reference  to  the  ventilation  of  habita- 
tions and  disposal  of  household  wastes. 


TRANSACTIONS   OF  THE  SECOND  GENERAL  INTERNATIONAL 
SANITARY  CONVENTION  OF  THE  AMERICAN  REPUBLICS. 


FIRST  DAY— MONDAY,  OCTOBER  9. 

The  convention  was  called  to  order  by  Surgeon-General  Wyman, 
presiding,  at  11.15  o'clock  a.  m. 

OPENING   REMARKS    BY    SURG.    GEN.   WALTER    WYMAN    OF    THE    PUBLIC 
HEALTH    AND    MARINE-HOSPITAL    SERVICE. 

Gentlemen  :  I  have  the  honor  of  calling  to  order  the  Second  Inter- 
national Sanitary  Convention  of  the  American  Republics,  convened 
pursuant  to  resolutions  adopted  by  the  Second  International  Confer- 
ence of  the  American  States,  City  of  Mexico,  January  29,  1902. 

Three  years  ago  next  December  the  First  Convention  was  held  in 
this  city,  eleven  Republics  being  represented  by  twenty-seven  dele- 
gates. So  far  as  I  am  at  present  informed  there  are  twelve  Republics 
represented  in  this  convention.  You  will  remember  that  it  was 
decided  to  hold  the  Second  Convention  March  15,  at  Santiago  de 
Chile,  in  accordance  with  the  cordial  invitation  presented  by  the 
distinguished  delegates  from  Chile.  As  the  time  approached  it 
became  evident  that  on  account  of  a  severe  epidemic  of  yellow  fever 
in  certain  portions  of  the  United  States  and  Mexico,  and  the  necessity 
of  precautionary  measures  for  the  ensuing  year,  it  would  be  very 
difficult  for  delegates  from  these  two  Republics  to  absent  themselves; 
therefore,  the  International  Sanitary  Bureau,  with  the  kind  concur- 
rence of  the  Chilean  authorities,  agreed  to  a  postponement  and  finally 
determined  upon  this  date  and  this  city  for  the  present  convention. 

The  good  results  of  the  First  Convention  have  been  made  mani- 
fest in  various  ways,  and  the  resolutions  which  were  adopted  have 
been  of  value  certainly  to  the  health  authorities  of  the  United  States, 
and  as  I  believe  to  "the  authorities  of  the  other  Republics.  I  will 
review  these  resolutions,  of  which  there  were  seven,  giving  their  titles, 
but  not  attempting  here  to  quote  them  in  full. 

First,  the  convention  to  be  governed  by  the  resolutions  of  the  con- 
ference in  Mexico ; 

Second,  resolutions  relating  to  the  time  of  detention  and  disinfec- 
tion at  quarantine; 

Third,  resolutions  relating  to  yellow  fever,  mosquitoes,  and  quar- 
antine ; 

Fourth,  resolution  relating  to  the  geographical  distribution  of  the 
yellow-fever  mosquito ; 

Fifth,  resolution  declaring  the  relation  between  lower  animals, 
garbage,  and  disease; 

7 


8  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sixth,  resolution  relating  to  typhoid  fever  and  cholera,  declaring 
the  necessity  of  disinfection  of  discharges; 

Seventh,  resolutions  relating  to  the  international  Sanitary  Bureau, 
its  operations,  and  the  collection  of  a  fund  for  its  use. 

The  good  results  of  the  First  Convention  and  the  beneficial  effect 
of  the  resolutions  just  enumerated,  will,  I  am  confident,  be  made  to 
appear  in  tlie  reports  and  remarks  of  the  delegates  to  this  Second 
Convention.  I  will  here  mention  but  one  instance  in  illustration. 
After  the  yellow-fever  epidemic  in  Mexico  and  in  Texas  in  1903,  there 
was  great  apprehension  of  its  recurrence  in  both  countries  in  the 
following  summer  and  fall  of  1904,  and  it  became  evidently  necessary 
that  preventative  measures  similar  in  character  and  thoroughness 
should  be  adopted  in  both  countries.  Tlu"ough  the  International 
Sanitary  Convention  the  way  was  paved  for  securing  combined  action 
through  the  highest  authorities  of  both  nations.  A  plan  of  operations 
having  been  prepared  in  the  Bureau  of  the  Public  Health  and  Marine- 
Hospital  Service,  broad  in  character  and  definite  in  detail,  approved 
by  the  President  so  far  as  expenditures  from  the  appropriate  fund 
were  concerned,  by  the  Secretary  of  the  Treasury  as  to  the  application 
of  the  fund  and  the  scope  of  the  work  to  be  undertaken,  and  by  the 
Secretary  of  State  as  to  its  relations  to  a  neighboring  Republic,  I  had 
the  honor  of  pajdng  a  visit  in  January,  1904,  to  our  distinguished 
confrere.  Doctor  Licéaga,  president  of  the  superior  board  of  health  of 
Mexico.  I  was  pleased  to  find  that  practically  the  same  plan,  both 
in  scope  and  detail,  had  already  been  proclaimed  by  the  Mexican 
authorities  and  there  was  no  difficulty  in  determining  upon  conjoint 
and  concurrent  action.  President  Diaz  expressed  his  interest  and 
approval.  As  a  result  there  was  practically  no  yellow  fever  in  either 
Republic  during  the  ensuing  season.  A  description  of  the  methods 
employed  will  doubtless  be  given  by  the  delegates  from  both  countries. 

This  incident  is  but  one  of  many  which  might  be .  cited  to  show 
how  effective  may  be  the  work  of  sanitation  when  carried  on  by 
friendly  cooperation  between  two  nations,  each  inspired  by  friendly 
feelings  and  a  desire  to  protect  the  other  as  well  as  itself. 

This  idea  of  sanitation  by  international  agreement  is  but  one  of 
the  evidences  that  all  nations  are  to-day  more  nearly  related  than 
ever  before  in  the  world's  history.     Said  a  recent  writer: 

Not  only  has  the  narrow  ftith  been  practically  abolished,  but  the  wide  ocean  is  traversed 
by  passenger  ships  in  five  days  and  by  thoughts  put  into  words  in  a  few  seconds.  All  the 
world  has  become  one  neighborhood  so  far  as  relates  to  distances. 

In  no  manner  has  this  been  more  strikingly  shown  than  in  the  war- 
fare against  contagious  disease.  But  a  few  years  ago  a  violent  epi- 
demic of  yellow  fever  in  Cuba  would  excite  no  more  than  passing 
notice,  while  to-day  the  news  of  one  or  two  cases  anywhere  on  the  lit- 
toral of  our  Western  Hemisphere  would  be  immediately  communi- 
cated to  the  United  States  and  other  countries.  A  few  cases  of 
bubonic  plague  in  the  Orient  which  a  few  j^ears  ago  w^ould  receive  no 
attention  are  instantly  reported  and  published  and  one  case  of  cholera 
on  a  ship  in  the  Mediterranean  is  telegraphed  to  the  principal  cities 
of  the  world.  International  congresses,  conferences,  and  conventions 
are  frequent,  bringing  the  nations  together  as  one  family  in  the 
struo-prle  against  the  common  foe  of  mankind. 


SP:C0NU    IN'I'KHNA'IIONAI,    SANI'l'AKV     (;(>iN  V  KN'IION.  'J 

We  hear  much  at  the  ])resent  thne  of  international  peace  confer- 
■ences,  and  arbitration  treaties.  Is  it  too  niucli  to  expect  as  a  corol- 
lary, or  as  a  parallel  movement,  that  there  should  be  ultimately  a 
cooperation  of  all  nations  to  eliminate  connnunicable  diseases? 
International  sanitation  might  well  be  considered  as  an  adjunct  to 
the  movement  for  universal  peace.  It  miglit  prove  less  diííicult  of 
achievement  than  absolute  arbitration  or  it  might  be  made  a  power- 
ful influence  in  establishing  the  latter.  A  former  President  of  the 
French  Republic  at  the  opening  of  the  Hygienic  Conference  at  Paris 
in  1894,  gave  expression  to  the  following  sentiments: 

The  international  principles  which  had  their  origin  in  the  laboratory  and  are  based  on 
science  are  the  only  ones  which  bind  nations  togetlier  with  strong  ties  and  establish  equitable 
and  immutable  laws. 

This  principle  may  be  well  considered  by  those  who  are  seeking 
universal  peace;  and  international  responsil)ility  with  regard  to 
disease  is  worthy  of  the  attention  of  those  who  are  interested  in  the 
development  of  international  law.  There  is,  I  believe,  no  mention  in 
the  treatises  on  international  law  of  the  responsibilities  of  govern- 
ments to  one  another  in  matters  of  public  health,  but  the  time  is  ripe 
for  adding  a  chapter  on  this  subject. 

I  quote  from  a  recent  writer: 

It  seems  that  nations  are  beginning  to  develop  a  conscience  and  a  sense  of  justice  for  the 
rights  of  other  nations.  As  a  whole  the  peace  movement  is  another  step  toward  the  actual 
attainment  of  the  ideal  perfection  of  government. 

The  thought  of  the  writer  of  the  foregoing  quotation  can  find  no 
better  illustration  than  in  the  incidents  connected  with  the  treaty  of 
peace  recently  effected  at  Portsmouth. 

With  this  growing  sentiment  of  harmony  and  fraternity  among  the 
nations,  there  should  be  developed  an  international  sentiment  regard- 
ing sanitation  and  suppression  of  disease.  If,  as  Tolstoi  says,  the  only 
substitute  for  war  is  religion,  international  sanitation  would  be  a  pow- 
erful weapon  in  the  hands  of  religion,  if,  indeed,  it  could  not  in  itself 
be  made  a  substitute  for  war.  It  surely  would  furnish  a  plane  upon 
which  nations  might  meet,  and  a  more  worth}^  object  than  war  for  the 
expenditure  of  energy  and  money. 

I  have  before  given  expression  to  some  of  these  thoughts,  but  have 
deemed  them  particularl}"  appropriate  to  this  occasion.  It  remains 
for  me  only  to  express  the  hope  that  this  Second  Convention  will  be 
fruitful  for  good,  that  it  will  bring  us  still  nearer  together  and  make 
us  all  feel  that  the  interest  of  one  country  is  in  realit}^  the  interest  of 
the  others,  most  particularly  in  matters  relating  to  the  public  health. 

The  President  (continuing).  Gentlemen,  we  have  with  us  the 
distinguished  Secretar}^  of  State,  whom  I  liave  the  pleasure  of  intro- 
ducing to  bid  3^ou  a  few  words  of  welcome.  I  have  the  honor  of 
introducing  to  you  the  Hon.  Elihu  Root. 

ADDRESS    OF    WELCOME    BY    THE    HONORABLE    SECRETARY    OF    STATE, 

ELIHU    ROOT. 

Mr.  President  and  gentlemen:  It  is  a  pleasure  and  an  honor  to  wel- 
come you  to  Washington  in  behalf  of  the  Government  of  the  United 
States  and  to  extend  to  you  an  expression  of  the  good  wishes  of  our 
Government  for  the  success  of  all  your  deliberations. 


10  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

It  is  a  matter  of  sincere  satisfaction  to  the  people  of  the  United 
States  that  the  soil  of  our  country  should  be  found  a  favorable  place 
for  all  the  agencies  of  peace,  of  justice,  of  humanity,  that  the  atmos- 
phere which  is  breathed  here  should  be  one  favorable  to  kindly  feeling 
among  all  the  peoples  of  the  earth.  We  would  rather  contribute  to 
the  .saving  of  life  than  to  the  destruction  of  it.  I  do  not  know  that 
we  have  any  reason  to  believe  that  the  individual  intellect  of  man  is 
any  more  powerfid  now  than  it  was  2,000  years  ago;  but  there  is  rea- 
son to  believe  that  the  growth  of  organization  among  men  is  now  fur- 
nishing to  individual  human  intelligence  a  platform  upon  which  it 
may  stand  and  from  which  it  may  take  its  departure  toward  the 
accomplishment  of  results  that  were  impossible  to  the  men  of  past 
ages,  however  powerful  their  intelligence  may  have  been.  And  there 
is  reason  to  beheve  also  that  the  human  intelligence  is  capable  of  far 
greater  accomplishments  under  the  magnetic  influences  of  association 
with  other  minds  alive  to  the  same  interests  and  seeking  the  same, 
end.  That  you  may  promote  the  great  work  of  elevating  the  stand- 
ard from  which  you  yourselves  and  your  fellows  and  your  successors 
may  take  new  departures  for  the  accomplishment  of  great  things  for 
humanity,  that  you  may  feel  and  may  communicate  this  magnetic 
influence  which  tends  to  promote  the  successful  activity  of  human 
intelligence  is  my  sincere  wish. 

I  believe  that  almost  all  of  the  wars,  the  controversies,  the  bitter- 
ness between  nations,  result  from  a  want  of  good  understanding,  from, 
the  failure  by  the  people  of  one  nation  to  truly  understand  and  appre- 
ciate the  people  of  another  nation;  that  the  true  cure  and  preventive 
of  national  controversy  is  acquaintance,  personal  good  relation  and 
friendship  among  the  individual  people  of  the  two  countries;  and 
nothing,  certainly,  can  contribute  more  to  the  good  relations  which 
ought  to  exist  between  all  the  peoples  of  the  Western  Hemisphere 
than  to  have  the  men  who  represent,  as  you  represent,  that  humanity 
which  is  superior  to  all  national  interests,  to  all  national  divisions, 
know  each  other  and  understand  each  other. 

You  have  our  very  best  wishes  and  our  thanks  for  honoring  us  by 
your  presence  here  in  the  interest  of  that  common  humanity  for  which 
we  all  join  in  the  most  sincere  wishes  and  the  most  devout  prayers. 
[Applause.] 

The  President.  As  is  well  known,  the  Public  Health  and  Marine- 
Hospital  Service  of  the  United  States  is  a  Bureau  of  the  Treasury 
Department,  and  we  have  with  us  this  morning  the  Acting  Secretary 
of  the  Treasury,  whom  I  have  the  pleasure  of  introducing  to  you — the 
Hon.  Horace  A.  Taylor.     [Applause.] 

REMARKS  OF  HON.   HORACE  A.  TAYLOR,  ASSISTANT  SECRETARY  OF  THE 

TREASURY. 

Mr.  President  and  gentlemen:  As  acting  head  of  the  Treasury 
Department,  of  which,  as  the  Surgeon-General  has  told  you,  the  Public 
Health  and  Marine-Hospital  Service  is  one  of  the  prominent  bureaus, 
I  join  with  the  Secretary  of  State,  who  represents  all  the  Government, 
in  extending  to  you  a  cordial  welcome  to  Washington. 

We  have  here,  as  many  of  you  know,  in  this  capital  city  a  great 
many  distinguished  visitors  every  day  and  all  the  time,  coming  here' 
for  business  or  for  pleasure,  and  of  late  years  this  has  come  to  be  a 


SECOND    INTP:RNAT1()NAL    HANITAUY     CONVKNTION.  11 

popular  place  where  many  associations  devoted  to  the  diversified 
activities  of  life  hold  their  conventions,  and  we  are  always  ^lad  to  see 
them  here  whether  they  are  citizens  of  our  own  country  or  whether 
there  are,  as  is  the  case  with  this  convention,  other  countries  repre- 
sented. 

\  I  trust,  gentlemen,  that  this  convention  which  you  are  about  to  hold 
will  result  as  those  which  have  preceded  it  have  resulted — in  doing 
great  good.  Your  convention  is  not  as  large  as  many  that  assemble 
here,  bijt  there  is  none  that  has  higher  objects  to  attain  than  you  have. 
The  methods  which  you  are  to  discuss,  the  questions  that  come  before 
your  consideration,  are  those  which  affect  the  very  highest  interests  of 
the  communit3^  Nothing  is  so  dear  to  every  man,  woman,  and  child 
in  all  the  earth,  no  matter  from  what  country  he  comes  or  what  tongue 
he  speaks,  as  his  health,  and  you  are  here  as  the  result  of  the  progress 
that  has  been  made  in  medical  science  during  the  last  few  years.  You 
are  here  not  to  consider  questions  of  disease,  but  you  are  here  to  pre- 
vent disease,  and  certainly  we  all  know,  as  the  old  adage  says,  that  an 
ounce  of  prevention  is  worth  a  pound  of  cure.  And  so  I  am  glad  to 
know  that  the  medical  world  and  that  men  eminent  in  the  profession, 
as  you  gentlemen  before  me  are,  are  directing  their  attention  not  to 
curing  people  after  they  become  ill  so  much  as  to  prevent  them  from 
becoming  ill. 

As  Secretary  Root  well  said,  great  results  flow  from  organization. 
It  is  organization  and  association  and  discussion  and  agitation  that 
are  the  most  beneficent  agencies  in  the  world.  Stagnation  is  forever 
the  enemy  of  progress,  just  as  in  the  natural  world  it  is  a  menace  to 
healthful  existence.  In  nature  and  in  society,  in  government  and  in 
business,  in  the  sciences,  professions,  and  all  the  activities  of  life,  it  is 
agitation  that  brings  reform  and  safety.  We  are  told,  Mr.  President, 
that  there  is  but  one  sea  in  all  the  world  w^hose  waves  are  never  break- 
ing on  the  shores.  It  is  the  Dead  Sea.  Its  waters  are  forever  still, 
and  there  you  find  stagnation  and  disease.  It  is  after  the  storm,  the 
thunder  and  lightning,  and  the  gale  that  come  the  pure  air  and  the 
sunshine  and  the  song  of  the  birds. 

I  want  to  thank  you  for  selecting  one  of  the  prominent  officials  of 
the  Treasury  Department,  Surgeon-General  Wyman,  and  honoring 
him  with  the  presidency  of  this  association.  He  has  well  earned  the 
distinction,  for  those  of  us  who  come  in  official  or  personal  contact  with 
him  know  that  he  is  forever  wide-awake  to  every  movement  that  has 
for  its  interest  the  promotion  of  the  public  health  [applause] ,  and  you 
well  know  in  these  very  recent  days,  when  a  portion  of  our  country 
has  been  scourged  with  the  yellow-fever  epidemic,  his  efforts  for  its 
suppression  have  met  with  notable  success. 

We  are  glad  to  see  you  here  and  we  hope  you  will  have  a  good 
time.  I  assure  you  you  will  meet  with  the  most  cordial  hospitality 
and  the  best  wishes  of  all  our  citizens  and  they  will  unite  with  me 
in  expressing  the  hope  that  your  deliberations  will  result  in  adopt- 
ing such  methods  and  in  the  establishment  of  such  principles  as  when 
put  into  force  will  be  of  great  benefit  to  the  public  health  of  the 
various  countries  and  communities  that  you  represent.     [Applause.] 

The  President.  The  Secretary  of  State  and  the  Acting  Secretary 
of  the  Treasury  seem  to  think  that  when  they  delivered  their  speeches 
they  might  go.  I  wish  to  say  for  the  benefit  of  the  next  speaker 
that  we  would  like  very  much  to  have  him  remain,  and  I  am  sure 


12  SECOND    INTERNATIONAL    8ANTTARY    CONVENTION. 

you  will  ao-ree  with  me  when  you  know  who  he  is.  We  have  with  us 
one  of  the  board  of  directors  of  the  Bureau  of  the  American  Eepub- 
lics,  who  on  behalf  of  that  very  efficient  and  useful  Bureau  will  o;ive 
us  an  address.  I  refer  to  the  Hon.  Gonzalo  de  Quesada,  minister 
to  the  United  States  from  Cuba,  and  I  take  great  pleasure  in  intro- 
ducing him  to  you. 

REMARKS    or    MINISTER    QUESADA,  OF    CUBA. 

^Ir.  President,  gentlemen  and  ladies  of  the  Second  Pan-American 
Sanitary  Conference:  I  thank  your  chairman  heartily  for  this  oppor- 
tunity lie  gives  me  of  addressing  a  few  words  to  the  delegates  of 
the  Second  Pan-American  Congress  in  the  name  of  the  governing 
board  of  the  American  Republics.  It  was  tliis  same  liigh  privilege 
wliich  I  enjoyed  two  years  ago  when  you  met  for  the  first  time,  and 
the  prophecies  then  made  as  to  the  result  of  the  labors  you  then 
initiated  have  turned  out  gratifying  realities.  You  have  brought 
together  by  the  better  acquaintance  of  their  sanitary  conditions  and 
understanding  between  their  respective  boards  of  health,  by  the  tol- 
erance and  sympathy  in  the  common  effort,  the  countries  here  repre- 
sented, in  a  most  commendable  and  sincere  spirit  of  mutual  respect 
and  confidence. 

In  the  past  there  might  have  been  distrust  in  the  methods  pur- 
sued in  various  nations  or  a  self-pride  far  from  conducive  to  the 
high  aim  of  scientists;  to-day  there  is  collaboration  and  friendship 
and  the  best  of  feeling  among  the  distinguished  physicians  in  whose 
hands  is  the  care  of  the  lives  and  interests  of  these  free  communities. 

Were  this  the  only  outcome  of  the  happy  idea  of  these  confer- 
ences it  would  by  itself  constitute  a  glory  for  those  who  planned 
them  and  for  those  who  have  put  in  fruitful  practice  its  inspirations. 

But  more  has  been  accomplished,  the  interchange  of  honest  dif- 
ferences of  opinion,  their  thorough  discussion,  and  the  subsequent 
publicity  given  your  papers  and  transactions  have  undoubtedly  con- 
tributed to  the  propagation  of  scientific  sanitary  measures  and  the 
actual  adoption  of  prophylactic  and  preventive  methods  recommended 
by  you. 

In  this  respect  we  have  reasons  for  warm  praise.  The  wise  direc- 
tions of  some  members  of  this  conference  who  are  here  present  have 
caused  changes  worthy  of  the  most  cordial  commendation,  and  I  am 
sure  I  am  only  voicing  the  sentiments  of  all  present  with  the  same 
enthusiasm  you  showed  before  for  my  native  country,  when  we  ex- 
tend, our  felicitations  to  the  representatives  of  Mexico  who  have  made 
such  progress,  since  our  last  meeting,  in  the  eradication  of  yellow 
fever  in  that  progressive  and  beloved  sister  Republic.     [Applause.] 

And  the  theories  advocated  by  you  have  not  only  been  practically 
tested  there  and  in  other  places,  but  also  during  these  last  months 
in  some  points  of  the  Southern  States  of  this  Union  with  the  suffer- 
ings of  which  our  hearts  are  in  unison.  Our  vows  are  that  s^iortly 
they  shall  cease  to  be  sources  of  concern.  But  even  in  this  mis- 
fortuné  some  consolation  and  useful  purpose  are  to  be  found,  for 
not  only  have  the  theories  advocated  by  you  been  tested  and  found 
true,  and  important  researches  are  being  made  by  American  inves- 
tigators wliicn  we  hope  will  contribute  to  increase  our  knowledge  of 


RECOND    INTIÍRNATIONAL    SANITARY    CONVENTION.  13 

the  disease,  but  we  have  seen  the  comforting  spectacle  of  physicians 
from  other  countries  come  to  share  witli  you  the  diííiculties  of  the 
struggle  and  to  help  in  the  magniiiceiit  task  assumed  by  your  authori- 
ties, of  which  our  cliairman  is  the  illustrious  head.  An  example  of 
real  human  interest  which  were  it  to  be  followed  in  other  phases  of 
international  relations  would  contribute  to  the  attainment  of  the 
supreme  ideal  of  mankind,  universal  brotherhood. 

Gentlemen,  in  that  spirit  and  under  the  ever-conquering  banner 
of  science  which  knows  of  no  frontiers,  ra-ce,  nationality,  or  time, 
but  whioh  has  for  adversaries  only  ignorance  and  error,  let  us  com- 
mence this  Second  Pan-American  Conference,  assured  beforehand  that 
it  can  have  onl}^  one  end — the  pursuit  of  truth  and  the  advancement 
of  the  welfare  of  humanity.     [Applause.] 

The  President.  I  will  request  Doctor  Ulloa,  of  Costa  Rica,  to  act 
as  temporary  secretary  of  this  convention  and  will  request  that  he 
call  the  roll  of  Republics,  and  as  the  name  of  the  Republic  is  called 
I  will  thank  the  delegates  or  one  delegate  to  arise  and  announce  the 
name  of  the  delegate  and  leave  a  card  with  the  secretary,  or  his 
credentials,  which  will  be  turned  over  to  the  advisory  council. 

The  Director  of  the  Bureau  of  American  Republics  informs  me 
that  we  have  a  book  here  in  which  at  your  leisure  you  are  requested 
to  register  your  names. 

(The  same  request  and  announcement  were  made  in  Spanish  by 
Doctor  Ulloa.) 

The  President.  Before  proceeding  with  the  roll  call,  I  take  the 
privilege  of  inviting  the  attendance  upon  this  meeting,,  he  being  here 
and  interested  in  tliis  work,  a  very  distinguished  representative  from 
Japan;  I  would  like  to  present  to  you  Doctor  Suzuki,  surgeon-general 
of  the  navy  of  Japan.     [Applause.] 

The  acting  secretary  called  the  roll  and  the  following  delegates 
were  present: 

Republic  of  Chile :  Dr.  Eduardo  Moore.  ' 

Republic  of  Costa  Rica:  Dr.  Juan  J.  Ulloa.  ^ 

Republic  of  Cuba:  Dr.  Juan  Guiteras  and  Dr.  Enrique  B.  Barnet.^ 

Dominican  Republic:  Sr.  Emilio  C.  Joubert.^ 

Republic  of  Ecuador:  Sr.  Serafín  S.  Whither  and  Dr.  Miguel  H. 
Alcivar. . 

Republic  of  the  United  States  of  America:  Dr.  Walter  Wyman; 
Dr.  H.  D.  Geddings;  Dr.  J.  F.  Kennedy;  Dr.  John  S.  Fulton;  Dr. 
Walter  D.  McCaw;  Dr.  J.  D.  Gatewood;  Dr.  H.  L.  E.  Johnson. 

Republic  of  Guatemala:  Dr.  Joaquin  Yela.v 

Republic  of  Mexico :  Dr.  Eduardo  Licéaga. 

Republic  of  Nicaragua:  Dr.  J.  L.  Medina. 

Republic  of  Perú :  Dr.  Daniel  Eduardo  Lavorería. 

Republic  of  Uruguay:  Sr.  P.  Requena  Bermudez. 

Republic  of  Venezuela:  Mr.  Nicolás  Veloz-Goiticoa. 

The  President.  Gentlemen,  we  have  with  us  one  who  helped  to 
make  our  last  convention  successful,  whose  interest  in  it  was  marked, 
and  whose  efficiency  in  the  conduct  of  such  conventions  as  this  has 
been  shown  on  many  occasions,  and  one  who  is  now  heart  and  soul 
with  us  in  our  effort  to  make  this  an  effective  convention.  I  refer 
to  the  recently  appointed  Director  of  the  Bureau  of  the  American 
Republics,  and  I  have  the  honor  of  introducing  to  you  Mr.  W.  C. 
Fox,  Director  of  the  Bureau  of  the  American  Republics.     [Applause.] 


1-1  SECOND    INTERNATIONAL    SANITARY    CONVENTION, 

REMARKS    OF    HON.    W.    C.    FOX,    DIRECTOR    OF    THE    BUREAU    OF    THE 
AMERICAN    REPUBLICS. 

Mr,  President  and  gentlemen:  I  fully  appreciate  the  distinguished 
honor  of  being  called  upon  on  this  occasion.  By  sufferance  of  the 
honorable  representatives  of  the  International  Union  of  the  American 
Republics  I,  for  the  moment,  fulfill  the  functions  of  Director  of  the 
International  Bureau  of  the  American  Republics. 

While  apparently  the  fabric  which  holds  this  union  together  is  of 
such  fine  and  delicate  texture  that  one  would  tliink  the  slightest 
element  of  discord  would  tear  it  asunder,  the  very  fact  of  its  exist- 
ence under  these  conditions  is  an  assurance  of  its  permanency. 

If  I  understand  the  reasons  for  an  International  Union  of  American 
Republics  aright,  it  is  not  to  create  harmony — but  the  union  exists 
because  there  is  harmony.  That  harmony  is  a  fact  for  the  reason 
that  the  distinguished  men  who  control  the  destinies  of  the  various 
Republics  are  in  mutual  accord;  and  I  believe,  without  fear  of  con- 
tradiction, that  this  union  is  supported  no  more  heartily  than  by  the 
giant  brain,  the  strong  arm,  and  courageous  heart  of  the  President  of 
the  United  States. 

Mr.  President  and  gentlemen,  we  have  come  together  here  to 
again  show  our  fealty  and  loyalty  to  the  interests  of  the  American 
continent.  We  are  here  carrying  out  in  part  the  dictates  of  the 
First  International  Conference  of  the  American  Republics,  held  in 
this  city  in  1889,  and  those  of  the  Second  American  Conference  held 
in  Mexico  in  1901.  We  have  already  met  together  two  years  ago, 
and  now  are  forging  another  link  in  the  chain  which  binds  the  Ameri- 
can Republics  so  firmly  together. 

I  do  not  feel  that  I  can  add  one  word  to  what  has  already  been 
said,  except  that  it  becomes  my  duty  now  to  acquaint  you  with  what 
in  a  modest  way  we  have  attempted  to  do  for  your  comfort  while 
you  are  with  us  here  in  Washington,  and  with  your  kind  permission 
I  will  read  the  programme. 

Luncheon  will  be  served  to-day  and  every  other  day  during  the 
sessions  of  the  convention,  to  which  you  are  cordially  invited. 

This  afternoon  at  3.30  o'clock  we  will  meet  here  and  take  an 
automobile  to  visit  the  new  filtration  plant  in  connection  with  the 
water  service  of  this  city. 

On  Wednesday,  October  11,  through  the  courtesy  of  the  Secretary 
of  the  Treasury,  an  excursion  w;ill  be  given  on  a  revenue  cutter  down 
the  Potomac  River,  The  party  will  go  to  Indian  Head  and  Mount 
Vernon,  returning  to  the  city  before  dusk. 

It -seems  to  me  that  it  will  be  more  practicable  if  we  should  meet 
in  this  room  at  9.30  o'clock  and  proceed  in  a  body  to  the  wharf 
where  the  revenue  cutter  will  be  in  waiting. 

The  management  of  the  Bankers'  Convention,  which  is  being  held 
simultaneously  with  ours,  have  very  courteously  sent  invitations  to 
the  delegates  to  attend  the  reception  at  the  Corcoran  Art  Gallery  on 
Wednesday  evening  and  the  general  reception  in  this  hotel  on  Friday 
evening  next. 

Dr.  H.  L.  E.  Johnson,  Mr,  President,  I  move  that  the  following 
physicians  and  others  be  entitled  to  the  floor: 

Dr.  George  M.  Kober,  Washington,  D.  C. 


SECOND    INTERNATIONAL    SANITARY     (¡ONVENTION.  15 

Surg.  Preston  11.  Bailhache,  Public  Ilealth  and  Marine-Hospital 
Service. 

Dr.  Reid  Hunt,  pharmacologist,  Public  Health  and  Marine-Hospital 
Service. 

The  president  of  the  Navy  Medical  School,  Washington,  D.  C. 

The  president  of  the  Army  Medical  School,  Washington,  1).  C. 

The  Surgeon-General,  United  States  Navy. 

The  Surgeon-General,  United  States  Army. 

Surg.  Gen.  George  M.  Sternberg,  U.  S.  Army  (retired). 

Dr.  Ch.  Wardell  Stiles,  zoologist.  Public  Health  and  Marine-Hos- 
pital Service. 

Dr.  William  C.  Woodward,  health  officer  of  the  District  of  Columbia. 

Surgeon-General  Suzuki,  Imperial  Japanese  Navy. 

Prof.  H.  C.  Wood,  Philadelphia,  Pa. 

The  motion  was  seconded;  and  the  question  being  taken,  was  unani- 
'mously  agreed  to. 

The  President.  This  afternoon  we  have  an  invitation  to  inspect 
the  filtration  plant  here  in  Washington.  I  think  it  will  be  well 
worth  our  while,  because  it  is  a  plant  to  purify  the  Potomac  River 
water  for  drinking  purposes  ancf  it  is  one  of  the  most  up-to-date 
works  of  that  kind.  I  am  sure  it  will  be  worth  a  visit.  We  are  to 
start  at  half-past  three,  as  Mr.  Fox  informs  us,  in  automobiles  from 
the  New  Willard  Hotel. 

The  only  thing  that  remains  to  be  done,  so  far  as  I  can  see  and  so 
far  as  I  know  your  wishes,  is  to  appoint  a  committee  on  organization 
to  determine  how  this  present  convention  shall  be  conducted,  and 
if  some  gentleman  will  make  a  motion  that  such  committee  be 
appointed  I  will  put  it  and  the  committee  can  be  preparing  their 
report  between  now  and  the  meeting  to-morrow  morning. 

Dr.  H.  L.  E.  Johnson.  I  move  that  such  a  committee  be  ap- 
pointed by  the  chairman. 

The  motion  was  numerously  seconded;  and  the  question  being 
taken,  it  was  agreed  to. 

The  Peesident.  I  appoint  on  that  committee  Doctor  Liceaga,  of 
Mexico;  Doctor  Moore,  of  Chile;  Assistant  Surgeon-General  Ged- 
dings,  of  the  Public  Health  and  Marine-Hospital  Service,  and  Major 
McCaw,  of  the  Army,  and  I  will  ask  these  gentlemen  to  remain  after 
the  adjournment. 

Doctor  GuiTERAS.  Mr.  President,  I  move  that  Dr.  Juan  J.  Ulloabe 
made  secretary  of  this  convention. 

Several  Delegates.  I  second  the  motion. 

The  question  was  taken  and  Doctor  Ulloa  was  elected  secretary. 

The  President.  I  wish  to  add  Doctor  Guiteras  to  that  committee 
on  organization,  making  five  members  in  all. 

Tliis  completes  the  programme  for  this  morning,  but  if  there  is 
any  delegate  that  has  any  particular  matter  to  bring  before  the  con- 
vention we  will  be  glad  to  have  him  do  so. 

Doctor  Guiteras.  I  move  we  adjourn  until  10  o'clock  to 
morrow  morning. 

The  question  was  taken  and  the  motion  was  agreed  to. 


SECOND  DAY— TUESDAY,  OCTOBER  10. 
Morning  Session. 

The  convention  was  called  to  order  by  Dr.  Eduardo  Moore,  pre- 
siding, at  10.20  o'clock  a.  m. 

Doctor  Moore.  As  chairman  of  the  advisory  committee  I  will  now 
call  the  convention  to  order,  and  I  will  ask  Doctor  Ulloa  to  read  the 
resolutions  adopted  by  the  committee  appointed  yesterday. 

The  resolutions  were  read  by  the  secretary,  as  follows: 

(1)  Resolved,  That  the  name  of  Surgeon-General  Wynian  be  presented  to  the  convention 
as  president  for  this  meeting,  and  that  the  name  of  Dr.  Eduardo  Licéaga  be  presented  to 
the  convention  as  president  of  the  next  convention,  and  that  Dr.  Juan  J.  Ulloa  be  nominated 
as  permanent  secretary. 

(2)  Resolved,  That  the  convention  be  held  every  two  years. 

(3)  Resolved,  That  the  next  meeting  be  held  in  the  City  of  Mexico  in  December,  1907, 
subject  to  the  call  of  the  International  Sanitary  Bureau. 

(4)  Resolved,  That  immediately  upon  the  completion  of  the  organization  the  president 
recognize  Dr.  Eduardo  Licéaga  for  a  statement  of  general  interest. 

(5)  Resolved,  That  the  committee  suggest  that  reports  of  the  Republics  of  great  length 
should  be  abstracted  for  presentation  to  the  convention.  The  full  papers  will  be  published 
in  the  transactions. 

Doctor  GuiTERAS.  Mr.  Chairman,  I  move  that  these  resolutions  be 
taken  up  one  by  one  and  presented  to  the  conference  seriatim. 
The  motion  was  seconded. 

The  question  was  taken  and  the  motion  was  agreed  to. 
The  Secretary.  The  first  resolution  is : 

Resolved,  That  the  name  of  Surgeon-General  Wjnnan  be  presented  to  the  convention  as 
president  for  this  meeting,  and  that  the  name  of  Dr.  Eduardo  Licéaga  be  presented  to  the 
convention  as  president  of  the  next  convention,  and  that  Dr.  Juan  J.  Ulloa  be  nominated  as 
permanent  secretary. 

Doctor  GuiTERAS.  I  move  that  this  resolution  be  adopted. 

The  motion  was  seconded. 

The  question  was  taken  and  the  motion  was  agreed  to. 

The  chair  was  here  assumed  by  Surgeon-General  Wyman. 

The  President.  Gentlemen,  I  wish  to  thank  you  for  this  renewed 
honor.  Personally,  it  would  have  been  more  acceptable  to  me  if 
some  other  delegate  had  been  elected,  and  had  been  given  this  honor 
for  this  meeting.  It  seems,  hovt^ever,  that  the  presiding  officer  should 
be  a  native  of  the  country  in  which  the  convention  is  held,  and  inas- 
much as  he  naturally  has  an  oversight  of  the  preparations  for  the 
meetings  and  is  more  intimately  connected  with  the  details  of  the 
programme  than  others  could  possibly  be,  on  that  account  I  am  pleased 
to  accept  this  great  honor  which  you  have  again  tendered  me. 

The  next  resolution  is : 

Resolved,  That  the  convention  be  held  everj'^  two  years. 

Are  you  ready  for  the  question  ? 

The  question  was  taken  and  the  resolution  was  agreed  to. 

16 


SECOND    INTERN ATIONAL    HANITAR\i    CONVENTION.  17 

The  President.  The  third  resolution  is : 

Resolved,  Tiiat  tho  next  meeting  of  the  convention  be  held  in  the  City  of  Mexico  in 
December,  1907,  subject  to  tlie  call  of  the  International  Sanitary  Bureau. 

Are  there  any  remarks  on  tliat?     If  not,  we  will  vote  upon  it. 

The  question  was  taken  and  the  motion  was  af^reed  to.  Doctor 
Licéaga  here  addressed  the  convention  in  Spanish,  his  remarks  being 
translated  by  the  secretary.  Doctor  Ulloa.  He  thanked  the  conven- 
tion for  the  honor  done  his  country  in  resolving  to  hold  the  next 
sanitary,  convention  in  the  City  of  Mexico.  He  confessed  himself 
very  highly  pleased  with  this  solution  of  the  question,  because  the 
Second  Pan  American  Congress  was  held  at  the  City  of  Mexico,  and 
there  in  that  meeting  resolutions  were  adopted,  one  of  which  was  for 
the  meeting  of-  the  International  Sanitary  Congress.  He  extended 
his  thanks  for  the  courtesy  and  hoped  that  the  success  of  this  conven- 
tion would  tend  yearly  to  the  strengthening  of  the  ties  that  unite  all 
the  countries  of  this  continent.  He  spoke  very  highly  of  the  modern 
ways  of  uniting  different  countries  and  bringing  them  together  in 
intellectual,  social,  and  moral  matters  which  he  believed  are  the 
strongest  means  of  accomplishing  all  those  ends  at  which  the  highest 
motives  of  nations  aim. 

The  President.  I  will  read  the  fifth  resolution  before  the  fourth. 

Resolved,  That  the  committee  suggest  that  reports  of  the  Republics,  of  great  length, 
should  be  abstracted  for  presentation  to  the  convention.  The  full  papers  will  be  published 
in  the  transactions. 

The  question  was  taken  upon  the  resolution,  and  it  was  agreed  to. 
The  President.  The  fourth  resolution  is : 

Resolved,  That  immediately  upon  the  completion  of  the  organization,  the  president 
recognize  Dr.  Eduardo  Licéaga  for  a  statement  of  general  interest. 

The  question  was  taken  upon  the  resolution,  and  it  was  agreed  to. 

The  President.  The  resolution  was  carried;  we  will  now  hear 
from  Dr.  Licéaga. 

Doctor  Licéaga  here  read  in  Spanish  his  address.  (See  Appendix, 
page  111.) 

The  President.  Gentlemen,  you  have  all  heard  tliis  interesting 
paper  of  Doctor  Licéaga,  and  the  matter  is  now  open  for  discussion. 
We  will  be  very  glad  to  hear  from  any  member  who  wishes  to  speak 
on  the  subject. 

I  would  further  say  that  if  it  meets  with  the  approval  of  Doctor 
Licéaga,  this  matter,  after  discussion,  will  be  referred  to  the  advisory 
council,  where  it  will  be  taken  up  in  detail,  and  worked  out  and 
presented  again  to  the  convention.  That  was  the  order  of  procedure 
of  last  year,  and  I  suppose  it  is  agreeable  to  all  that  it  should  be  the 
order  this  year;  but  we  would  like  to  have  expressions,  without  any 
vote  being  taken,  or  any  resolutions  being  offered  just  now.  We 
would  like  to  have  expressions  from  any  of  the  delegates  who  would 
like  to  speak  on  the  subject  to  express  their  views. 

Doctor  GuiTERAS.  As  you  ask  that  an  opinion  be  expressed,  I 
would  like  to  say  that  undoubtedly  our  colleague  from  Mexico  is  right 
when  he  says  that  we  should  begin  as  soon  as  possible,  and  that  we 
should  undertake»  the  getting  up  and  iinisliing  of  sanitary  regulations 
that  should  govern  uniformly  the  Western  Hemisphere.  That  is  cer- 
tainly the  object  for  which  we  have  been  sent  here.  At  the  same  time 
5610—06 2 


18  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

it  appears  to  me  that  at  the  present  moment  v:e  are  not  quite  prepared 
to  do  that.  It  seems  to  me  tliat  we  may  prepare  for  that  during  the 
next  year.  We  should  have  had  presented,  it  seems  to  me,  before 
this  meeting,  a  sort  of  a  plan  of  an  organization  or  reglamento  of  that 
kind.  It  seems  lo  me  we  could  act  at  the  present  meeting  in  tliis 
wa}^;  that  we  might  instruct  the  present  committee  on  organization 
to  present  to  the  representatives  of  the  different  Republics  at  this 
convention  the  outline  of  the  plan  of  such  an  arrangement  between 
the  different  governments,  and  the  present  committee  having  pre- 
sented such  a  plan  we  would  have  one  year  to  study  it,  and  we  would 
come  to  Mexico,  to  the  next  convention,  prepared  and  ready  to 
present  sucli  an  agreement. 

Doctor  Licéaga  here  addressed  the  convention  in  Spanish. 

Doctor  GuiTERAS.  I  suppose  that  I  should  repeat  what  I  haVe 
just  said  in  Eiiglish  to  the  Convention  in  Spanish,  so  that  those  who 
speak  Spanish  may 'understand  the  drift  of  what  is  being  said. 

The  President.  Certainly. 

Doctor  Guiteras  here  repeated  in  Spanish  the  last  preceding 
remarks  wliich  were  made  in  English. 

Doctor  GuiTERAS.  Doctor  Licéaga  has  said  that  he  objects  to  my 
remarks.  He  states  that  I  seem  not  to  have  understood  what  he 
proposes  to  do.  He  does  not  think  we  are  ready  to  come  to  a  very 
definite  conclusion  or  to  establish  a  sanitary  convention  of  science 
positively;  but  he  tliinks  that  we  should  give  more  force  to  such 
things  as  we  may  have  agreed  upon  at  the  last  meeting,  and  may 
agree  upon  at  this  meeting.  They  seem  to  stand  now  in  the  air, 
but  they  are  not  enforced,  although  v/e  have  accepted  them;  and 
he  thinks  that  we  ought  to  give  them  validitj^  and  weight  in  some 
way. 

The  President.  I  beg  leave  to  state  that  these  resolutions  which 
we  adopted  at  the  last  convention  have  been  carried  out  in  practice 
by  the  United  States  Public  Health  and  Marine  Hospital  Service. 
I  can  not  sa.}^  that  they  have  been  carried  out  b}^  every  State  of  the 
United  States,-  but  we  have  lived  up  to  them  ourselves  as  faithfully 
as  we  could.  And  in  this  connection  I  think  it  would  be  interesting 
to  hear  from  one  of  the  delegates  from  the  United  States,  who  was  a 
member  of  the  international  conference,  with  regard  to  plague,  in 
Paris  in  1903,  where  an  agreement  such  as  I  think  Doctor  Licéaga 
has  in  liis  mind  was  actually  prepared,  which  agreement  has  been 
put  in  the  shape  of  treaties,  and  has  been  confirmed  by  the  several 
countries,  or  by  a  number  of  them,  at  any  rate.  I  can  not  say  at 
once  whether  all  the  countries  who  sent  delegates  to  that  conference 
have  adopted  formal  treaties,  or  made  formal  treaties  or  not,  or  sub- 
scribed to  this  treaty;  the  United  States  has,  I  understand. 

There  was  some  question  about  one  detail,  but  it  was  arranged 
by  the  State  Department,  and  the  United  States  Government  has 
been  committed  to  it,  with  one  exception.  That  agreement  covers 
all  the  points  with  regard  to  quarantine,  observation,  detention  and 
so  forth,  very  perfectly,  and  yet  in  general  terms  so  that  it  could  be 
adopted  by  all  the  countries.  I  think  that  with  your  permission 
I  vdll  request  Doctor  Geddings,  who  has  a  translation  of  that  con- 
vention, to  bring  it  to  the  advisory  council  for  consideration  when 
we  discuss  tliis  matter;  and  it  might  be  that  we  might  save  our- 
selves a  great  deal  of  trouble,  and  practically  cover  these  subjects 


SKUOND    INTKKNA'J'IONAL    HANITAUY    OOxN  VKNTION.  19 

under  discussion,  by  taking  that  up  and  making  it  a  part  of  our 
agreement. 

I  would  like  to  call  upon  Assistant  Surgeon-General  Geddings  to 
make  a  little  statement  as  to  that  convention,  as  to  what  countries 
were  represented  and  where  it  was  held,  and  the  final  action  taken 
as  to  its  findings. 

Doctor  Licéaga  here  asked  leave  of  the  president  to  make  a  short 
statement,  wliich  he  did,  in  Spanish.  Ilis  statement  was  translated 
into  English  by  the  secretary.  Doctor  Ulloa.  He  said  with  refer- 
ence to  what  General  Wyman  had  just  said,  that  he  wished  to  express 
the  great  satisfaction  he  had  in  acknowledging  that  the  united 
States  has  really  complied  with  all  the  resolutions  taken  in  the  pre- 
vious sanitary  conference;  but  he  intimated  that  the  United  States 
lias  really  fuliilled  all  the  suggestions  of  the  congress  because  it 
wanted  to.  He  said  that  he  would  much  prefer  that  a  country 
should  comply  with  the  proper  hygienic  requirements,  not  because 
it  wants  to  but  because  it  is  obliged  to,  and  he  would  like  to  have 
those  requirements  complied  with  according  to  the  resolutions 
taken  at  the  previous  m.eeting. 

Doctor  Geddings.  Mr.  Chairman  and  gentlemen:  In  accordance 
with  the  request  of  the  chairman,  I  would  beg  to  outline  as  well  as  I 
can,  from  memory,  and  as  briefly  as  the  occasion  requires,  the  results 
of  the  International  Sanitary  Conference  of  Paris  of  1903,  which  assem- 
bled in  Paris  in  October  of  that  year  and  remained  in  continual 
session  until  December. 

This  convention  interested  itself  particularly  mth  the  questions  of 
plague  and  cholera.  The  members  of  that  convention  committed 
themselves  to  several  important  declarations.  In  regard  to  plague, 
they  held  the  bold  and  perfectly  justifiable  conclusion  that  plague 
was  transmissable  only  by  the  dejections,  by  the  discharges,  and  by 
soiling  of  articles  and  of  apartments  with  the  secretions  or  excre- 
tions of  those  sick  with  the  plague;  that  merchandise  itself  was 
incapable  of  conveying  the  plague  and  was  only  dangerous  when 
it  had  served  as  a  vehicle  for  plague-stricken  animals,  or  was  soiled 
by  the  discharges  of  those  sick  with  plague. 

The  same  was  held  with  regard  to  cholera;  that  a  vessel,  an  apart- 
ment, or  merchandise,  was  dangerous  from  the  point  of  view  of 
communicability  of  cholera  only  when  soiled  by  the  discharges  of 
those  previously  sick  with  the  disease. 

I  would  say  that  the  convention  lent  itself  very  strongly  to  what 
was  a  practical  abolition  of  quarantine,  namely,  they  divided  ves- 
sels into  three  categories — safe,  suspected,  and  infected.  To  go  into 
the  definitions  coming  under  those  categories  would  take  too  long; 
but  their  regulations  as  to  what  constituted  a  suspected  or  infected 
vessel  were  in  the  main  more  lenient  than  we  of  the  United  States 
have  been  in  the  habit  of  holding.  The  quarantine  measures  pro- 
posed by  the  convention  were  efficacious,  could  they  be  carried  out 
in  their  entirety;  but  their  safet}^  depends  upon  the  absolute  integ- 
rity of  the  measures  directed  against  a  disease  in  question.  The 
slightest  slip,  the  slightest  dereliction,  the  slightest  neglect,  would 
possibly  produce  a  catastrophe.  In  view  of  this  fact,  the  United 
States  found  itself  bound  to  dissent  from  the  findings  of  the  conven- 
tion, and  became  signatory  to  the  results,  with  tliis  in  its  way.  We 
can  not  under  our  laws  and  under  our  system  recognize  surveillance 


20  SECOND    INTERNATIONAL    SANITAKY    CONVENTION. 

as  the  equivalent  of  observation,  surveillance  meaning  that  the  ves- 
sel arriving  with  those  on  board  suspected  of  having  the  plague,  or 
those  on  board  who  have  had  plague,  and  those  who  are  exposed  to 
the  infection,  those  passengers  should  be  allowed  to  proceed  to  their 
destination,  and  be  observed  there  b}^  local  authorities,  or  be  obliged 
to  report  from  time  to  time  until  the  period  of  the  incubation  of  the 
disease  has,  passed.  As  we  understand  observation,  we  direct  our 
measures  against  a  vessel,  but  detain  the  personnel  and  hold  them 
under  observation.  The  delegates  for  the  United  States  dissented 
from  the  plan  of  surveillance,  and  the  United  States  has  since  become 
signatory  to  the  convention  of  Paris,  with  the  exception  that  obser- 
vation must  be  substituted  for  surveillance  wherever  it  occurs  in 
the  convention.  In  the  matter  of  yellow  fever,  it  is  to  be  regretted^ 
that  the  representation  of  the  Western  Hemisphere  was  confined  to* 
the  United  States,  the  Argentine  Kepublic,  and  Brazil.  There  was 
a  very  determined  efl'ort  made  to  get  the  convention  of  Paris  to 
commit  itself  definitely  on  the  question  of  yellow  fever.  You  will 
remember  that  this  was  two  years  ago.  Were  the  convention  to  be 
held  to-day  the  action  might  be  different;  but  the  convention 
declined  to  put  itself  on  record  or  to  formulate  definite  regulations 
as  to  yellow  fever,  and  contented  itself  with  the  simple  declaration 
that  in  the  matter  of  yellow  fever  it  was  recommended  to  the  powers 
interested  to  amend  their  regulations  in  accordance  with  the  recent 
scientific  discoveries  on  the  subject.  After  considerable  deliberation 
tlüs  view^  was  acceded  to  by  the  delegates  of  the  Argentine  Republic 
and  Brazil.  It  is  mj  belief  that  the  convention  of  Paris  has  adopted 
the  firm  and  safe  basis  for  a  stable  international  agreement. 

I  will  take  great  pleasure,  as  directed  by  the  chairman,  in  submit- 
ting to  the  committee  on  organization  the  text  of  the  convention  in 
print  and  a  translation,  which  I  made  upon  my  return,  into  English, 
which  I  think  will  answer  the  purposes  of  the  committee. 

The  President.  Are  there  any  further  remarks  on  this  subject? 

The  Secretary  (Doctor  Ulloa).  With  reference  to  the  point  in 
discussion  about  the  petition  of  Doctor  Licéaga,  I  have  the  honor  to 
say  that  I  agree  fully  w4th  Doctor  Licéaga.  I  agree  with  hini  as  to 
the  fact  that  w^e  are  here  not  only  to  discuss  different  points  in  con- 
nection with  sanitary  science  and  to  attend  to  this  convention  with 
the  interest  and  with  the  pleasure  which  we  always  have  in  attend- 
ing scientific  congresses,  but  to  come  to  some  agreement  of  a  prac- 
tical nature.  Oin-  representation  here  is  a  combined  one,  if  you  will 
allow  me  to  express  it  so.  It  is  a  scientific  and  a  diplomatic  one,  as 
I  would  put  it.  I  understand  that  the  majority  of  us  came  to  the 
previous  convention,  and  also  to  this  one,  with  full  powers  from 
our  respective  governments  to  sign  ad  referendum  any  agreement 
that  w^e  may  come  to.  Our  governments  in  sending  us  here  have 
fidl  confidence  in  us,  and  they  have  authorized  us  to  come  to  agree- 
ments and  to  vote  in  accordance  v/ith  our  judgment  on  the  scientific 
problems  to  be  discussed  here.  We  are  authorized  to  sign  agree- 
ments on  sanitary  matters;  but  of  course  w^e  have  to  submit  them 
the  approbation  of  our  governments  afterwards — that  is  to  say,  we 
are  authorized  to  sign  ad  referendum. 

I  agree  with  Doctor  Licéaga  and  with  Doctor  Guiteras  in  the  opin- 
ion that  we  might  sign  the  resolutions  which  have  been  already 
taken,  based  on  scientific  facts  which  have   been  already  demon- 


SECOND    INTKUNATIONAL    MANITARY    (X)NVENTION.  ,  21 

strated.  The  resolutions  of  the  last  sanitary  convention  cover,  I 
believe,  all  the  ground  as  far  as  yellow  fever  is  concerned.  Now  we 
are  going  to  discuss  other  important  subjects,  plague  particularly, 
and  I  have  no  doubt  that  we  shall,  some  of  us,  at  least,  learn  a  good 
deal  from  the  discussions  that  will  take  place  about  said  disease.  I 
feel  as  if  I  was  not  justified  yet  in  signing  anything  in  regard  to 
bubonic  plague;  but  after  I  have  heard  your  discussion  of  the  sub- 
ject I  will  learn  a  good  deal  more  about  it,  and  I  shall  feel  wholly 
empowered  to  sign  any  agreement  that  we  may  come  to.     (Applause.) 

Doctor  Lavoreria  here  addressed  the  convention  in  Spanish,  his 
remarks  being  translated  by  the  secretary,  Doctor  Ulloa,  into  English. 

Doctor  Lavoreria,  after  running  over  one  by  one  the  different 
clauses  pointed  out  by  Doctor  Licéaga  of  the  resolutions  of  the 
Second  Pan-American  Conference  in  Mexico,  expressed  the  view 
that  although  Peru  was  not  represented  at  the  last  sanitary  conven- 
tion for  reasons  that  he  did  not  deem  it  necessary  to  enumerate,  they 
have  agreed  in  everything  that  was  resolved  at  the  last  conference, 
and  he  said  that  several  executive  decrees  have  been  dictated  in  Peru 
maldng  lawful  the  different  resolutions  of  the  last  sanitary  congress. 
He  said  that  they  have  the  national  board  of  health,  which  makes 
all  the  different  rules  and  regulations  in  regard  to  hygiene,  and  that 
those  regulations  are  obligatory  in  all  sections  of  the  country.  He 
said  that  he  accepts  Doctor  Licéaga' s  propositions,  and  that  one 
of  the  principal  wishes  of  the  Government  of  Peru  is  that  we  shall 
Come  to  some  agreement  by  which  all  the  different  countries  of  the 
continent  may  be  bound  by  uniform  sanitary  regulations.  He  said 
that  there  was  a  decree  emitted  binding  Peru  to  all  the  different  regu- 
lations, among  which  he  mentioned  the  International  Sanitary 
Bureau.  He  went  into  some  details  as  to  the  resolutions  cited  by 
Doctor  Licéaga,  wliich  have  been  read  by  all  the  members  of  the  con- 
vention, and  which  it  is  not  necessary  to  translate  here. 

Mr.  Withers  addressed  the  convention  in  Spanish,  his  address 
being  translated  into  English  by  the  secretary.  Doctor  Ulloa. 

Mr.  Withers  agreed  also  with  the  proposition  of  Doctor  Licéaga. 
He  signified  that  the  Republic  of  Ecuador  had  accepted  the  resolu- 
tions adopted  by  the  First  Sanitary  Convention  at  Washington,  and 
he  believed  in  the  full  observance  of  all  their  provisions.  He  said 
that  Ecuador  had  the  good  fortune  of  being  free  from  the  bubonic 
plague. 

He  entirely  agreed  with  Doctor  Licéaga,  and  hoped  in  the  name 
of  his  country  that  an  agreement  might  be  signed  by  tliis  convention 
binding  all  the  different  countries  of  the  continent. 

Doctor  Alcivar  addressed  the  covention  in  Spanish,  his  remarks 
being  translated  into  English  by  the  secretary. 

Doctor  Alcivar  expressed  his  opinion  in  entire  accordance  with 
Doctor  Licéaga' s  opinion.  He  said  that  he  believed  it  Yevj  impor- 
tant that  all  of  the  delegates  here  present  should  return  to  their 
countries  carrying  with  them  a  signed  agreement  binding  the  difier- 
ent  countries  to  the  methods  according  to  the  resolutions  of  this 
congress. 

Doctor  Medina  agreed  also  with  Doctor  Licéaga' s  proposition. 

Doctor  Moore  addressed  the  convention  in  Spanish,  his  remarks 
being  translated  into  English  hj  the  secretary. 


22  _  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Doctor  Moore  said  that  he  also  agreed  with  Doctor  Licéaga  and 
stated  that  he  beheved  all  the  delegates  to  be  in  accord  with  this 
opinion.  He  said  he  believed  that  such  opinion  should  form  a  part 
or  the  convention  which  should  be  signed  at  this  meeting  and  sub- 
mitted to  the  respective  governments.  He  said  that  he  thought  the 
discussion  had  been  carried  a  little  too  far,  and  he  believed  that  it 
would-be  better  to  submit  a  resolution  to  the  advisor}^  committee  to 
the  effect  that  a  convention  should  be  signed  and  then  submitted  to 
the  respective  governments. 

Doctor  Licéaga  here  addressed  the  convention  in  Spanish,  liis 
remarks  being  translated  into  English  by  the  secretary. 

Doctor  Licéaga  said  that  he  felt  very  fortunate  and  very  happy 
in  hearing  the  opinions  expressed  by  the  several  delegates  here  pres- 
ent, and  he  remarked  that  he  did  not  care  what  the  governments 
might  do ;  but  that  he  w^anted  all  who  were  here  present  and  who  might 
be  convinced  of  the  trutliñüness  and  effectiveness  of  the  resolutions 
here  taken  to  demonstrate  it  practicalh^  by  signing  their  names  to 
the  resolutions  and  complj'ing  with  their  duty  in  that  way,  and  then 
he  wanted  them  sent  to  their  respective  governments,  and  if  the  gov- 
ernments approved  them,  verj^  well,  and  if  they  did  not,  so  much 
the  worse;   but  the  delegates  would  have  complied  with  their  duty. 

The  President.  Are  there  any  more  remarks  on  this  subject?  If 
not,  before  the  closing  of  this  matter  I  would  request  some  gentleman 
to  make  a  motion  to  the  effect  that  the  organizing  committee  which 
was  appointed  yesterday  should  be  continued  as  the  advisory  coun- 
cil ;  or  if  any  other  plan  suggests  itseli  to  anyone  I  would  be  pleased 
to  hear  from  them.  But  otherwise  we  have  not  an  advisory  council 
to  which  to  refer  all  papers,  resolutions,  and  reports. 

Dr.  H.  L.  E.  Johnson.  I  move  that  all  the  matters  arising  before 
the  convention  be  referred  to  the  committee  on  organization  ap- 
pointed j^esterday  as  the  advisory  council. 

The  motion  was  seconded. 

The  question  was  taken  and  the  motion  was  agreed  to. 

Doctor  GuiTERAS.  May  I  make  a  motion  now? 

The  President.  Doctor  Guiteras. 

Dr.  Guiteras.  I  do  not  laiow  whether  this  is  the  proper  place,  or 
whether  I  should  bring  this  up  before  the  advisory  council,  but  I 
believe  that  at  the  last  meeting  we  had  vice-presidents  appointed. 

The  President.  Yes,  sir. 

Doctor  Guiteras.  And  would  it  not  be  proper  now  to  have  vice- 
presidents  appointed  from  the  different  Republics? 

The  President.  We  shall  consider  Doctor  Guiteras's  motion  as 
soon  as  the  matter  under  discussion  is  disposed  of.  A  resolution 
should  be  made  referring  Doctor  Licéaga's  paper  to  the  advisory 
council.  If  there  is  no  dissent  this  matter  will  be  referred  to  the 
advisory  council  to  be  reported  on.  Is  that  agreeable  to  Doctor 
Licéaga  ? 

The  remarks  of  the  president  were  translated  into  Spanish  by  the 
secretary,  and  Doctor  Licéaga  signified  his  assent. 

Doctor  Guiteras.  I  move  that  vice-presidents  be  nominated. 

The  President.  In  open  meeting  or  by  the  committee? 

Doctor  Guiteras.  I  move  that  it  be  referred  to  the  committee. 

The  President.  I  hear  no  objection,  and  therefore  the  motion  is 
announced  as  nassed. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  23 

The  scieiitiiic  program inc  reads: 

1.  Reports  ]>y  a  delegate  from  eacli  Republic.  Tlicse  reports  slioiild  include  (a)  reports 
on  prevalence  of  diseases,  with  special  reference  to  plague,  yellow  fever,  and  malaria,  since 
January  1,  1904,  being  appi'oximately  the  date  of  adjournment  of  tlie  last  convention ;  (b)  a 
summary  of  all  quarantine  and  sanitary  laws  enacted  since  the  first  convention;  (c)  special 
sanitary  work  in  progress  or  in  contemplation.  These  reports  are  to  be  rendered  in  behalf 
of  each  Republic,  or  each  division  of  the  subject  may  be  committed  to  a  delegate  for  pres- 
entation.    A  written  report  is  requested  for  publication. 

Ill  accordance  with  this  programme  we  will  call  upon  the  Republics 
by  name,  and  request  the  delegates  to  malve  verbal  reports;  or  if 
they  haVe  briefs  or  written  reports  to  present  them,  so  that  we  may, 
during  the  day,  hear  from  the  Republics  on  the  topics  mentioned  in 
this  paragraph. 

In  accordance  with  that,  we  will  call  fii'st  upon  Chile. 

Doctor  GuiTEiiAS.  I  make  the  suggestion  that  perhaps  it  would  be 
better  tV)  begin  the  hearing  of  these  reports  during  the  afternoon 
meeting,  as  the  executive  committee  has  to  meet  before  lunch,  and 
it  will  be  difficult  to  find  the  time  for  the  executive  committee  to 
meet  if  we  prolong  this  session.  I  therefore  move  to  adjourn,  and  to 
take  up  these  different  reports  of  the  Republics  in  the  afternoon 
session. 

The  motion  was  seconded. 

The  President.  Before  I  put  the  motion  to  adjourn  I  would  like 
to  say  that  there  are  two  or  three  announcements  to  make.  The 
secretary  will  make  these  announcements. 

(The  secretary  here  made  announcements  of  various  invitations 
extended  to  the  members  of  the  Sanitary  Convention.) 

The  President.  We  have  here  a  number  of  copies  of  the  revised 
edition  of  the  report  of  Dr.  L.  O.  Ploward  on  the  prevalence  of  the 
Stegomyia  mosquito  in  the  United  States,  and  the  regions  in  wliich 
it  prevails.  It  has  been  of  great  use  to  us  in  managing  the  3?^ellow 
fever  epidemic  in  the  South  this  year.  It  shows  where  the  Stegomyia 
mosquito  prevails.  Doctor  Howard  is  chief  entomologist  of  the 
United  States  Department  of  Agriculture,  and  is  also  consulting 
entomologist  of  the  United  States  Public  Health  and  Marine-Hospital 
Service,  and  for  that  reason  I  would  like  him  to  be  present  and  to 
have  the  courtesy  of  the  floor  during  our  meetings.  He  may  be  able 
to  give  us  some  little  talk  on  the  yellow-fever  mosquito. 

Doctor  GuiTERAS.  I  move  that  the  privilege  of  the  floor  be  ex- 
tended to  Doctor  Howard  and  also  to  Dr.  James  Carroll.  I  do  not 
think  that  this  was  done  in  regard  to  these  two  gentlemen  yesterday. 

The  motion  was  seconded. 

The  question  was  taken,  and  the  motion  was  agreed  to. 

The  President.  It  is  carried,  and  I  wall  request  the  secretary  to 
notify  those  gentlemen. 

In  the  absence  of  the  Director  of  the  Bureau  of  American  Republics,' 
Mr.  Fox,  I  wish  to  make  an  announcement  in  regard  to  to-morrow, 
so  that  it  will  be  perfectly  plain  to  you  all.  We  are  to  meet  here  and 
about  this  neighborhood  in  the  hotel,  in  this  room  or  in  the  lobby  of 
the  entrance  on  F  street,  and  we  wiU  start  from  that  side  of  the  hotel, 
because  on  Wednesday  morning  there  will  be  a  great  many  members 
of  the  American  Bankers'  Association  in  the  hotel,  that  association 
meeting  on  that  day,  which  will  cause  the  other  lobb}''  to  be  crowded. 
We  will  start  from  here  at  half  past  9  and  go  to  the  wharf  at  the  foot 
of  Eleventh  street.     The  steamer  is  expected  to  leave  the  wharf  at  10 


24  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

o'clock,  and  we  will  be  gone  all  day,  -visiting  various  points  down  the 
Potomac  River,  ^.loiint  Vernon,  and  other  points.  Of  course,  it  is 
expected  that  all  the  delegates  and  the  ladies  and  invited  guests  will 
be  present.     AVe  expect  to  be  gone  all  day,  returning  about  dusk. 

If  there  is  no  other  motion  to  put  before  the  convention,  the 
motion  of  Doctor  Guiteras  to  adjourn,  which  has  been  seconded,  will 
be  put  to  you.  The  motion  is  to  adjourn  until  3  o'clock  this  after- 
noon. 

The  question  was  taken,  and  the  motion  was  agreed  to. 

Thereupon  the  convention  adjourned  until  3  o'clock  p.  m. 

Afternoon  Session. 

The  convention  was  called  to  order  by  the  president,  Surgeon- 
General  W3'Tiian. 

The  President.  The  first  order  of  business  of  this  session  will  be 
the  readmg  of  the  minutes  of  the  first  meeting. 

(The  minutes  of  the  first  meeting  of  the  convention  were  read  by 
the  secretary.) 

Doctor  Guiteras.  I  move  that  the  minutes  be  adopted  as  just 
read. 

The  President.  Before  that  motion  is  seconded,  or  put,  I  want  to 
say  that  I  think  there  were  one  or  two  names  left  off  of  persons  who 
were  invited  to  the  floor.  Dr.  J.  F.  Anderson  was  one.  He  is  assist- 
ant director  of  the  hygenic  laboratory,  United  States  Public  Health 
and  Marine  Hospital  Service.  With  the  consent  of  the  convention 
his  name  will  be  added  to  the  official  list  of  persons  entitled  to  the 
privilege  of  the  floor. 

You  have  heard  the  minutes,  and  it  is  moved  and  seconded  that 
they  be  adopted  as  read. 

The  question  was  taken,  and  the  motion  was  agreed  to. 

The  President.  Before  proceeding  further,  I  noticed  when  the 
minutes  were  being  read  that  on  the  committee  of  organization,  which 
you  by  resolution  this  morning  have  made  the  advisory  council,  there 
was  one  member  omitted  who  ought,  I  think,  in  the  broadened  scope 
given  to  the  committee  to  be  included,  and  I  think  that  his  name 
should  be  added  now,  because  we  have  two  of  the  medical  depart- 
ments of  this  Government  represented,  and  it  was  by  an  oversight 
that  one  was  not  put  on  originally.  With  your  assent  I  would  like 
to  add  an  officer  of  the  United  States  Navy  on  that  committee.  Doc- 
tor Gatewood,  who  is  the  delegate  from  the  Navy. 

Doctor  Guiteras.  I  make  the  motion  that  Doctor  Gatewood  be 
included  on  the  advisory  council. 

The  motion  vv^as  seconded,  and  the  question  was  taken  and  the 
motion  was  agreed  to. 

The  President.  I  v/ish  to  say  that  our  guests  are  expected  to  go 
with  us  when  we  have  our  social  occasions,  particularly  on  the  excur- 
sion to-morrow  down  the  river  to  Indian  Head  and  Mount  Vernon. 

Before  we  begin  the  proceedings  of  the  afternoon,  I  might  ask  if 
any  delegate  has  any  special  measure,  or  any  special  remarks  that  he 
wishes  to  make.  If  not,  v.^e  will  begin  with  the  call  of  the  Republics, 
in  accordance  with  the  provisional  programme.  I  suppose  that  every 
member  has  a  copy  of  this  provisional  programme — the  scientific 
programme — the  first  paragraph  of  which  was  read  this  morning,  and 


SEOOND    INTERN ATrON AL    HANri'AKY    CONVENTION.  25 

I  will  not  read  it,  over  aj^ain,  but  I  will  procood  to  the  call  of  delegates. 
I  will  ask  the  secretary  to  call  tliein  in  alphabetical  order. 

The  Secketaky.  Chile;  Dr.  Eduardo  Moore. 

Doctor  Moore  here  r<3ad  his  report  as  delegate  from  Chile,  in  Span- 
ish, and  his  remarks  were  translated  by  the  secretary  into  English. 
(See  Appendix,  p.  115.) 

Mr.  Withers  moved  that  to  save  time  all  the  reports  from  the  dif- 
ferent Republics  be  handed  to  the  secretary  witliout  reading  them. 

The  President.  You  have  heard  the  motion  that  the  papers  should 
not  be  fead,  but  that  each  delegate  should  give  a  brief  extempore 
abstract  of  what  his  paper  contains,  stating  what  it  is  about  and  what 
he  shows. 

Doctor  GuiTERAS.  I  understand  that  is  what  we  had  decided  upon 
at  the  meeting  of  the  council,  or  organization  committee,  that  brief 
abstracts  should  be  read.     I  do  not  think  that  will  require  much  time. 

The  President.  That  was  passed  by  the  convention,  was  it  not? 

Doctor  GuiTERAS.  Yes,  sir. 

The  President.  That  will  be  the  understanding,  then.  Next,  we 
will  have  the  report  from  Doctor  Ulloa,  the  delegate  from  Costa  Rica. 

Doctor  Ulloa  read  his  report  in  Enghsh.     (See  Appendix,  p.  116.) 

The  President.  The  secretary  will  now  call  on  the  delegate  from 
Cuba. 

The  Secretary.  Cuba;  Dr.  Juan  Guiteras. 

The  report  of  the  delegates  from  Cuba  was  read  by  Dr.  E.  B.  Barnet, 
in  Spanish.     (See  Appendix,  p.  117.) 

The  Secretary.  The  Dominican  Republic;  Señor  Don  Emilio  C. 
Joubert. 

The  President.  Mr.  Joubert  requested  to  be  excused  to-da}^,  say- 
ing that  he  would  be  very  glad  to  make  the  report  on  Thursday,  so 
that  we  will  defer  that  report  until  Thursday.  Doctor  Joubert  was 
here  this  afternoon,  but  was  obliged  to  leave,  and  he  will  make  his 
report  later.     (See  Appendix,  p.  191.) 

The  Secretary.  Ecuador. 

The  report  for  Ecuador  was  read  in  Spanish  by  Dr.  Miguel  Alcivar. 
(See  Appendix,  p.  154.) 

The  Secretary.  Guatemala. 

The  report  for  Guatemala  was  read  in  Spanish  by  Señor  Dr.  Don 
Joaquin  Yela.      (See  Appendix,  p.  158.) 

The  Secretary.  Mexico. 

The  report  for  Mexico  was  read  by  the  delegate,  Dr.  Eduardo 
Licéaga,  m  Spanish.     (See  Appendix,  p.  160.) 

The  Secretary.  Nicaragua. 

The  report  for'  Nicaragua  was  read  by  the  delegate,  Dr.  J.  L, 
Medina.     (See  Appendix,  p.  — .) 

The  report  for  Peru  was  read  by  the  delegate,  Doctor  Lavoreria,  in 
Spanish.      (See  Appendix,  p.  175.) 

The  President.  Dr.  H.  D.  Geddings  will  speak  for  the  National 
Government  of  the  United  States. 

Doctor  Geddings  addressed  the  convention  in  Enghsh.  (See  Ap- 
pendix, p.  192.) 

Dr.  J.  S.  Fulton,  of  Maryland,  addressed  the  convention  in  English. 
(See  Appendix,  p.  193.) 


26  SECOND    INTERNATIONAL    SANITAEY    CONVENTION. 

The  President.  The  delegates  from  Uruguay  and  Venezuela  have 
asked  me  to  put  before  the  convention  their  excuses  for  not  present- 
mg  reports  for  their  respective  countries. 

The  delegate  from  Uruguay  has  not  yet  received  all  the  data 
required  for  his  report,  and  he  expresses  the  opinion  that  he  very 
likely  will  not  present  his  report,  but  that  he  will  accept  anything 
that  may  be  carried  through  in  this  convention,  and  that  he  will 
appear  in  the  name  of  his  countrj^  as  a  signatory  to  the  resolutions 
here  adopted.     (See  Appendix,  p.  195.) 

The  delegate  from  Venezuela  could  not  present  his  report  to-day, 
but  he  told  me  that  he  would  present  it  in  time  to  be  printed  in  the 
proceedings  of  the  congress.  (See  Appendix,  p.  196.)  I  wish  to  read 
you  a  telegram  which  I  have  received  ÍTom  Dr.  Rhett  Goode,  as 
follows : 

Mobile,  Ala. 
To  Gen.  Walter  Wyman,  Chairman,  International  Sanitary  Bureau,  Washington,  D.  C: 

Supervision  of  existing  quarantines  prevent  my  attending  convention.  The  most 
important  points  to  be  considered  are  the  spread  of  yellow  fever  and  the  sanitation  of 
cities.  Please  express  to  the  members  my  sincere  regret  and  ver}^  best  wishes  for  a  successful 
meeting. 

Rhett  Goode,  M.  D., 
President  Quarantine  Board)  Mobile,  Ala. 

I  wish  also  to  announce  that  the  President  of  the  United  States 
will  receive  this  convention  on  Thursday  at  12  o'clock.  We  will  be 
in  session  then,  and  will  start  about  a  quarter  of  12  to  go  over  and 
pay  our  respects  to  the  President. 

Doctor  GuiTERAS.  I  move  that  we  now  adjourn  to  meet  at  10 
o'clock  on  Thursday  morning. 

Doctor  Medina.  I  second  the  motion. 

The  question  was  taken  and  the  motion  was  agreed  to. 

Thereupon,  at  5.20  o'clock  p.  m.,  the  convention  adjourned  until 
Thursday,  October  12,  1905,  at  10  o'clock  a.  m. 


THIRD  BAY  -THURSDAY,  OCTOBER  12. 

Morning  Session. 

The  convention  was  called  to  order  by  the  President,  Surgeon- 
General  Wyman,  at  10.30  o'clock  a.  m. 

The  President.  In  order  that  there  may  be  no  misunderstanding 
I  wish  to  announce  that  we  will  go  to  pay  our  respects  to  the  Preisdent 
at  a  quarter  before  12.  It  is  desirable  that  we  should  have  a  full 
attendance  at  that  time. 

The  minutes  of  the  previous  meeting  were  read  by  the  secretary. 

When  the  secretary  had  read  the  portion  of  the  mmutes  containing 
the  remarks  of  Doctor  Medina,  Doctor  Medina  said:  Mr.  President, 
I  wish  to  make  a  statement  in  regard  to  what  occurred  yesterday. 
My  idea  was  not  in  any  way  to  criticise  the  different  boards  of  health 
in  Central  America.  My  idea  was  simply  that  they  should  be  united 
under  uniform  rules.  I  did  not  mean  to  criticise  anyone  individually, 
but  simply  to  express  my  opinion  that  if  the  system  were  put  under 
uniform  rules  for  all  the  Central  American  Republics,  which  are  so 
close  together,  one  port  being  only  a  few  hours  from  another,  there 
would  be  a  possibility  of  carrying  the  undertaking  to  a  better  success. 
It  would  be  far  from  me  to  criticise  any  of  the  Republics  in  reference 
to  their  ways  of  handling  their  boards  of  health.  Each  one  has 
done  what  he  has  been  able  to  do.  Most  of  them  are  in  prettA'  good 
sanitary  condition,  and  the  only  thing  is,  it  seems  to  me,  that  they 
are  working  in  different  directions,  without  that  uniformity  which, 
it  seems  to  me,  would  be  very  desirable,  and  I  now  wish  to  submit  a 
paper  relating  to  this  subject,  which  I  now  hand  to  the  secretary. 

The  President.  Do  you  wish  to  substitute  this  for  what  you 
said  at  the  last  meeting?  Do  you  wish  to  amend  the  minutes  to 
that  effect  ? 

Doctor  Medina.  Yes;  I  wish  to  withdraw  the  proposition  which  I 
made,  and  to  substitute  this. 

The  President.  If  there  be  no  objection  tliis  paper  will  be  sub- 
stituted for  the  one  Doctor  Medina  presented  yesterday  and  it  will 
be  printed  as  a  part  of  the  transactions  of  yesterday.  It  will  be 
inserted  in  place  of  the  other. 

The  secretary  then  translated  the  foregoing  remarks  into  Spanish. 

The  secretary,  Doctor  Ulloa,  then  spoke  in  English  as  follows: 

"  I  am  very  glad  that  my  esteemed  colleague  from  Nicaragua, 
Doctor  Medina,  has  put  things  in  their  right  place  with  reference 
to  the  unwarranted  remarks  he  made  at  the  last  meetmg  of  tliis  con- 
vention, and  which  showed  me  in  a  bad  light,  contradictmg  in  an 
indhect  manner  the  statements  that  I  had  made  with  respect  to  the 
conditions  of  Costa  Rica,  which  I  have  the  honor  to  represent  here, 
as  far  as  sanitation  and  quarantine  regulations  are  concerned. 

27 


28  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

"The  explanations  given  by  Doctor  Medina  relieve  me  from  the 
painful  duty  of  protesting  in  strong  terms  against  the  injustice  done 
to  Costa  Kica  in  this  matter.  We  do  not  pretend  to  have  as  much 
in  the  sanitary  line  as  other  more  advanced  countries,  but  as  I  said 
in  my  report,  we  have  done  some  effective  work  in  this  respect 
already,  and  we  hope  to  go  ahead,  little  b}^  little,  and  accomplish  a 
good  deal  before  long,  as  we  want  to  keep  abreast,  as  far  as  possible, 
with  the  progress  of  sanitary  science,  which  we  may  say  to-day  has 
abolished  quarantine  in  the  sense  of  ignorant  interpretation.  Central 
America  is  a  section  which  comprises  five  sovereign  republics.  Three 
of  them  have  authorized  representatives  at  this  conference,  and  each 
one  of  these  is  the  only  one  who  has  a  right  to  speak  for  his  respective 
country.  As  I  am  aware  of  the  bad  effect  that  some  statements 
have  about  our  countries,  among  peoples  who  unfortunately  know 
very  little  about  us,  I  beg  to  conclude  by  the  following  remarks, 
the  authenticity  of  wliich  can  be  vouched  for  by  anybody  who 
knows  anything  about  my  country.  In  Costa  Rica  we  hold  regular 
Presidential  elections  every  four  years,  and  we  have  there  a  complete 
independence  of  the  different  departments  of  the  Government.  We 
have  never  had  in  Costa  Rica  any  coercive  action  of  the  sword  or  of 
unla^^^ul  procedures  in  sanitary  matters,  and  all  our  health  officers 
are  able  professional  men  who  perform  their  duties  in  a  thoroughly 
consciencious  manner,  and  whose  dispositions  are  duly  put  in  force 
by  our  sanitary  police." 

Doctor  Medina.  I  am  pleased  to  hear  the  remarks  of  my  friend, 
and  I  fully  agree  with  him  in  what  he  has  stated  regarding  the 
progress  of  Costa  Rica.  It  is  a  little  country,  but  one  of  the  most 
progressive  in  Central  America.  He  states  that  we  come  here  to 
represent  each  of  us  but  one  country,  and  I  understand  him  to  sug- 
gest that  we  ought  to  confine  ourselves  only  to  the  country  we 
represent.  I  take  a  different  view  of  that.  I  do  not  come  here  to 
speak  for  Costa  Rica,  because  I  have  no  right  to  speak  for  it;  but 
being  members  of  a  sanitary  international  congress,  if  we  think  a 
measure  could  be  adopted  by  which  all  that  region  could  be  benefited, 
I  think  we  have  a  right  to  suggest  such  a  proposition.  Whether  it 
be  accepted  or  not  is  an  entirely  different  question.  My  proposition 
is  that  in  some  way  or  other  this  conference  should  use  its  valuable 
efforts  toward  securing  uniformity  of  action  on  the  part  of  these 
five  little  republics,  so  that  their  boards  of  health,  acting  under 
uniform  rules,  may  act  in  harmony,  so  that  none  of  thern  will  destroy 
or  impair  the  good  that  a  country  like  Costa  Rica  is  doing.  If  that 
can  be  done,  we  shall  accomplish  a  great  good.  That  is  why  I  made 
the  proposition  I  did  make  the  other  day.  I  wish  to  say  that  I  fully 
agree  with  Doctor  Ulloa  in  all  his  remarks  as  to  the  progress  of 
Costa  Rica. 

Doctor  Ulloa.  I  consider  the  matter  ended.  Though  we  differ 
slightly  as  to  the  details,  I  consider  the  incident  closed. 

Doctor  Guiteras  moved  to  dispense  with  the  reading  at  length  of 
the  remarks  of  the  other  speakers. 

The  motion  was  agreed  to. 

The  secretary  resumed  and  completed  the  reading  of  the  minutes. 

On  motion,  the  minutes  as  read  and  amended  were  approved. 


láECOND    INTKKNA'riONAI.    SANI'I'AKY    (JON  V  KNTION,  2'.J 

The  President.  I  wish  to  read  now  a  letter  from  Doctor  Kennedy, 
one  of  the  delegates  from  the  United  States.     He  says: 

I  greatly  regret  to  leave  this  a.  m.  I  must  stop  off  a  couple  of  days  in  New  York  City, 
and  nave  some  examinations  at  homo  (Dcs  Moines)  next  Wednesday.  I  have  the  press 
reports  of  our  sessions  as  licld  thus  far.  If  you  will  kindly  send  mo  copies  containing 
1  ater  reports  I  will  be  greatly  obliged.  I  have  enjoyed  and  been  benefited  by  our  conference 
sessions  thus  far,  and  only  wish  1  could  stay  to  the  finish..  I  am, 
Very  respectfully,  yours, 

J.  A.  F.  Kennedy. 

The  PjiESiDENT.  The  secretary  has  some  letters  to  read. 
The  secretary  read  the  following: 

Health  Department  of  the  District  of  Columbia, 

Washington,  D.  C,  October  11,  1905. 
Dr.  Juan  Ulloa, 

Secretary  International  Sanitary  Conference, 

The  New  Willard,  Washington,  D.  C. 
Dear  Sir  :  I  have  the  honor  to  acknowledge  the  receipt  of  your  letter  of  the  10th  instant 
notifying  me  that  at  the  meeting  of  the  Second  International  Sanitary  Conference  I  was 
accorded  the  privileges  of  the  floor.  I  desire  to  express  my  appreciation  of  this  courtesy, 
and  to  express,  further,  my  great  regret  that  the  pressure  of  official  business  has  rendered 
it  impossible  for  me  to  attend  all  of  the  meetings  of  the  convention. 
Very  respectfully,  yours, 

William  C.  Woodward,  M.  D., 

Health  Officer. 

War  Department, 
Office  of  the  Surgeon-General, 
Army  and  Medical  Museum  and  Library, 

Washington,  October  11,  1905. 
Hon.  Juan  J.  Ulloa, 

Secretary  International  Sanitary  Conference, 

Washington,  D.  C. 
Dear  Sir  :  I  beg  to  acknowledge  the  receipt  of  your  letter  of  the  10th  instant  conveying 
an  invitation  to  be  present  at  the  meetings  of  the  convention,  and  extending  to  me  the 
privileges  of  the  floor.     I  hasten  to  assure  you  of  my  deep  appreciation  of  the  honor,  and 
acceptance  of  the  same. 

Yours,  very  truly,  James  Carroll. 

The  President.  Gentlemen,  in  a  very  few  moments  it  will  be 
necessary  for  us  to  start  to  the  White  House  to  pay  our  respects  to 
the  President  of  the  United  States.  Before  leaving  the  convention 
hall  for  that  purpose,  I  desire  to  make  a  short  statement  with  regard 
to  the  interest  which  President  Roosevelt  has  always  expressed  in 
the  medical  profession  and  in  sanitation. 

Before  starting  to  the  White  House  I  wish  to  assure  you  that  you 
will  have  a  cordial  reception,  and  that  you  v/ill,  without  doubt,  be 
greeted  with  words  of  encouragement  as  regards  the  objective  aiiíis 
of  this  convention.  I  wish  to  state  that  no  other  President  of  the 
United  States  has  publicly  expressed  so  often  and  so  eloquently  an 
appreciation  of  the  character  and  labors  of  the  phj^sician  in  regard 
to  his  sacred  relation  to  his  patients,  to  his  civic  duties,  and  to  his 
labors  as  a  sanitarian.  In  his  address  before  the  Association  of 
Military  Surgeons  ^of  the  United  States,  his  address  at  the  unveiling 
of  the  monument  in  Washington  erected  to  the  memor}'  of  Dr.  Ben- 
jamm  Rush,  at  the  laying  of  the  corner  stone  of  the  Naval  Medical 
School,  and  very  recently  before  the  Association  of  Physicians  of 
Long  Island,  his  words  were  words  of  encouragement  and  wisdom. 
He  has  declared  that  in  military  life  the  surgeon,  besides  being  a 


30  SECO^'D    INTKKNATIONAL    SANITARY    CONVENTION. 

surgeon,  bears  all  the  hardships  of  the  soldier  and  the  responsibilities 
of  an  administrator;  he  has  declared  that  the  doctor  who  stands 
high  ill  liis  ])rofession  in  any  city  counts  as  one  of  the  most  valuable 
assets  in  that  city's  civic  work,  and  that  no  doctor  can  be  a  good 
doctor  or  a  good  citizen  unless  he  does  his  duty  by  the  state,  and  that 
doctors  must  personally  pa}"  attention  to  their  civic  duties,  because 
"everybody's  business  is  nobody's  business."  "It  must  not  be  left 
to  everybody,  but  individually  the  medical  man  should  take  an 
interest  in  State  matters." 

He  has  sho\\n  his  appreciation  of  the  sentiments  that  are  so  dear 
to  us  as  ph^'sicians  and  sanitarians,  namely,  that  our  labors  are 
highly  essential  to  the  welfare  of  the  State  as  well  as  to  the  individual. 
In  exemplification  of  this,  he  has  expressed  the  greatest  interest  and 
confidence  in  the  work  of  the  sanitarians  in  the  Isthmian  Canal  Zone, 
and  has  taken  an  initiative  the  good  results  of  which  are  incalculable 
in  the  sanitary  work  which  was  begun  and  is  still  being  conducted 
in  New  Orleans  against  the  yellow-fever  pestilence. 

In  expressing  this  appreciation  of  our  President  I  am  only  echoing 
the  voluntary  expressions  which  I  have  heard  on  many  sides,  and 
particularly  at  the  recent  meeting  of  the  Great  American  Medical 
Association,  in  Portland,  Oreg.,  where  comments  of  the  above  nature 
were  frequent,  prompted  solely  by  appreciation  in  the  minds  of  the 
medical  profession  of  the  sentiments  and  support  of  our  President 
in  matters  relating  to  individual  and  public  health. 

The  secretary  translated  the  above  remarks  into  Spanish. 

On  motion  of  Doctor  Guiteras,  the  convention  adjourned  to  meet 

at  2.30  p.  m. 

Afternoon  Session. 

The  convention  was  called  to  order  by  the  president  at  2.30  p.  m. 

Doctor  Guiteras.  Mr.  President,  I  have  the  honor  of  presenting 
the  following  resolution  concerning  the  United  States  Pharmaco- 
poeia: 

Whereas  the  decennial  edition  of  the  United  States  Pharmacopoeia  has  just  been  pub- 
lished and  issued  by  the  board  of  tmstees  of  the  convention  of  the  United  States  Pharma- 
copoeia appointed  by  the  American  Pharmaceutical  Association,  and 

\\Tiereas  this  revised  pharmacopoeia  embraces  many  new  forms  of  value,  both  for  use  in 
therapeusis  and  prevention  of  epidemic  disease  and  represents  the  best  thought  and  labor 
of  experts  on  these  matters:  Tñerefore  be  it 

Resolved,  That  a  translation  of  this  United  States  Pharmacopcsia  into  the  Spanish 
language  would  prove  of  great  benefit  to  the  medical  profession  and  pharmacists  in  each 
of  the  republics  represented  in  this  convention;  and  further, 

Resolved,  That  the  said  pharmacoposia  be  referred  to  the  several  governments  to  report 
upon  at  the  next  meeting  in  Mexico,  with  a  view  to  the  adaption  of  an  international  phar- 
macopoeia for  the  American  republics;  and  be  it  further 

Resolved,  That  the  International  Sanitary  Bureau  be  requested  to  ascertain  if  it  is  pos- 
sible for  the  payment  for  such  translation  and  publication  of  an  edition  of  5,000  copies 
to  be  made  out  of  the  fund  provided  for  in  section  7  of  the  resolutions  adopted  by  the 
Second  International  Conference  of  American  States,  held  in  the  City  of  Mexico  in  the 
wdnter  of  1901-2;  and  be  it  further 

Resolved,  Tliat  if  it  is  found  the  expense  of  this  translation  an(J  publication  can  not  be 
provided  for  from  the  fund  provided  hj  said  section  7,  the  matter  to  be  referred  to  the 
Bureau  of  the  ^imerican  Republics,  with  the  request  that  if  possible  the  said  translation  and 
publication  be  provided  for  by  the  said  Bureau. 

Doctor  Guiteras  then  translated  the  above  resolutions  into 
Spanish. 

The  President.  You  have  heard  the  resolutions,  and  they  will  be 
referred  to  the  advisory  council.     In  the  meantime,  you  will  recall 


8P:(J0ÍÍD    INTERNATIONAL    SANITARY:     CONVENTION.  31 

that  by  a  vote  we  extended  the  courtesy  of  the  floor  to  Dr.  II.  C. 
Wood,  of  Philadelphia.  He  is  very  much  interested  in  this  subject 
and  has  been  invited  especially  to  speak  about  it.  J  le  is  a  gentleman 
whose  name  is  known  nationally  and  internationally,  and  he  has 
paid  groat  attention  to  matters  of  materia  medica  and  pharmacology 
and  pharmacy, 'and  I  therefore  beg  leave  to  present  to  you  J)r.  11.  C. 
Wood,  of  l^hiladelphia,  who  will  speak  upon  this  subject. 

Doctor~Woor>.  Gentlemen,  in  spite  of  the  fact  that  nearly  all  of  the 
members  of  this  conference  or  convention  are  physicians,  1  will  })egin 
my  remai-ks  by  explahiing  what  a  pharmacopoeia  is. 

A  pharmacopoeia  is  a  list  of  medicines  with  tests  for  tluúr  purity 
and  with  methods  of  making  preparations  from  the  crude  drugs, 
these  preparations  to  be  used  by  the  individual  doctors.  Tne 
pharmacopoeia  has,  however,  a  wider  scope  than  the  mere  practice 
of  medicine,  because  upon  it  are  based  many  of  the  laws  of  the  cus- 
toms of  the  various  countries,  and  because  upon  it  are  based  all  the 
so-called  pure-food  bills,  and  because  it  comes  continually  into  the 
courts  as  a  legalized  standard. 

In  most  countries  the  pharmacopoeia  is  produced  directly  by  the 
Government.  In  Anglo-Saxon  countries  a  need  has  frequently  pro- 
duced popular  means  of  meeting  it,  extra  or  without  or  beyond  gov- 
ernmental supervision;  precisely  as  in  England  the  whole  light-house 
system  of  Great  Britain  is  in  the  hands  of  the  Brothers  of  the  Trinity 
and  not  under  the  direct  control  of  the  Government,  because  origi- 
nally it  was  the  merchants  of  England  who  started  the  light-houses 
in  Great  Britian. 

So  in  the  United  States  the  Pharmacopoeia  was  produced  by  joint 
conventions  of  the  two  professions  concerned  and  has  so  continued 
to  be  .produced,  although  it  has  become  recognized  by  Government 
statutes  as  the  law  of  the  land. 

Before  there  is  any  pharmacopoeia  in  a  country  the  practice  of 
medicine  in  that  country  must  be  more  or  less  chaotic.  The 
apothecary  has  no  official  standard,  and  so  if  you  want  a  tincture  of 
a  wine  you  get  a  preparation  from  the  apothecary  on  one  side  of  the 
street  different  in  strength  from  that  which  the  apothecary  on  the 
other  side  of  the  street  gives  you.  Now,  since  the  modern  habit  of 
travel  has  brought  all  nations  into  continual  intercourse,  the  differ- 
ences in  the  different  pharmacopceias  have  become  serious  in  their 
practical  results.  So  in  1902  there  was  called  at  the  instance  of  the 
Belgian  Governm_ent  the  so-called  conference  on  heroic  remedies, 
which  was  held  at  Brussels,  where  certain  standards  were  agreed  upon 
for  the  preparation  of  heroic  or  powerful  drugs.  The  pharmacopoeia 
of  the  United  States  is  the  first  national  pharmacopoeia  to  conform 
with  the  international  standard,  and  made,  therefore,  a  great  advance 
in  the  world's  history  in  regard  to  the  practice  of  medicijie.  I  hap- 
pened to  be  president  of  the  United  States  Pharmacopoeia,  so-called, 
and  it  is  for  this  reason,  I  suppose,  that  I  have  been  asked  to  appear 
before  you.  The  movement  for  a  Spanish  edition  of  the  United 
States  pharmacopoeia  did  not  originate  with  the  pharmacopoeia  con- 
vention of  the  United  States  at  all.  Long  before  the  pharmacopoeia 
was  published  appeals  were  made  from  Cuba  first,  I  believe,  after- 
wards from  Panama,  later  from  the  Philippmes,  for  a  Spanish  trans- 
lation of  the  work.  The  need  of  such  a  translation  for  the  American 
possessions  in  the  Spanish-speaking  countries  is  of  coufse  imperative, 


32  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

and  when  we  look  at  the  condition  of  the  South  American  repubhcs 
in  general  I  think  you  will  see  that  the  need  for  some  common  stand- 
ard is  no  less  imperative.  Mexico  is  the  only  one  of  the  republics,  I 
believe,  that  has  any  official  pharmacopoeia  whatever.  In  Cuba 
three  pharmacoposias  are  used,  the  United  States,  the  Spanish,  and 
the  French,  and  there  is  perpetual  confusion,  and  I  suppose  it  was 
the  result  .of  this  confusion  which  led  the  Cubans  hrst  to  ask  for  a 
Spanish  edition  of  the  United  States  Pharmacopoeia. 

In  most  of  the  Spanish  spealdng  countries  the  French  Codex  is 
employed.  In  Chile  the  German  Pharmacopoeia  is  used.  Now,  the 
French  Codex  is  of  course  not  in  the  Spanish  language.  There  is  no 
Spanish  edition  of  it,  so  that  at  present  in  none  of  the  vast  territories 
south  of  the  United  States  and  Mexico  is  there  a  pharmacopoeia  in 
the  language  of  the  people  recognized  by  the  governments  as  a  legal 
standard.  If  there  be  any  underhung  truth  in  the  so-called  Monroe 
Doctrine  it  is  that  the  peoples  of  America  shall  not  be  only  politically 
but  scientifically  and  professionally  independent:  Under  the  present 
condition  you  can  see  that  in  the  South  American  Republics  this  is 
not  at  all  so.  They  draw  their  sustenance  or  their  law  from  foreign 
countries,  with  reference  to  this  subject.  Now,  the  United  States 
Pharmacopoeia  is  of  course  not  an  international  pharmacopoeia,  but 
it  is  hoped  and  expected  that  if  the  Spanish  translation  is  made,  and 
if  it  is,  as  will  almost  certainly  be  the  case,  more  or  less  widely  ex- 
ploited, it  will  lead  finallj^  to  our  all  coming,  not  under  the  United 
States  Pharmacopoeia,  but  under  some  form  of  American  or  Pan- 
American  pharmacopoeia  if  you  please.  There  are  several  ways  in 
which  this  can  happen.  It  may  be  very  well  that  there  shall  be 
appointed  finally  an  internafional  body  which  shall  prepare  a  new 
Pharmacopoeia  based  upon  that  of  the  most  complete  that  there  is  at 
present  in  the  world.  It  may  be  verj  well  that  the  so-called  conven- 
tion of  the  United  States  Pharmacopoeia  shall  be  so  modified  in  its 
nature  that  it  shall  become  Pan-American  by  the  reception  of  dele- 
gates from  all  parts  of  South  America.  Which  of  these  two  ways  will 
work  out  in  the  future  no  one  can  know,  but  the  present  being  merely 
the  inception  of  a  movement,  it  seems  to  me  of  the  very  greatest 
importance,  which  belongs  strictly  to  the  province  of  this  convention, 
and  which  I  hope  you  will  see  fit  to  support  in  your  wisdom,  and  then 
in  Mexico  two  years  from  now  or  in  some  other  wa}^  we  will  certainly 
be  able  to  bring  about  that  which  is  most  desirable  thing,  namely, 
a  Pan-American  pharmacopoeia.' 

Doctor  LicÉAGA  (translation).  In  Mexico  there  is  a  special  board 
for  the  pharmacopoeia.  They  study  the  different  pharmacopoeias 
and  then  make  a  special  publication,  or  else  accept  some  particular 
one  and  have  it  translated  into  Spanish  with  the  official  approbation 
of  that  country. 

Doctor  Wood.  I  expressly  excepted  Liexico  from  my  general  state- 
ment, being  well  aware  of  the  fact  which  Dr.  Licéaga  has  just  stated. 

Doctor  LiCKAGA  (translation).  I.  did  not  quite  understand  the 
statement  of  Doctor  Wood  in  that  respect. 

Doctor  MooEE.  In  Chile  they  have  accepted  the  German  Pharma- 
copoeia and  the  national  publication  is  almost  a  copy  of  the  German 
one,  being  translated  into  Spanish.  I  agree  entirely  with  the  solution 
proposed  by  Doctor  Guiteras  and  I  consider  it  very  important  that 
there  should  \Je  a  pharmacopoeia  of  an  international  character  for  the 


SECOND    INTERNA'I'IONAI.    HANITAKY    CON  V  I0NTÍON.  Í33 

American  Republics.  From  the  information  I  have  received  1  know 
that  the  American  pharmacopoeia  is  very  much  ahead  of  the  others 
which  have  been  in  use  in  the  Spanish-American  Kepu})lics. 

Doctor  Ulloa.  As  the  representative  of  Costa  Kica,  I  do  not  have 
much  to  ¿idd  to  what  Doctor  Moore  has  said.  I  adopt  his  words  with 
the  exception  that  we  do  not  have  a  national  pharmacopoeia  and 
never  had  one.  There  are  several  pharmacopoeias  in  use  in  Costa 
Rica.  We  use,  principally,  the  United  States  pharmacopíüia,  because 
the  majority  or  the  doctors  in  Costa  Rica  were  j^radiiated  in  the 
United  States.  We  use  that  one,  and  also  the  German  and  the 
French  pharmacopoeias-.  I  fully  ataree  with  the  statements  of  the 
previous  speakers  in  reference  to  this  matter  and  I  will  gladly  give 
my  assent  to  the  proposition  made  by  Doctor  Guiteras. 

Doctor  Barnett  (translation).  I  agree  to  the  expression  made 
here.  The  Government  of  Cuba  has  appointed  a  special  commis.sion 
with  the  purpose  of  preparing  a  national  pharmacopfpia,  t)ut  after 
they  held  several  meetings  they  found  the  task  before  them  to  be 
a  very  heavy  one  and  that  there  were  many  difficulties  to  be  encoun- 
tered,.so  they  decided  after  due  discussion  and  consultation  that 
the  best  plan  would  be  to  recommend  the  adoption  of  the  United 
States  pharmacopoeia,  of  course  having  it  translated  into  Spanish. 
That  idea  having  been  agreed  upon,  it  was  decided  that  Doctor 
Guiteras  in  the  name  of  Cuba  should  present  at  this  conference  the 
resolutions  which  he  has  presented  to  that  effect. 

The  President.  Is  there  any  other  gentleman  who  desires  to 
make  remarks  on  this  subject?  If  not,  then  the  resolutions  will  be 
reported  back  from  the  advisory  council  at  some  future  time  during 
the  sessions  of  this  convention.  I  would  like  to  ask  the  chairman  of 
the  advisor}^  council  if  there  is  anything  to  report  from  that  council  ? 

Doctor  Moore  (translation) :  I  wish  to  inform  the  congress  that  the 
advisor}^  council  after  discussing  the  subject,  have  decided  to  recom- 
mend the  adoption  of  the  convention  of  Paris  of  1903,  of  course, 
omitting  from  said  convention  all  those  articles  that  do  not  relate  to 
America.  There  are  some  articles  relating  to  the  Red  Sea,  and  other 
subjects,  that  would  not  be  of  importance  or  interest  on  this  side  of 
the  Atlantic.  They  also  made  an  exception  to  the  effect  that  pas- 
sengers should  not  be  allowed  to  go  free  after  the  arrival  of  infected 
vessels,  but  that  they  be  put  under  observation  in  proper  quarters. 
Besides  this,  they  have  added  to  this  convention  all  the  articles 
referring  to  yellow  fever  's^hich  have  been  agreed  upon  in  the  last 
meeting  of  the  same  convention,  and  it  is  proposed  to  read,  article  by 
article,  all  the  different  articles  of  said  convention,  for  the  approval 
of  this  meeting. 

The  Secretary.  An  official  copy  on  parchment  is  to  be  made  of 
this  convention  to  be  ready  for  the  signatures  of  the  delegates. 

Doctor  Guiteras.  The  different  articles  must  be  approved  before 
they  are  engrossed.  Therefore  we  should  read  them  section  by 
section. 

The  President.  I  understand  we  have  an  English  version  and  a 
Spanish  translation  here.  We  will  have  the  English  article  read  first 
and  then  the  Spanish  translation  read  also,  so  that  when  all  are  read 
and  agreed  upon,  they  will  be  ready  for  our  signatures  to-morrow. 
Each  article  will  be  presented  to  the  Convention  to  be  voted  upon 

5610—06 3 


¿i-i  SECOND    INTERNATIONAL    S.^NITAKY    CONVENTION. 

before  the  delegates  are  called  upon  to  sign.  I  will  call  ujion  Doctor 
Guiteras  to  read  the  English  version  and  Doctor  Moore  to  read  the 
Spanish. 

The  preamble  was  first  read  in  English  and  in  Spanish. 

The  President.  The  preamble  as  read,  both  in  English  and  Span- 
ish is  before  the  convention.  Are  there  ñnj  remarks  to  be  made  upon 
it?  It  has  been  suggested,  and  correctly,  too,  that  this  is  the  report  of 
a  committee  which  was  to  report  to  the  advisory  council,  and  the 
advisory  council  vras  to  report  it  to  the  convention.  As  nearly  every- 
one connected  with  the  advisory  council  has  expressed  the  opinion 
that  it  should  be  presented  now,  I  shall  take  it  for  granted,  unless 
some  one  expresses  himself  to  the  contrary,  that  it  is  in  order  to  be 
presented  as  coming  from  the  advisory  council  for  the  action  of  the 
convention.  If  any  member  of  the  advisory  council,  all  of  whom  are 
here  present,  has  any  objection  to  its  coming  before  this  convention, 
he  may  express  that  objection  now.  T'here  are  two  members  of  the 
advisory  council  who  have  not  been  lieard  from  yet,  being  the  repre- 
sentatives of  the  Army  and  Navy  of  the  United  States,  Major  McCaw 
and  Doctor  Gatewood.  I  would  like  to  have  them  express  themselves 
before  proceeding  further.  Are  both  these  gentlemen  satisfied  with 
course  of  procedure  ? 

Major  McCaw.  I  am  perfectly  satisfied. 

Doctor  Gatewood.  And  so  am  I. 

Doctor  Geddings.  Among  the  names  of  the  delegates  from  the 
United  States  there  appears  the  name  of  Dr.  A.  H.  Doty,  of  New  York. 
Doctor  Doty  was  regularly  invited  to  represent  the  United  States  on 
this  occasion,  but  owing  to  a  stress  of  business  at  the  port  of  New  York 
he  has  been  unable  to  attend.  He  therefore  has  never  regularly 
qualified  as  a  delegate  on  behalf  of  the  United  States,  and  I  move, 
Mr.  President,  that  wherever  the  name  of  Doctor  Doty  occurs  it  be 
stricken  from  the  record. 

The  motion  was  seconded. 

The  President.  Before  putting  this  motion  I  wish  to  state  that 
Doctor  Doty  has  expressed  great  interest  in  this  convention,  and  that 
he  accepted  the  invitation  to  come  here  if  it  was  possible  for  him  to 
do  so,  that  he  has  sent  as  many  as  three  telegrams  concerning  it, 
expecting  each  day  that  he  would  be  able  to  come,  but  finding  that 
some  pressing  duty  at  his  quarantine  station  has  prevented  it.  So 
that  this  resolution  is  in  no  wise  a  reflection  on  Doctor  Doty.  In 
order  to  make  it  absolutely  regular  in  every  particular,  it  is  proposed 
that  this  action  be  taken.  Doctor  Doty  wished  to  express  to  the  con- 
vention his  great  regret  that  he  could  not  be  here,  and  I  have  thought 
it  best  to  make  this  explanation.     (See  Appendix,  p.  — .) 

The  motion  was  agreed  to. 

Doctor  Barnett  (translation) .  This  convention  is  to  be  signed  by 
representatives  of  the  Government  of  the  United  States,  both  the 
Army  and  the  Navy.  Inasmuch  as  the  various  States  of  the  Ameri- 
can Union  have  different  regulations  on  these  subjects,  it  would  be 
interesting  to  know  in  what  situation  these  States  will  find  themselves 
and  what  their  attitude  wdll  be  toward  this  agreement. 

The  President.  That  is  a  most  interesting  question.  Are  there 
any  further  remarks  ?  If  not  the  question  is  on  the  adoption  of  the 
preamble. 

The  preamble  was  agreed  to. 


SECOND  INTERNATIONAL  SANITARY  CONVENTION.      35 

Doctor  Giiitoras  read  in  English  aru]  I)o(;tor  Moore  in  Spanish 
article  1. 

The  President.  Are  there  any  remarks  upon  article  l'{ 

Doctor  GuiTERAS.  I  should  like  to  look  at  the  French  copy. 
I  think  a  wrong-  word  has  been  ein})]oyed  in  the  vSpanish  translation. 
The  French  word  is  ciiuivalent  to  the  Knglish  word  "  conlirni."  The 
Spanish  translation  does  not  give  that  idea  exactly.  It  says- "cases 
that  have  been  found  out,"  which  gives  a  sort  of  indeñnite  expression. 
The  better  word  would  be  the  Spanish  equivalent  for  the  English 
word  "confirmed." 

Doctor  Moore.  We  have  changed  that  and  have  inserted  the  equiv- 
alent Spanish  word. 

Article  1  was  agreed  to. 

Article  2  was  read. 

Doctor  Lavoreria.  I  wish  to  ])ropose  that  the  different  paragraphs 
of  this  article  be  taken  up  separately  instead  of  the  entire  article  all  at 
once. 

The  President.  That  suggestion  is  a  very  good  one. 

The  following  paragraph  was  read : 

Article  2.  The  notification  is  to  be  accompanied  or  veiy  promptly  followed  by  the  follow- 
ing circumstantial  information:  (1.)  The  neighborhood  where  the  disease  has  appeared. 

The  President.  Are  there  any  remarks  on  this  paragraph?     If 
not  the  question  will  be  taken  on  its  adoption. 
The  paragraph  was  agreed  to. 
The  following  was  read : 

(2.)  The  date  of  its  appearance,  its  origin,  and  its  form. 

The  President.  You  have  heard  the  reading  of  the  second  para- 
graph; are  there  any  remarks? 

Doctor  Guiteras.  The  question  is  raised  as  to  the  difficulty  some- 
times of  tracing  the  orjgin  of  the  disease.  It  is  suggested  that  a 
request  to  give  the  origin  can  not  always  be  compiled  with.  We  have 
replied  to  that,  that  of  course  if  the  origin  is  not  known  then  it  can  not 
be  given. 

The  paragraph  was  agreed  to. 

The  following  was  read: 

(3.)  The  number  of  established  cases  and  the  number  of  deaths. 

The  paragraph  was  agreed  to. 
The  following  was  read: 

(4.)  For  plague,  the  existence  among  rats  and  mice  of  plague,  or  a  pronounced  mortaUty ; 
for  yellow  fever,  the  existence  of  Stegomyia  fasciata. 

The  paragraph  was  agreed  to. 
The  following  was  read: 

(5.)  The  measures  immediately  taken  following  the  first  appearance. 

The  President.  I  hope,  the  English-speaking  members  here  are 
paying  particular  attention  to  the'  wording  of  this  English  version, 
because,  as  Doctor  Guiteras  states,  this  has  been  gotten  up  in  a  hurry 
and  there  may  be  errors  in  the  English.  Doctor  Guiteras  wished  me 
to  make  that  statement. 

The  paragraph  as  read  was  agreed  to. 

The  President.  Now,  I  think  article  2  should  be  adopted  as  a 
whole.  It  has  been  read  by  paragraphs,  but  the  question  should  be 
taken  on  its  adoption  as  an  entire  article. 


36  SECOND    INTEKNATIOKAL    SANITARY    CONVENTION. 

The  article  as  a  whole  was  agreed  to. 

The  President.  Is  it  the  desire  that  the  remaining  articles  shall  be 
read  by  separate  paragraphs'? 

Doctor  GuiTEEAS.  That  request  has  been  made. 
The  following  was  read : 

Article  3.  The  notification  and  information  prescribed  in  articles  1  and  2  are  to  be 
addressed  to  diplomatic  and  consular  agents  in  the  capital  of  the  infected  country. 

The  Peesident.  This  is  a  A^ery  important  matter.  I  understand 
that  there  would  be  nothing  in  this  to  prevent,  for  instance,  the  presi- 
dent of  the  superior  board  of  health  of  Mexico  wiring  to  the  Surgeon- 
General  of  the  Public  Health  and  Marine-Hospital  Service  or  the 
United  States. 

Doctor  GuiTEEAS.  I  understand  there  is  nothing  to  prevent  him, 
but  there  is  nothing  mandatory  compelling  him  to  do  it. 

Dr.  H.  L.  E.  Johnson.  Could  not  that  be  amended  so  as  to  pro- 
vide that  the  information  should  be  sent  to  the  Public  Health  and 
Marine-Hospital  Service  of  the  United  States  instead  of  to  the  United 
"States  State  Department? 

The  Peesident.  We  would  get  it  through  the  State  Department, 
and  there  is  nothing  to  prevent  its  also  being  sent  to  the  Service 
direct.  For  instance,  I  frequently  cable  to  the  president  of  íhe 
superior  board  of  health  of  Cuba  and  also  to  President  Licéaga,  and 
both  do  the  same  to  me. 

Doctor  Baenett  (translation).  I  move  that  a  paragraph  be 
inserted  in  that  article  embodjñng  the  statement  which  has  just 
been  made. 

Doctor  Gatewood.  I  suggest  that  the  proposed  amendment  be 
worded  as  follows: 

Article  3.  The  notification  and  information  prescribed  in  articles  1  and  2  are  to  be 
addressed  to  diplomatic  or  consular  agents  in  the  capital  of  the  infected  country. 

This  being  construed  as  not  preventing  direct  communication  between  officials  charged 
with  the  public  health  of  the  several  countries. 

I  propose  that,  to  overcome  the  objections  which  are  made  in 
regard  to  the  slowness  with  which  information  comes  through 
diplomatic  channels. 

The  President.  You  have  heard  the  paragraph  as  amended. 
Are  there  any  further  remarks  ? 

The  paragraph  as  amended  was  agreed  to. 

The  following  was  read : 

For  countries  which  are  not  thus  represented,  they  are  to  be  transmitted  dhectly  by 
telegraph  to  the  Governments  of  such  countries. 

The  paragraph  was  agreed  to. 
Doctor  GuiTEEAS  (reading) : 

Article  4.  The  notification  and  information  prescribed  in  articles  1  and  2  are  to  be  fol- 
lowed by  further  communications  dispatched  in  the  regular  manner  in  order  to  keep  the 
Governments  informed  of  the  progress  of  the  epidemic.  ■  These  communications,  which  are 
to  be  made  at  least  once  a  week,  and  which  are  to  be  as  complete  as  possible,  should  indicate 
very  particulaily  the  precautions  taken  to  prevent  the  extension  of  the  disease.  They 
should  set  forth — 

1.  The  prophylactic  measures  taken  relative  to  sanitary  or  medical  inspection,  to  isola- 
tion and  disinfection,  and 

2.  The  measures  taken  upon  the  departure  of  vessels  to  prevent  the  exportation  of  the 
disease;  and  especially  in  the  case  mentioned  by  No.  4,  of  article  2,  given  above,  the  meas- 
ures taken  against  rats  and  mosquitoes. 


SECOND    INTKKNATIONAL    SANITARY    CONVENTION.  'ó7 

The  above  paragraph  was  here  read  in  Spanish  by  Doctor  Moore, 

The  paragraph  was  agreed  to. 

The  President.  Doctor  Guitoras,  will  you  kindly  let  me  know  if 
we  have  reached  the  end  of  that  article? 

Doctor  GuiTERAS.  Yes;  that  is  the  end  of  article  4. 

The  President.  Article  4  lias  been  read  to  the  convention  in  both 
Spanish  and  English,  as  amended.  The  question  now  is  on  the 
adoption  of  the  article  in  toto. 

The  article  was  agreed  to. 

Doctor  Moore  here  addressed  the  convention  in  Spanish,  his 
remarks  being  translated  into  English  by  Doctor  Ulloa.  Doctor 
Moore  said  that  there  was  nothing  special  in  the  different  paragraphs 
of  that  article;  that  he  thought  the  convention  should  go  ahead  and 
read  the  entire  article,  and  then  discuss  the  whole  article  at  once. 

Doctor  Guiteras  here  read  article  5,  as  follows: 

Article  5.  The  prompt  and  honest  accomplishment  of  the  provisions  which  precede 
above  is  of  the  very  first  importance,  the  notifications  only  having  real  value  if  each 
Government  is  warned  in  time  of  cases  of  plague,  cholera,  or  yellow  fever,  and  of  doubtful 
cases  supervening  in  its  territory.  It  can  not  then  be  too  strongly  recommended  to  the 
various  Governments  to  make  obligatory  the  declaration  of  cases  of  plague,  cholera,  or 
yellow  fever,  and  of  giving  information  upon  all  established  unusual  mortality  of  rats  and 
mice. 

Doctor  Gatewood.  IVIr.  President,  it  seems  to  me  that  you  might 
substitute  the  word  "frank"  for  "honest"  and  the  word  "execu- 
tion" for  "accomplishment." 

Dr.  H.  L.  E.  Johnson.  Had  we  not  better  use  the  words*  agi'eed 
on  ?     How  does  that  read  ? 

Doctor  Guiteras.  It  reads  "the  prompt  and  honest  execution." 
That  is  better  than  "  accomphshment,"  there  is  no  doubt  about  that. 

Doctor  Gatewood.  "The  prompt  and  faitliful  execution?" 

Doctor  Guiteras.  Yes;  "prompt  and  faitliful." 

The  President.  Does  that  correspond  with  the  original  ? 

Doctor  Guiteras.  It  reads  "the  prompt  and  faithful  execution 
of  the  provisions  which  precede  above  is  of  the  very  first  importance." 
Then  it  reads  "doubtful  cases  in  its  territory." 

The  President.  "Doubtful  cases?" 

Doctor  Guiteras.  Yes;  "doubtful  cases." 

Doctor  Gatewood.  The  word  "suspicious"  is  better  than  "doubt- 
ful." 

Doctor  Guiteras.  Yes;  it  is. 

Doctor  Gatewood.  I  would  like  to  ask  the  force  of  the  word  "pro- 
nounced," in  regard  to  the  mortality?  Would  not  the  word  "unus- 
ual" be  better? 

Doctor  Guiteras.  Very  well.     Now  it  reads  m  tliis  way: 

Article  5.  The  prompt  and  faithful  execution  of  the  provisions  which  precede  above  is 
of  the  very  first  importance,  the  notification  only  having  real  value  if  each  Government  is 
warned  in  time  of  plague,  cholera,  or  yellow  fever,  and  of  suspicious  cases  supervening  in  its 
territory.  It  can  not  then  be  too  strongly  recommended  to  the  various  Governments  to 
make  obligatory  the  declaration  of  cases  of  plague,  cholera,  or  yellow  fever,  and  of  giving 
information  upon  all  unusual  mortality  of  rats  and  mice,  especially  in  ports. 

Article  5  was  here  read  in  Spanish  by  Doctor  Moore. 

The  President.  Is  that  an  entire  article,  or  one  paragraph  of  an 
article  ? 

Doctor  Guiteras.  It  is  an  entire  article.  That  is  article  No.  5.  I 
wish  to  speak  on  this  article,  Mr.  President;  simply  as  to  the  Spanish 
translation. 


38  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Doctor  Guiteras  here  addressed  the  convention  in  Spanish. 

Doctor  Guiteras.  That  is  all,  Mr.  President.  I  simply  wanted  to 
mention  the  verbal  corrections. 

Doctor  Moore  here  read  article  No.  5,  as  amended,  in  Spanish. 

The  President.  You  have  heard  article  No.  5.  The  question  now 
is  on  the  adoption  of  article  No.  5. 

The  article  was  agreed  to. 

The  President.  Before  proceeding  further  there  is  one  question  I 
would  like  to  ask  Doctor  Guiteras,  and  that  is  how  this  convention  is  to 
be  signed,  whether  on  parchment  or  on  a  galley  proof  or  on  a  type- 
written copy,  because  if  it  is  to  be  on  parchment,  or  printed,  we  will 
have  to  take  some  special  measures  to  get  it  done  promptly.  It  would 
take  some  time  to  prepare  the  parchment  or  the  printed  copy,  and  it 
may  be  advisable  to  give  these  sheets  that  we  are  going  over  into  the 
hands  of  the  ofRcial  representative  of  the  Bureau  of  the  American  Re- 
publics as  they  are  finished  to  have  them  transcribed,  so  that  we  can 
get  through  to-morrow.  I  suppose  all  the  delegates  will  want  to  sign 
that  here  before  they  go  away,  and  it  would  be  very  difficult  to  prepare 
the  copy  for  signatures  before  to-morrow  evening. 

Doctor  Guiteras.  I  have  suggested  that  there  should  be  here  two 
gentlemen  writing  out  these  articles  as  they  are  approved,  one  writing 
them  in  English  and  another  in  Spanish ;  but  it  seems  to  me  that  your 
suggestion  should  be  accepted,  and  that  the  sheets  should  be  handed 
over  as  they  are  approved. 

The  President.  Is  it  the  wish  of  the  convention  that  they  should 
be  on  parchment? 

Doctor  Guiteras.  I  do  not  think  so.  If  it  could  be  done  on  parch- 
ment it  would  be  better,  but  I  suppose  that  it  could  not  be  done. 

The  President.  It  might  be  possible. 

Doctor  Ulloa  here  addressed  the  convention. 

Doctor  Licéaga  addressed  the  convention  in  Spanish. 

The  President.  If  acceptable,  the  Spanish  copy  and  the  English 
copy  as  finished,  page  by  page,  will  be  handed  to  the  chief  clerk  of  the 
Bureau  of  the  American  Republics  for  preparation  on  parchment. 
I  think  there  are  some  of  the  sheets  that  have  been  finished  and  are 
ready  now. 

Doctor  Guiteras.  Yes. 

The  President  (after  informal  conversation  among  the  members). 
I  will  call  upon  Doctor  Guiteras  to  make  a  suggestion  as  to  the  pre- 
liminary part  of  this  paper  as  it  shall  be  transmitted  to  the  transcriber 
to  be  transcribed.  I  think  this  is  very  plain  now.  There  is  only  one 
other  subject  to  determine  upon  in  regard  to  the  mechanical  part  of  it, 
and  that  is  whether  we  shall  have  this  prepared  for  our  signatures 
upon  parchment  or  upon  typewritten  copies. 

The  remarks  of  the  president  were  translated  into  Spanish  by  Doc- 
tor Guiteras,  and  informal  conversation  among  the  members  followed. 

The  President.  You  understand  the  subject,  and  it  will  not  be  nec- 
essary to  put  it  to  a  vote.  Unless  there  is  some  objection,  that  will  be 
the  procedure,  that  the  first  part  of  the  document  presented  by  the 
committee,  having  been  edited  in  such  manner  as  is  satisfactory  to  the 
committee  and  in  a  proper  manner  for  its  transcription  by  the  tran- 
scriber, the  transcription  shall  be  typewritten  upon  good  heavy  paper, 
and  there  shall  be  one  copy  in  English  and  one  m  Spanish.  Also  that 
there  will  be  a  certificate  as  to  the  correctness  of  the  transcription 
from  one  copy  to  the  other. 


SECOND    INTKRNATIONAL    SANITARY    CONVENTION.  />.> 

The  remarks  of  the  president  were  translated  into  Spanish  by  Doc- 
tor Giiiteras. 

The  President.  Wo  will  now  proceed  with  the  reading  of  article  6. 
Doctor  Guiteras  read  article  6,  as  follows: 

Article  6.  It  is  imdorstood  that  neighboring  oountrics  rcHcrvc  to  thi'rnsclvfH  tho  right 
to  make  special  arrangomonts  with  a  viow  of  organizing  a  hi  rvicc  of  din-ct  infoiination 
between  the  chiefs  of  administration  on  the  frontitrs. 

Article  G  was  read  in  Spanish  by  Doctor  Moore. 

Doctor  Lavoreria  here  addressed  the  convention  in  Spanish. 

The  paragraph  was  agreed  to. 

Doctor  Guiteras.  We  now  come  to  section  2,  a  new  section.  The 
heading  is,  "Conditions  permitting  the  consideration  as  contaminated 
or  rendered  healthy  a  given  territorial  area."  That  does  not  mean 
anything. 

Informal  discussion  among  the  members  followed. 

Doctor  Guiteras.  We  have  made  that  read,  "Conditions  permit- 
ting a  given  territorial  area  to  be  considered  as  contaminated  or  as 
restored  to  health." 

Article  7.  Information  of  a  first  case  of  plague  or  cholera  or  yellow  fever  does  not  entail 
against  the  territorial  area  where  it  may  come  to  light  the  application  of  the  measures  pre- 
scribed in  chapter  2,  as  hereinafter  indicated. 

The  President.  The  word  "chapter"  is  used  there,  and  that  is  the 
first  time  I  have  heard  that  word  used. 

Doctor  Gatewood.  It  is  section  2  of  chapter  1. 

Doctor  Guiteras.  Yes,  that  is  it.  I  will  read  this  again  and  con- 
tinue it: 

Article  7.  Information  of  a  first  case  of  plague  or  cholera  or  yellow  fever  does  not  entail 
against  the  territorial  area  where  it  may  come  to  light,  the  application  of  the  measures  pre- 
scribed in  chapter  2,  as  hereinafter  indicated. 

Upon  the  occurrence  of  several  cases  of  plague  or  a  nonimported  case  of  yellow  fever,  or 
when  cases  of  cholera  form  a  focus,  the  area  is  to  be  declared  inf  jcted. 

Doctor  Guiteras.  Now,  I  wish  to  speak  on  this  a  moment.  I 
want  simply  to  have  it  brought  out  that  we  are  here  deciding  that 
one  case  of  nonimported  yellow  fever  is  going  to  declare  that  area 
infected.  I  am  sorry  to  say  that  I  have  not  a  very  positive  opinion 
on  this  point,  but  I  would  like  the  conference  to  think  of  the  matter 
and  decide  with  a  clear  understanding  that  this  is  right.  It  is  said 
that  several  cases  of  plague  must  exist  before  the  place  is  declared 
infected.  It  is  said  that  the  cases  of  cholera  must  be  sufficient  to 
make  a  focus  before  a  place  is  declared  infected.  Now,  we  are  going 
to  decide  that  a  single  case  of  yellow  fever  is  enough  to  cause  the 
place  where  it  is  to  be  declared  contaminated.  Certainly,  if  the 
modern  theory  of  the  transmission  of  yellow  fever  was  generally 
understood  and  all  were  willing  to  carry  out  the  measures  to  prevent 
the  spread  of  yellow  fever  that  our  present  knowledge  indicates,  I 
would  oppose  the  calling  of  a  place  infected  because  there  was  one 
single  case,  not  imported;  but,  as  there  is  considerable  doubt  as  to 
the  application  in  some  places  of  the  modern  doctrine  of  the  trans- 
mission of  yellow  fever,  I  am  rather  inclined  to  favor  the  retaining 
of  the  provision  that  one  single  case  of  yellow  fever  shall  be  enough 
to  make  a  place  infected.  I  would  like  to  hear  Doctor  Licéaga's 
opinion  on  that. 

The  remarks  of  Doctor  Guiteras  were  here  repeated  by  him  in 
Spanish. 


40  SECOND   INTERNATIONAL    SANITARY    CONVENTION. 

Doctor  Liceaga  here  addressed  the  convention  in  Spanish,  his 
remarks  being  translated  by  Doctor  L'lloa. 

Doctor  Liceaga  said  that  he  is  in  favor  of  the  article  just  as  it 
appears  in  the  convention,  because  he  is  fully  convinced  of  the  truth- 
fulness of  the  doctrine  of  mosquito  infection  for  yellow  fever,  and  he 
believes  that  a  single  case  of  yellow  fever  is  sufficient  to  infect  enough 
mosquitoes  to  produce  a  good  many  cases  of  the  disease.  And,  being 
determined,  as  we  are  to  extinguish  yellow  fever  ft'om  the  continent 
of  America,  he  thought  it  was  best  that  this  article  should  be  left  as 
it  is. 

The  President.  I  understand  that  the  extent  of  the  area  is  not 
mentioned,  or  has  not  been  mentioned  yet,  but  that  it  is  mentioned 
further  on,  and  therefore  for  a  thorough  imderstanding  of  the  point 
made  I  think  it  would  be  better  to  read  what  is  said  further  on  in 
regard  to  the  extent  of  the  infected  area,  and  then  come  back  to  this 
proposition  and  vote  upon  it. 

Doctor  GuiTERAS.  It  says  here  ''the  territorial  area."  That  is 
any  territorial  area,  no  matter  what. 

The  President.  Does  it  mean  a  house,  a  block,  or  an  acre? 

Doctor  GuiTERAS.  The  next  article  defines  it.     I  will  read  that. 

The  President.  Read  what  it  says  in  the  next  article. 

Doctor  GuiTERAS.  That  reads: 

By  the  word  "area"  is  understood  a  well-determined  portion  of  territory  in  the 
information  which  accompanies  or  follows  the  notiiicaticn.  Thus,  a  p^o^^^ce,  a  state,  a 
govermnent,  a  district,  a  department,  a  canton,  an  island,  a  commune,  a  city,  a  quarter  of 
a  city,  a  callage,  a  port,  a  polder,  or  a  hamlet,  whatever  may  be  the  extent  of  these  portions 
of  territory. 

The  President.  It  is  evident,  then,  from  this  clause  as  to  the 
information  of  the  infected  area,  that  it  is  to  be  indicated  and  that 
the  extent  of  the  area  shall  be  signified  promptly.  Have  you  fin- 
ished reading  that  article? 

Doctor  GuiTERAS.  We  have  discussed  the  question  of  whether  one 
case  of  yellow  fever  shall  be  considered  as  sufficient  reason  for  declar- 
ing an  area  contaminated,  and  the  Spanish-speaking  colleagues  of 
the  convention  seem  to  be  of  the  opinion  that  one  case  ought  to  be 
enough  to  cause  the  place  to  be  declared  infected. 

The  President.  I  believe  that  the  English-speaking  delegates  will 
concur  in  that. 

Doctor  GuiTERAS.  Then  it  stands  as  a  whole. 

Article  7  reads  as  follows: 

Akticle  7.  Information  of  a  first  case  of  plague  or  cholera  or  yellow  fever  does  not 
entail  against  the  territorial  area  where  it  may  come  to  light,  the  application  of  the  meas- 
ures prescribed  in  chapter  2,  as  hereinafter  indicated. 

Upon  the  occurrence  of  several  cases  of  plague  or  a  nonimported  case  of  yellow  fever,  or 
when  cases  of  cholera  form  a  focus,  the  area  is  to  be  declared  infected. 

Article  7,  as  read  by  Doctor  Guiteras,  was  here  translated  into 
Spanish  by  Doctor  Moore. 

The  President.  The  question  will  be  put  now  on  the  adoption  of 
this  article. 

The  question  was  taken  and  the  article  was  agreed  to. 

Doctor  GuiTERAS.  The  next  is  article  8. 

Article  8.  To  limit  the  measures  to  the  plague-stricken  regions  alone,  governments 
should  only  apply  them  to  those  growing  out  of  the  infected  or  contaminated  area. 


SECOND    INTERNATIONAL    SANITAKY    (JON VKNTION.  41 

The  note  heretofore  read  was  here  again  read  by  Doctor  Guiteras. 
Doctor  Guiteras  (reading) : 

But  this  restriction  limited  to  the  iiifrctcd  area  slioiild  only  Ijc  accfptcd  upon  tfif;  formal 
condition  that  the  government  oí  the  infected  couiitiy  should  take  tlie  nicessaiy  measures, 
first,  to  prevent,  by  means  of  preliniinary  disinfectifjn,  the  ailicles  named  in  aiiiclcs  1  and 
2  of  article  12  emanating  from  the  infected  area. 

Doctor  Ulloa.  What  is  that  ? 

Doctor  Guiteras.  How  can  you  prevent  the  articles  emanating 
by  means  of  disinfection? 

Doctor  Ulloa.  It  means  the  prevention  of  the  objects  going  from 
the  contaminated  area.  Make  it  read  "objects"  instead  of  "ar- 
ticles. " 

Doctor  Guiteras.  Do  you  prevent  them  from  emanating  by  dis- 
infection? No.  It  says  to  prevent  them  from  emanating  from  the 
area  by  a  preliminary  disinfection.  That  is  not  right.  And  yet  I 
see  it  is  so  in  the  French  translation,  too.  It  reads  there  "to  pre- 
vent by  a  preliminary  disinfection  the  importation  of  objects." 
That  is  very  strange.     It  is  certainly  not  right. 

Informal  discussion  among  the  members  of  the  convention  followed. 

Doctor  Guiteras.  We  have  made  it  read  as  follows: 

But  this  restriction,  Umited  to  the  infected  area,  should  only  be  accepted  upon  the  formal 
condition  that  the  government  of  the  infected  coimtry  should  take  the  necessary  precau- 
tions, first,  to  prevent,  unless  previously  disinfected,  the  exportation  of  articles  named  in 
articles  1  and  2  of  article  12  coming  from  the  contaminated  area. 

Then,  also,  further: 

And,  second,  measures  to  prevent  the  extension  of  the  epidemic. 

And  provided  further,  that  there  be  no  doubt  that  the  sanitary  authorities  of  the  infected 
country  have  faithfully  complied  with  article  1  of  this  convention. 

When  an  area  is  infected  no  restrictive  measure  is  to  be  taken  against  departures  from 
this  area  if  these  departures  have  occurred  five  days  at  least  before  the  beginning  of  the 
epidemic. 

Article  8  was  here  read  in  Spanish  by  Doctor  Moore. 

The  foregoing  article,  article  No.  8,  was  here  again  read  from  begin- 
ning to  end  by  Doctor  Guiteras  in  English,  and  w^as  also  again  read 
in  Spanish  by  Doctor  Moore. 

The  President.  You  have  heard  that  article  read  in  both  Spanish 
and  English.     Are  you  ready  for  the  question  ? 

The  question  was  taken,  and  the  article  was  agreed  to. 

Doctor  Geddings.  Mr.  Chairman. 

The  President.  Doctor  Geddings. 

Doctor  Geddings.  Mr.  President  and  gentlemen,  it  is  very  evident 
that,  owing  to  the  haste  with  which  this  proposed  convention  has 
been  prepared,  it  stands  in  serious  need  of  editing  in  order  to  perfect 
it,  and  we  are  sacrificing  the  time  of  the  whole  convention  by  making 
corrections  here  on  the  floor  of  the  convention  which  ought  to  be 
made  in  committee.  I  have  the  honor,  therefore,  sir,  to  move  that 
the  convention  do  now  adjourn,  and  that  the  text  of  this  convention 
,be  returned  to  the  committee  with  mstructions  to  edit  it  overnight, 
and  to  present  it  in  smooth  shape  to  the  convention  on  its  reassem- 
bling in  the  morning. 


42  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

The  motion  of  Doctor  Geddings  was  translated  into  Spanish  by 
Doctor  I'lloa. 

Doctor  Geddings.  And  I  might  add,  Mr.  President,  that  if  it  be 
convenient  and  agreeable  to  him,  I  would  move  that  Dr.  Eduardo 
Moore,  the  delegate  from  Chile,  be  added  to  that  committee  for  this 
purpose. 

The  additional  motion  of  Doctor  Geddings  was  translated  into 
Spanish  by  Doctor  Ulloa,  and  Doctor  Moore  signified  his  assent. 

The  President.  Are  there  any  remarks  on  this  motion  made  by 
Doctor  Geddings?     If  not,  I  will  put  the  motion. 

The  question  was  taken  and  the  motion  was  agreed  to. 

Thereupon,  at  5.25  o'clock  p.  m.,  the  convention  adjourned  until 
to-morrow,  October  13,  1905,  at  9.30  o'clock  a.  m. 


FOUETH  DAY— FRIDAY,  OCTOBER  13. 

Morning  Session. 

The  convention  was  called  to  order  by  the  president,  Surgeon- 
General  Wyman,  at, 10. 30  o'clock  a.  m. 

The  minutes  of  yesterday,  October  12,  1905,  were  read  by  the 
secretary,  and  as  read  were  agreed  to. 

The  President.  I  will  call  upon  the  chairman  of  the  advisory 
council  to  make  any  report  that  he  may  have  ready. 

The  following  was  read : 

f  The  council  recommends  that  the  vice-presidents  of  the  last  convention  be  continued  in 
oflBce,  excepting  when  the  representation  to  this  convention  is  diil'erent,  in  which  case  the 
new  delegates  are  to  take  the  place  of  the  previous  ones. 

In  the  case  of  the  Republics  which  were  represented  at  the  last  convention  and  which 
are  not  represented  at  the  present  convention  no  vice-presidents  shall  be  appointed;  and 
the  council  recommends  that  the  respective  delegates  from  the  countries  which  are  repre- 
sented at  this  convention  for  the  first  time  shall  be  appointed  as  vice-presidents  also. 

2.  That  the  International  Sanitary  Bureau  as  constituted  at  the  last  meeting  be  continued. 

3.  That  the  resolutions  presented  by  Doctor  Guiteras  concerning  the  printing  of  the 
5j000  copies  of  the  United  States  Pharmacopoeia  be  recommended  for  approval. 

Doctor  Guiteras.  The  editing  committee  is  now  ready  to  report 
on  the  convention. 

The  foregoing  recommendation  was  here  translated  into  Spanish 
by  Doctor  Moore. 

Doctor  Barnett.  I  move  that  the  report  be  adopted. 

The  motion  was  seconded. 

The  President.  Are  there  any  remarks.  If  not,  I  will  put  the 
motion. 

Doctor  Guiteras.  Mr.  Chairman. 

The  President.  Doctor  Guiteras. 

Doctor  Guiteras.  I  have  some  resolutions  to  offer  to  the  con- 
ference, as  follows: 

Whereas  the  Republic  of  Mexico  and  the  Panama  Canal  Zone,  by  the  application  of  the 
mosquito  doctrine  to  public  sanitation,  are  nearing  rapidly  the  desideratum  of  the  final 
extinction  of  yellow  fever;  and 

Whereas  the  Republic  of  Cuba,  by  the  application  of  the  same  methods  has  continued 
to  maintain  its  territory  free  from  yellow  fever;  and 

Whereas  the  lack  of  preparation  for  the  thorough  application  of  these  methods  'has 
been  the  cause  of  the  propagation  of  the  disease  in  vai-ious  territories;  and 

Whereas  in  the  city  of  NeW  Orleans  an  epidemic  which  had  been  unfortunately  allowed 
by  the  State  authorities  to  take  a  firm  foothold  has  been  held  in  check  and  gradually 
reduced  by  the  application  of  the  said  methods  in  the  midst  of  the  largest  nonimmune 
population  that  was  ever  exposed  to  ji^ellow  fever:  Therefore  be  it 

Resolved,  That  this  conference  sees  in  these  results  a  further  confirmation  of  the  view 
that  yellow  fever  is  naturally  transmitted  only  by  the  bite  of  an  infected  mosquito. 

2.  That  the  conference  is  of  opinion  that  an  eflSicient  plan  of  defense  against  the  propa- 
gation of  yellow  fever  at  the  beginning  of  an  epidemic  can  be  easily  established  upon  the 
basis  of  this  doctrine. 

3.  That  the  successful  carrying  out  of  such  plan  depends  upon  a  thorough  understanding 
of  the  mosquito  doctrine  by  the  people  and  upon  the  support  that  they  may  give  to  the 
prompt  and  frank  reporting  and  the  proper  handling  of  the  first  cases  and  of  all  suspicious- 
cases. 

43 


44  SECOND    INTEKNATIÜNAL    SANITARY    CONVENTION. 

4.  That  all  authorities  who  do  not  promptly  report  cases  of  yellow  fever  are  worthy  of  the 
censure  of  this  conference. 

5.  That  the  congratulations  of  the  conference  be  extended  to  the  Republics  of  Mexico  and 
Cuba  and  to  the  Canal  Zone  of  Panama  for  the  success  attained,  and  also  to  the  Public 
Health  and  Marine-Hospital  Service  for  the  brilliant  work  done  in  New  Orleans.  And  be 
it  further 

Besolyed,  That  in  the  opinion  of  this  conference  all  maritime  quarantines  and  the  manage- 
ment of  all  epidemics  that  threaten  to  extend  to  neighboring  States  and  countries  should  be 
placed  in  the  hands  of  the  national  health  authorities. 

The  President.  Those  resolutions  will  be  referred  to  the  advisory 
council.  Is  there  any  other  matter  to  come  before  the  convention 
before  we  proceed  to  the  articles  of  agreement  which  were  under 
consideration  when  we  adjourned  yesterday?  Has  any  delegate  any 
motion  to  make  ? 

Doctor  Ulloa  translated  the  questions  of  the  President  into 
Spanish. 

The  President.  If  there  are  no  remarks,  we  will  then  proceed 
with  the  reading  of  the  articles  of  the  convention  of  Paris,  wliich  it  is 
hoped  we  will  all  sign.  I  presume  it  would  be  pertinen,t  to  begin  with 
the  section  following  the  last  section  which  we  adopted,  and  the  pro- 
cedure will  be  the  same  as  before,  the  articles  of  the  convention  being 
read  in  English  and  in  Spanish. 

Doctor  Guiteras.  I  move  that  it  be  so  ordered. 

The  President.  If  we  are  all  ready,  then,  the  next  article  is 
article  9. 

The  following  was  read  by  Doctor  Guiteras : 

Article  9.  That  an  area  should  no  longer  be  considered  as  infected,  official  proof  must 
be  furnished,  first  that  there  has  been  neither  a  death  nor  a  new  case  of  plague  or  cholera 
for  five  days  after  isolation,  death,  or  cure  of  the  last  plague  or  cholera  case.  In  the  case  of 
yellow  fever  the  period  shall  be  eighteen  daj's,  but  each  government  may  presei-ve  the 
right  to  extend  this  period. 

Doctor  Guiteras.  There  is  a  note  here  defining  isolation,  which 
reads  as  follows : 

Note. — The  word  "isolation"  signifies  isolation  of  the  patient,  of  the  persons  who  care 
for  him  constantly,  and  the  forbidding  of  visits  of  all  persons,  the  physician  excepted. 

Mr.  Chairman,  I  suppose  that  if  I  have  any  remarks  to  make 
explanatory  of  this,  I  may  make  them  now  ? 

The  President.  Yes. 

Doctor  Guiteras.  I  may  say  in  a  general  way  that  we  have  avoided 
adding  anything  that  was  not  in  the  Paris  convention,  excepting  in 
regard  to  yellow  fever,  which  is  distinctively  American  business ;  but 
in  this  instance  we  have  something  to  say  in  regard  to  these  last 
words.  It  says,  "the  physician  excepted."  The  definition  given  in 
this  note  in  the  Paris  convention  actually  excludes  the  physician 
from  visiting  the  sick,  because  it  says  "isolation  of  the  patient,  of 
the  persons  who  care  for  him  constantly,  and  the  forbidding  of  visits 
of  all  persons."  That  would  include  in  this  exclusion  the  doctor, 
so  that  we  have  added  the  words,  "the  physician  excepted." 

This  reads  further : 

2.  That  all  the  measures  of  disinfection  have  been  applied;  in  the  case  of  plague  that  the 
precautions  against  rats  have  been  observed  and  in  the  case  of  yellow  fever  that  the  meas- 
ures against  mosc^uitoes  have  been  executed. 

Doctor  Moore  here  translated  into  Spanish  what  had  been  read  by 
Doctor  Guiteras. 


SKCOND    INTKIÍNATIONAL    HANITARY    CONVENTION.  45 

The  President.  We  agreed  yesterday  to  tlie  addition  of  something 
further  to  the  deñiiition  of  isolation,  which  [^y  an  oversi<;ht  has  not 
been  inchided  in  the  English  copy,  and  1  wish  to  add  it  now.  It  refers 
especially  to  yellow  fever.     To  the  note  defining  isolation  we  add : 

By  isolation,  in  the  caso  of  yellow  fever,  is  understood  the  isolation  of  the  patient  in  an 
apartment  ao  screened  as  to  prevent  the  access  of  mosquitoes. 

That  has  been  read  in  the  Spanish  copy  and  we  simply  forgot  yester- 
day to  put  it  into  the  Englisli  copy. 

The  Pkesident.  You  have  all  heard  this  read  in ,  Spanish  and 
English.  '  Are  there  any  remarks  ? 

Doctor  Ulloa.  I  have  to  difl'er  slightly  ÍTom  the  article  as  it  has 
been  read,  and  I  make  a  motion  to  the  effect  that,  with  regard  to 
plague,  the  article  should  be  left  as  it  reads  in  the  French  copy,  as  it 
was  agreed  to  by  the  Sanitary  Congress  in  Paris.  I  believe  in  exclud- 
ing the  physician  from  those  visits  because  he  may  carry  infection  the 
same  as  anybody  else. 

The  President.  Is  the  motion  of  Doctor  Ulloa  seconded? 

Doctor  GuiTERAS.  I  will  second  his  motion  for  purposes  of  dis- 
cussion. 

The  convention  was  here  addressed  in  Spanish  by  Doctor  Guiteras 
and  by  Doctor  Licéaga. 

The  President.  Doctor  Ulloa  will  now  interpret  Doctor  Licéaga's 
remarks  into  English. 

Doctor  Ulloa.  Doctor  Licéaga  said,  in  regard  to  my  motion,  that 
a  doctor  who  visits  a  case  of  plague  takes,  of  course,  all  the  necessary 
precautions  wliich  we  all  know  are  taken  with  respect  to  infectious 
diseases,  and  Doctor  Guiteras  added  that  of  course  it  would  be  better 
not  to  make  the  alteration  that  I  proposed,  because  doctors  are  called 
in,  and  have  to  be  called  in,  to  make  diagnoses  of  the  plague  in  many 
cases,  and  of  course  they  are  admitted  for  doing  so.  I  would  say,  in 
reply  to  these  statements,  that  there  must  have  been  some  reason 
why  the  convention  of  Paris  left  this  as  it  is  and  I  do  not  see  w^hy  we 
should  alter  that  article.  Of  course  I  have  great  respect  for  the  views 
of  men  like  Doctor  Guiteras  and  Doctor  Licéaga,  but  in  the  case  of 
plague  I  believe  that,  in  order  to  have  any  practical  effect  in  Spanish 
America,  the  cases  must  be  well  isolated  and  the  phj^sician  who  attends 
them  must  stay  v/ith  the  cases.  In  a  case  of  isolation,  of  course,  a 
doctor  could  come  in  and  be  disinfected  before  coming  into  contact 
with  others. 

Doctor  Guiteras.  He  could  not  come  in  at  all,  according  to  that 
•article.  According  to  that  he  could  not  do  that.  That  is  w'hat  we 
want  to  avoid,  and  according  to  the  language  here  no  visits  could  be 
allowed. 

The  President.  I  would  like  to  ask  Doctor  Geddings  for  his 
views  upon  this.  He  w^as  present  at  the  signing  of  the  Paris  con- 
vention. 

Doctor  Geddings.  I  was  present  at  the  signing  of  this  convention^ 
and  I  believe  that  the  language  used  in  that  note,  which  is  a  mere 
footnote,  was  left  as  it  is  by  a  pure  oversight.  But,  apart  from  that, 
as  one  interested  in  sanitary  science,  I  object,  and  as  a  physician  I 
protest,  with  all  respect  for  our  esteemed  colleague,  Doctor  LHloa, 
against  such  a  narrowing  of  the  professional  functions  of  a  physician 
as  is  implied  in  Doctor  Ulloa's  amendment.     For  3'ears  and  years, 


46  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

from  tlie  very  beginning  of  medicine,  physicians  have  regarded  it 
not  only  as  a  sacred  duty,  but  as  a  privilege,  to  visit  the  sick — sick 
with  whatever  disease  it  might  be — and  without  fear  for  themselves, 
and,  exercising  reasonable  precautions  in  regard  to  others,  they  have 
continued  to  give  their  ministrations;  and  I  ask  this  convention, 
com})osed  of  men  of  experience,  how  many  instances  are  known  to 
them  where  the  infection  of  any  of  the  communicable  diseases — small- 
pox, scarlet  fever,  plague,  measles,  and  so  on — has  been  conveyed  to 
the  public  outside  by  the  physician  leaving  the  sick  room? 

I  sincerely  hope  that  the  convention — this  conference — will  adhere 
to  the  language  of  this  footnote  as  ameiided  bj'"  the  committee,  and 
that  they  will  not  circumscribe  the  usefulness  and  the  dignity  and 
the  effectiveness  of  the  pltysician  b}*  demanding  that  each  case  of 
plague,  of  cholera,  or  of  yellow  fever  should  have  its  special  medical 
attendant,  vdio,  once  he  has  seen  him,  should  share  in  the  quarantine 
and  isolation  of  that  patient. 

The  President.  Ai'e  there  any  other  remarks  upon  this  motion  of 
Doctor  Ulloa  ?     If  not,  are  you  ready  for  the  question  ? 

The  question  upon  the  motion  of  Doctor  Ulloa  was  taken,  and  the 
motion  was  not  agreed  to. 

Doctor  Barnett  addressed  the  convention  in  Spanish,  and  his 
remarks  were  translated  by  the  secretary.  Doctor  Ulloa. 

Doctor  Barnett  proposed  that  tliis  note  should  be  amended  to  the 
effect  that  the  word  "constantly"  should  be  eliminated,  and  that 
there  should  be  included  in  that  any  person  affected  with  the  plague, 
if  it  was  only  for  a  few  hours,  because  the  danger  of  infection  would 
be  incurred  if  the  person  was  allowed  to  come  out. 

The  President.  For  the  benefit  of  the  stenographer  I  would  like 
to  have  Doctor  Guiteras  translate  and  put  into  proper  form  the 
motion  of  Doctor  Barnett. 

Doctor  Guiteras.  Doctor  Barnett's  motion  is  to  the  effect  that 
instead  of  reading,  "the  word  isolation  signifies  isolation  of  the  patient 
or  the  persons  who  care  for  him  constantly,"  and  so  on,  that  the 
word  "constantly"  should  be  stricken  out. 

Doctor  Guiteras.  I  second  the  motion  of  Doctor  Barnett. 

The  question  was  taken,  and  the  motion  was  agreed  to. 

The  President.  Are  there  any  further  remarks  on  this  article  ? 

Doctor  Lavoreria  here  addressed  the  convention  in  Spanish. 

Doctor  Guiteras.  Doctor  Lavoreria  sa3^s  that  he  does  not  rise  to 
make  an  objection,  but  he  wishes  to  have  explained  to  him  why  we 
have  fixed,  in  the  case  of  yellow  fever,  the  period  of  eighteen  days. 
With  3^our  permission  I  will  explain  that. 

The  President.  Doctor  Guiteras  will  explain  that. 

Doctor  Guiteras  here  addressed  the  convention  in  Spanish. 

The  President.  We  have,  unfortunately,  no  Spanish  stenogra- 
pher present  at  this  meeting.  Mr.  Fox,  the  Director  of  the  Bureau 
of  the  American  Republics,  tried  very  hard  to  get  one,  and  we  tried 
very  hard — others  of  us — to  get  one,  but  we  could  not  do  so,  and 
therefore  those  parts  of  the  proceedings  which  are  spoken  in  Spanish 
have  to  be  translated  into  English.  That  is  a  very  interesting  expla- 
nation which  Doctor  Guiteras  has  just  made,  and  I  think  that  it 
ought  to  be  translated  and  that  it  ought  to  appear  in  the  record. 
Will  you  translate  it  into  English,  Doctor  Guiteras  ? 


SECOND    INTERNATIONAL    HANITAKY    CONVENTION.  47 

Doctor  (JiTii'EiiAS.  I  fsliall  try  to  he  us  biici  as  possible.  The 
period  of  eighte(m  days  bas  been  fixed  uj)or)  as  tlie  number  of  days 
after  which,  witliout  the  presence  of  a  new  cas(i  of  yellow  fever,  the 
locality  may  be  considered  as  free  from  the  disease.  That  period  has 
been  fixed  upon  as  scientiiically  true,  taking  into  consideration  the 
extrinsic  period  of  incubation  and  the  intrinsic  p(;riod  of  incubation; 
.  that  is,  it  takes  twelve  days  after  the  inos(|uito  has  bitten  the  last 
person  aillicted  with  yellow  fever  bc^fore  it  is  ready  to  produce  a  new 
case.  It  bites  the  noninnnune  individual,  and  it  will  take  six  days 
before  tlmt  develops  in  tliat  individiuil.  '^I'welve  and  six  make  eight- 
een. So  that  after  the  expiration  of  eight(ien  days  we  should  con- 
sider any  place  free  from  yellow  fever.  We  are  dealing  witli  a  single 
locality,  of  course.  Take,  for  instance,  the  case  of  Tampa,  Fla.  After 
eighteen  days  I  considered  Tampa  to  be  free  from  yellow  fever;  we 
were  sure,  and  there  was'  no  doubt  about  it. 

Now,  we  have  added  here  the  provision  that  the  authorities  may 
extend  that  period  of  expectancy  or  waiting  before  declaring  the 
place  free  from  yellow  fever;  that  they  may  extend  it  ad  libitum, 
because  we  have  considered  that  at  certain  places  where  yellow  fever 
regularly  prevails — that  is,  is  endemic — the  number  of  immune  people 
is  so  great  that  there  might  be  a  large  number  or  a  quite  consid- 
erable number  of  mosquitoes  still  lurking  in  that  locality  without 
invoking  the  yellow  fever,  because  of  the  immunity  of  the  inhab- 
itants, and  we  might  be  surprised  at  any  time  by  a  case  of  yellow 
fever.  We  have  therefore  allowed  this  freedom  to  the  authorities  to 
extend  this  period — to  extend  it  the  whole  length  of  the  yellow  fever 
season,  or  the  whole  summer,  if  they  desire.  At  any  rate,  we  have 
given  them  the  freedom  to  extend  this  period. 

The  President.  It  seems  to  me  this  explanation  is  very  clear. 
There  is  one  question  I  would  like  to  ask  of  Doctor  Guiteras,  and  that 
is  whether  the  matter  of  the  appearance  of  frost  is  to  be  considered 
in  this  connection.  As  I  understand  it,  you  have  a  period  prescribed 
here  of  eighteen  days.  It  is  customary  in  the  United  States,  as  soon 
as  frost  appears,  to  stop  all  precautionary  measures. 

Doctor  Guiteras.  The  time  may  be  less,  at  the  option  of  the 
authorities.     It  is  left  in  that  way. 

The  President.  Are  there  any  further  remarks  upon  this  article? 
Does  anyone  wish  to  make  a  motion?  If  not,  the  article  itself  is 
before  the  convention  for  adoption. 

The  article  was  agreed  to. 

The  President.  The  article  is  adopted.     The  next  is  chapter  2. 

Doctor  Guiteras  (reading): 

Chapter  2.  Measures  of  defense  by  other  countries  against  territories  declared  infected. 

Sec.  1.  Publication  of  prescribed  measuies. 

AiiTicLE  10.  The  Government  of  each  country  is  obliged  to  immediately  publish  the 
measures  which  it  believes  necessary  to  take  against  departures,  either  from  a  country  or 
from  an  infected  territorial  area.  The  said  Government  is  to  conunrmicate  at  once  this 
publication  to  the  diplomatic  or  consular  agents  of  the  infected  country  residing  in  its  cap- 
ital, as  well  as  to  the  International  Sanitary  Bureau. 

The  Government  shall  be  equally  obliged  to  make  known  thi-ough  the  same  channels  a 
revocation  of  these  measures,  or  modifications  which  may  be  made  in  them.  In  the  default 
of  a  diplomatic  or  consular  agency  in  the  capital,  communications  are  made  directly  to  the 
Government  of  the  country  interested. 

The  preceding  article  was  here  read  in  Spanish  by  Doctor  Moore. 
The  President.  Are    there    any    comments    on    this?     Are    you 
ready  for  the  question  as  to  adopting  this  article  ? 


48  SECOND    INTERNATIONAL    SANITARY    COIS^VENTION. 

The  article  was  agreed  to. 
Doctor  GuiTEKAS.  The  next  is: 

Section  2.  Merchandise,  disinfection,  importation,  and  transit;  baggage. 

Article  11.  Tlierc  exists  no  merchandise  which  is  of  itself  capable  of  transmitting  plague, 
cholera,  or  yellow  fever.  It  only  becomes  dangerous  in  case  it  is  soiled  by  festous  or  chol- 
eraic products,  or,  in  case  of  yellow  fever,  when  such  merchandise  may  harbor  mosquitoes. 

Article  11  was  here  read  in  Spanish  by  Doctor  Moore. 
The  President.  The  article  is  now  oefore  the  convention.     Are 
there  any  further  remarks? 
The  article  was  agreed  to. 
Doctor  GuiTERAS  (reading): 

Article  12.  No  merchandise  or  objects  shall  be  subjected  to  disinfection  on  account  of 
yellow  fever,  but  in  cases  covered  by  the  previous  paragraph  the  vehicle  of  transportation 
may  be  subjected  to  fumigation  to  destroy  mosquitoes. 

In  the  case  of  cholera  and  plague,  disinfection  should  only  be  applied  to  merchandise 
and  objects  which  the  local  sanitary-  authority  considers  as  infected. 

Doctor  GuiTERAS.  This  article  is  rather  important,  and  I  shall  ask 
that  it  be  divided  into  paragraphs.     I  will  read  it  again. 
The  President.  Verj^  well. 
Doctor  GuiTERAS.  This  reads: 

In  cases  covered  by  the  previous  paragraph 

That  is,  that  mosquitoes  might  be  harbored 

the  vehicle  of  transportation  may  be  subjected  to  fumigation  to  destroy  mosquitoes. 

In  the  case  of  cholera  and  plague,  disinfection  should  only  be  applied  to  merchandise 
and  objects  which  the  local  sanitary  authority  considers  as  infected. 

The  above  article  was  read  in  Spanish  by  Doctor  Moore. 
The   President.  You   have   heard   these   two   paragraphs   read. 
Are  there  any  remarks?     If  not,  we  will  vote  upon  them. 
The  two  preceding  paragraphs  of  article  12  were  agreed  to. 
Doctor  GuiTERAS.  The  next  reads.: 

Nevertheless,  merchandise  or  objects  enmnerated  hereafter  may  be  subjected  to  disin- 
fection or  prohibited  entr^'  independently  of  all  proof  that  they  may  or  may  not  be  infected. 

1.  Body  linen,  wearing  apparel  in  use,  clothing  which  has  been  worn,  bedding  already 
used.  When  these  objects  are  transported  as  baggage  or  in  the  course  of  a  change  of  resi- 
dence (household  fm-niture)  they  should  not  be  pTohibited,  and  are  to  be  subjected  to  the 
regulations  prescribed  by  article  19.  Baggage  left  by  soldiers  and  sailors  and  returned  to 
their  country  after  death  are  considered  as  objects  comprised  in  the  first  paragraph  of  No. 
1  of  this  article. 

2.  Rags  and  rags  for  making  paper,  with  the  exception  as  to  cholera  of  rags  which  are 
transported  as  merchandise  in  large  quantities,  compressed  in  bales  held  together  by  hoops. 
New  clippings  coming  directly  from  spinning  mills,  weaving  mills,  manufactories,  or  bleach- 
eries,  shoddy,  and  clippings  of  new  paper,  should  not  be  forbidden. 

The.  above  was  read  in  Spanish  by  Doctor  Moore. 

The  President.  That  is  the  close  of  article  12? 

Doctor  GuiTERAS.  Yes,  sir.     ■ 

After  discussion  in  Spanish,  several  verbal  changes  were  made  in 
the  Spanish  version,  and  the  article  was  again  read  in  Spanish,  as 
altered,  by  Doctor  Moore. 

The  President.  It  has  been  read  as  amended,  then? 

Doctor  GuiTERAS.  Yes,  sir. 

The  President.  Are  there  any  remarks?  If  not,  I  presume  that 
you  are  ready  for  the  question  on  the  adoption  of  this  article  as  read — 
as  finally  prepared  here  in  Spanish  and  presented  in  English. 

The  article  was  agreed  to. 


RÍXJOND    INTERNATIONAL    BANÍTAKY    (JONVKNTION.  49 

Doctor  GuiTERAS.  Article  13  reads  as  follows: 

Article  13.  In  the  case  of  cholera  and  plague  there  is  no  reason  to  forbid  the  transit 
through  an  infected  district  of  merchandise,  and  the  objects  specified  in  Nos.  1  and  2  of 
the  preceding  article,  if  they  are  so  baled  that  they  can  not  have  been  exposed  to  infection 
in  transit. 

In  like  manner,  when  merchandise  or  objects  are  so  transported  that  in  transit  tliey  can 
not  corno  in  contact  with  soiled  objects,  their  transit  across  an  infected  teiritorial  area 
should  not  be  an  obstacle  to  their  entry  into  the  country  of  destination. 

Doctor  Ulloa.  I  would  suggest  the  changing  of  that  word  "baled" 
to  "packed."     They  can  not  bale  everything. 

Docttir  GuiTEiiAS.  Shall  we  substitute  "packed"?  What  do  you 
say,  Doctor  Geddings? 

Doctor  Geddings.  I  should  say  the  proper  word  was  "packed," 
I  thought  so  when  it  was  being  read. 

Doctor  GuiTERAS.  The  committee  will  accept  the  suggestion  of 
Doctor  Ulloa,  and  change  that  to  "packed."  , 

The  article  as  amended  was  agreed  to.  ■ 

Doctor  GuiTERAS.  I  will  read  the  next  article: 

AnTicLE  14.  The  entry  of  merchandise  and  objects  specified  in  Nos.  1  and  2  of  article  12 
should  not  be  prohibited  if  it  can  be  shown  to  the  authorities  of  the  country  of  destination 
that  they  were  shipped  at  least  five  days  before  the  beginning  of  the  epidemic. 

Article  14  was  agreed  to. 

Doctor  GuiTERAS.  Article  15  reads  as  follows: 

Aeticle  15.  The  method  and  place  of  disinfection,  as  well  as  the  measures  to  be  employed 
for  the  destruction  of  rats,  are  to  be  fixed  by  authoritj'  of  the  country  of  destination.  These 
operations  should  be  performed  in  such  a  manner  as  to  cause  the  least  possible  injury  to 
the  objects. 

It  devolves  upon  each  State  to  determine  questions  relative  to  the  payment  of  damages 
resulting  from  disinfection  or  from  the  destruction  of  rats.  If  taxes  are  levied  by  a  sanitary 
authority,  either  directly  or  through  the  agency  of  any  company  or  agent,  to  insure  meas- 
ures for  the  destruction  of  rats  on  board  ship,  the  amount  of  these  taxes  ought  to  be  fixed 
by  a  tariff  published  in  advance,  and  the  result  of  these  measures  should  not  be  a  soiu-ce  of 
profit  for  either  State  or  sanitary  authorities. 

The  President.  Are  there  any  comments  on  this  article  as  read? 

Discussion  in  Spanish  between  the  members  followed. 

Doctor  GuiTERAS.  I  will  translate  the  remarks  made  by  the  gen- 
tleman from  Ecuador  (Doctor  Alcivar),  who  suggests  the  introduc- 
tion here  of  the  word  "mosquitoes."  He  suggests  the  addition  of  the 
words  "and  mosquitoes,"  so  that  it  will  read  as  follows: 

Ajiticle  15.  The  method  and  place  of  disinfection,  as  well  as  the  measures  to  be  employed 
ror  the  destruction  of  rats  and  mosquitoes,  are  to  be  fixed  by  authority  of  the  country  of 
destination.  These  operations  should  be  performed  in  such  a  manner  as  to  cause  the  least 
possible  injury  to  the  objects. 

The  Preside-nt.  As  I  understand,  this  is  a  resolution  made  by  Doc- 
tor Alcivar  that  it  should  read  in  that  way  ? 

Doctor  GuiTERAS.  Doctor  Alcivar  makes  that  suggestion.  He 
moves  that  the  words  "and  mosquitoes"  be  introduced  in  connec- 
tion with  the  destruction  of  rats  wherever  those  words  occur,  so  as 
to  make  it  read  "rats  and  mosquitoes"  in  article  15,  so  that  that 
article  will  read : 

The  method  and  place  of  disinfection,  as  well  as  the  measures  to  be  employed  for  the 
destruction  of  rats  and  mosquitoes,  are  to  be  fixed  by  the  authority  of  the  country  of  des- 
tination upon  arrival  at  said  destination.  These  operations  should  be  performed  in  such 
a  manner  as  to  cause  the  least  possible  injury  to  the  merchandise. 

5610—06 4 


50  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

It  devolves  upon  each  State  to  determine  questions  relative  to  the  pajnnent  of  damages 
resulting  from  disinfection  or  from  the  destruction  of  rats  or  mosquitoes.  If  taxes  are 
levied  by  a  sanitary  authority,  either  directly  or  through  the  agency  of  any  company  or 
agent,  to  insure  measures  for  the  destruction  of  rats  and  mosquitoes  on  board  ship,  the 
amount  of  these  taxes  ought  to  be  fixed  by  a  tariff  publislied  in  advance,  and  the  result  of 
these  measm-cs  should  not  be  a  source  of  profit  for  either  State  or  sanitary  authorities. 

Article  15  was  here  read  in  Spanish  by  Doctor  Moore. 

The  President.  Are  you  ready  for  the  question  ? 

Doctor  Lavoreria  here  addressed  the  convention  in  Spanish,  liis 
remarks  being  translated  hj  Doctor  Ulloa. 

Doctor  Lavoreria  said  that  this  was  a  question  of  translation,  of 
fixing  in  clear  terms  the  meanino-  of  the  article  in  Spanish.  He  said 
that  in  Spanish  two  mterpretations  could  be  given  to  that  article. 
Some  might  understand  that  the  country  to  which  the  merchandise 
was  going  might  authorize  the  country  from  which  the  merchandise 
came  to  use  certain  disinfections,  but  the  proper  way  would  be  for 
the  country  from  which  the  merchandise  comes  to  put  in  force  the 
measures  to  disinfect  those  articles.  He  said  that  he  thought  it  was 
chiefly  a  question  of  interpretation. 

Doctor  GuiTERAS.  The  question  is  a  delicate  one,  and  to  make  it 
perfectly  clear  I  will  give  you  an  example.  Say,  for  example,  that 
we  understand  that  this  means  that  if  Peru  has  the  plague,  Chile 
should  tell  Peru  how  she  should  handle  these  tilings. 

The  President.  Is  that  your  understanding? 

Doctor  GuiTERAS.  That  is  my  understanding.  It  says :  ''The  place 
and  method  of  disinfection,  as  well  as  the  measures  to  be  emploj^ed 
for  the  destruction  of  rats  and  mosquitoes  are  to  be  fixed  by  authority 
of  the  country  of  destination." 

In  things  coming  from  Cuba  to  the  United  States  you  will  have 
to  tell  Cuba  how  she  should  disinfect,  and  I  think  that  is  right.  You 
should  object  if  Cuba  is  not  disinfecting  things  properly.  You  will 
refuse  to  receive  the  things  unless  they  are  disinfected  there  accord- 
ing to  your  notion,  and  we  will  do  the  same  thino-  with  you.  If 
things  are  not  being  disinfected  accordino-  to  our  views,  which  are 
coming  from  the  United  States,  we  will  object,  and  therefore  we  will 
force  you  to  do  the  thing  in  the  proper  way. 

I  am  trying  to  make  it  clear.  I  am  not  discussing  the  q^uestion 
as  yet.  I  am  simply  trjing  to  make  it  clear.  I  have  not  given  an 
opinion,  and  I  do  not  know  whether  I  can  give  one. 

Discussion  in  Spanish,  participated  in  by  Doctors  Licéaga.  Medina, 
Guiteras,  and  Moore,  followed  at  this  point. 

The  Secretary.  Here  I  have  a  translation  of  this  convention  which 
says:  "It  rests  with  the  authority  of  the  country  to  which  the  arti- 
cles are  consigned  to  decide  in  what  manner  and  at  what  place  the 
disinfection  shah  be  carried  out,"  etc.  I  tliink  by  simply  adding 
the  words  "of  this  country"  that  will  fix  it. 

Doctor  Guiteras.  "On  arrival."  It  means  that  the  country  that 
receives  the  goods  will  decide  how  it  will  manage  them,  and  I  think 
it  is  necessary  to  add  "upon  arrival." 

The  President.  Is  there  a  motion  before  the  convention? 

Doctor  Guiteras.  There  is  no  motion.. 

Further  discussion  in  Spanish  followed. 

Doctor  Guiteras  here  read  article  15  in  English  as  amended. 

Doctor  Moore  read  the  article  in  Spanish  as  amended. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  51 

Doctor  GuiTERAS.  That  is  plain  now. 

Article  15  was  agreed  to. 

Doctor  GuiTERAS.  Article  16  roads: 

AiiTiCLE  16.  Lottors  and  correspondence,  printed  matter,  books,  newspapers,  business 
papers,  etc.  (postal  parcels  not  included),  are  not  to  be  submitted  to  any  restriction  or 
disinfection.  In  case  of  yellow  fever  postal  parcels  are  not  to  be  subjected  to  any  restric- 
tions or  disinfection. 

Article  16  was  read  in  Spanish  by  Doctor  Moore. 

Ai'ticle  16  was  agreed  to. 

Doctpr  GuiTERAS.  The  next  article  reads: 

Article  17.  Merchandise  arriving  by  land  or  by  sea  should  not  be  retained  at  fron- 
tiers or  in  ports. 

Measures  which  it  is  permissible  to  prescribe  with  respect  to  them  are  specified  in  arti- 
cle 12. 

Nevertheless,  when  merchandise  arriving  by  sea  in  bulk  (vrac),  or  in  defective  bales, 
is  contaminated  by  pest-stricken  rats  during  the  passage,  and  is  incapable  of  being  disin- 
fected, the  destruction  of  the  germs  may  be  assured  by  putting  said  merchandise  in  a 
warehouse  for  a  period  to  be  decided  by  the  sanitary  autliorities  of  the  port  of  arrival. 

It  is  to  be  understood  that  the  application  of  this  last  measure  should  not  entail  delay 
upon  any  vessel  nor  extraordinary  expeases  resulting  from  the  want  of  warehouses  in 
ports. 

Article  17  was  here  read  in  Spanish  by  Doctor  Moore. 

The  President.  Are  there  any  comments  or  any  resolutions  to  be 
offered  on  this  article? 

Doctor  Lavoreria  addressed  the  convention  in  Spanish. 

Doctor  GuiTERAS.  Does  anyone  here  know  exactly  what  the  term 
"vrack"  means?  In  the  Spanish  translation  they  have  copied 
it  as  it  was  in  the  French  copy. 

Doctor  Geddings.  It  means  "in  bulk." 

Doctor  GuiTERAS.  It  says  "in  vrac,  or  imperfectly  packed." 

Doctor  Geddings.  It  means  not  packed,  or  imperfectly  packed. 

Doctor  GuiTERAS.  In  bulk,  or  in  defective  bales. 

Doctor  Geddings.  Defective  packages,  it  ought  to  be. 

Doctor  GuiTERAS  (reading) : 

Article  ¥7.  Merchandise  arriving  by  land  or  by  sea  should  not  be  retained  at  frontiers 
or  in  ports. 

The  President.  May  I  interrupt  you  to  ask  the  distinction 
between  "detained"  and  "retained?" 

Doctor  GuiTERAS.  As  I  understand  it,  "retained"  means  per- 
manently, whereas  "detained"  means  only  temporarily.  I  do  not 
know  whether  I  am  right  on  that.  I  do  not  know  whether  tliis  is 
really  so.  We  are  using  the  French  authority  for  it.  They  use 
"retinue;"  but  when  they  mean  for  a  limited  time  they  use  the 
word  "detinue." 

The  President.  That  word  is  not  a  sufficient  word  in  the  English 
language,  if  that  is  the  idea.  Doctor  Stiles  remarks  that  in  French 
that  really  means  "embargo." , 

Doctor  GuiTERAS.  Shall  we  say  "detained  permanently,"  then? 

The  President.  I  think  that  would  be  better. 

Doctor  GuiTERAS.  Very  well,  we  will  make  it  read  "detained 
permanently." 

I  will  read  it  again. 

Article  17.  Merchandise  arriving  by  land  or  by  sea  should  not  be  detained  perma- 
nently at  frontiers  or  in  ports. 

Measures  which  it  is  permissible  to  prescribe  with  respect  to  them  are  specified  in  article  12. 


52  SECOND    IXTERNATl(i>JAL    SANlTxVRY    CONVENTiON. 

Xevcrtheless,  when  merchandise  arriving  by  sea  in  bulk  (vrac)  or  in  defective  packages 
is  contaminated  by  pcst-stricken  rats  during  the  passage  and  is  incapable  ol'  being  disin- 
fected, the  desti-uction  of  the  germs  may  be  assured  by  putting  said  merchandise  in  a 
warehouse  for  a  period  to  be  decided  b}'  the  sanitary  authorities  of  the  poi-t  of  anival 

It  is  to  be  underetood  that  tlie  application  of  this  last  measure  should  not  entail  delay 
upon  any  vessel  nor  extraordinary  expenses  resulting  from  the  want  of  warehouses  in  ports. 

Article  17  was  read  in  Spanish  by  Doctor  Moore. 

Article  17  was  agreed  to. 

Doctor  GuiTERAS.  In  the  Spanish  copy,  in  article  17  they  have 
preserved  the  word,  in  brackets,  "[vrac],"  so  that  it  shall  be  known 
to  be  the  French.     I  wish  to  put  it  in. 

Article  IS  reads: 

Article  i^.  "Wlicn  merchandise  has  been  disinfected  by  the  application  of  the  measures 
prescribed  in  article  12  or  put  temporarily  in  warehouses  in  accordance  with  the  third 
paragrp.ph  of  article  17,  the  owner  or  his  representative  has  the  right  to  demand  from  the 
sanitary  authority  which  has  ordered  such  disinfection  a  certificate  setting  forth  the 
measures  taken. 

Article  18  was  read  in  Spanish  by  Doctor  Moore. 

The  President.  You  have  heard  the  article  read.  If  there  are  no 
remarks,  we  will  vote  upon  it. 

Article  18  was  agreed  to. 

Doctor  Geddings.  Mr.  Chairman,  I  would  like  to  speak  of  this 
article  18.     It  says — 

When  merchandise  has  been  disinfected  by  the  application  of  the  measures  prescribed 
in  article  12  or  put  temporarily  in  warehouses  in  accordance  with  the  third  paragraph  of 
article  12,  the  owner  or  his  representative  has  the  right  to  demand  from  the  sanitary 
authority  which  has  ordered  such  dismfection  a  certificate  setting  forth  the  measures 
taken. 

I  suggest  that  it  should  read  "such  disinfection  or  deposit." 

Doctor  GuiTERAS.  "Which  has  ordered  such  disinfection  or 
deposit."     I  find  that  this  is  in  the  Spanish  version  already. 

The  question  was  taken  upon  the  amendment  proposed  by  Doctor 
Geddings,  and  it  was  agreed  to. 

Doctor  Guiteras  here  read  article  19,  as  follows: 

Article  19.  Baggage.  In  the  case  of  soUed  linen,  bed  clothing,  clothing,  and  objects 
forming  a  part  of  baggage  or  furniture  coming  from  a  territorial  area  declared  con- 
taminated, disinfection  is  only  to  be  practiced  in  cases  where  the  sanitary  authority 
considers  them  as  contaminated.  There  shall  be  no  disinfection  of  baggage  on  account 
ofj yellow  fever.  ^ 

The  President.  Before  the  Spanish  is  read  I  would  like  to  call 
the  attention  of  Doctor  Geddings,  who  is  the  representative  of  that 
committee,  to  the  French  translation — which  is  very  good,  by  the 
way — where  they  use  the  word  "  local  area." 

Doctor  Gatewood.  The  word  "area"  is  defined.  Why  not  sub- 
stitute it  for  the  words  "territorial  area?"  Territorial  area  is  not 
defined. 

Doctor  Guiteras.  It  says  "territorial  area."  The  definition  has 
said  that  an  area  was  a  territory. 

Doctor  Gatewood.  "Area"  was  defined. 

Doctor  Guiteras.  It  was  defined  as  a  territory,  an.area,  a  village, 
or  any  one  of  the  tilings  which  it  might  be.  Among  the  others 
"territory"  was  included. 

Doctor  Gatewood.  Why  not  use  the  word  "area?" 

Doctor  Guiteras.  Shall  I  read  it  again? 

The  President.  Read  it  again. 


SECOND    INTKUNATIONAL    SANI'i'AKY    CONVENTION.  58 

Doctor  GuiTERAs.  It  reads: 

In  the  case  of  soilod  linon,  bed  clotliing,  clothing,  and  oljjects  forming  a  part  of  baggage 
or  furniture  coming  from  a  territorial  area  decJarcd  contaminated,  disinfection  is  only  to 
be  practiced  in  cases  when  the  sanitary  authority  considers  them  as  contaminated.  There 
shall  be  no  disinfection  of  baggage  on  account  of  yellow  fever. 

Article  19  was  read  in  Spanish  })y  Doctor  Moore. 
The  PnESiDENT.  I  would  like  to  ask  Doctor  Gcddings  if  he  is 
satisfied  with  that  in  its  present  form? 

Doctor  Geddings.  I  am  satisfied  with  that — ''territorial  area." 
Article  19  was  agreed  to. 
Doctor  Guiteras  read  as  follows: 

Section  3.  Measures  in  ports  and  at  maritime  frontiers. 

Abticlb  20.  Classification  of  ships.  A  ship  is  considered  infected  which  has  plague, 
cholera,  or  yellow  fever  on  board,  or  which  has  presented  one  or  more  cases  of  plague  or 
cholera  within  seven  days  or  a  case  of  yellow  fever  at  any  time  during  the  voyage. 

The  above  was  read  in  Spanish  by  Doctor  Moore. 

Discussion  in  Spanish  between  the  members  of  the  convention 
followed. 

Doctor  Guiteras.  We  have  been  discussing  merely  a  verbal 
correction,  which  is  understood  in  the  Spanish. 

The  above  part  of  article  20  was  again  read  by  Doctor  Moore  in 
Spanish. 

The  part  of  article  20  already  read  was  agreed  to.  Doctor  Guiteras 
read  as  f ollow^s : 

A  ship  is  considered  as  suspected  on  board  of  which  there  has  been  a  case  or  cases  of 
plague  or  cholera  at  the  time  of  departure  or  during  the  voyage,  but  no  new  case  ■s\ñthin 
seven  days;  also  such  ships  as  have  lain  in  such  proximity  to  the'  infected  shore  as  to 
render  them  liable  to  the  access  of  mosquitoes. 

The  above,  read  by  Doctor  Guiteras,  was  here  read  in  Spanish  by 
Doctor  Moore. 

That  part  of  article  20  last  read  in  English  and  Spanish  was  agreed  to. 

Doctor  Guiteras.  The  last  paragraph  of  article  20  reads  as 
follows : 

The  ship  is  considered   indemne  which,  although  coming  from    an  infected  port,  has 

had  neither  death  *nor  case  of  plague,  cholera,  nor  yellow  fever  on  board,  either  before 

(  departure,  during  the  voyage,  or  at  the  time  of  arrival,  and  which  in  case  of  j-ellow  fever 

has  not  lain  in  such  proximity  to  the  shore  as  to  render  it  hable  to  the  access  of  mosquitoes. 

I  think  that  should  read —  i 

in  such  proximity  to  the  shore  as  to  render  it  Hable,  in  the  opinion  of  the  authorities,  to 
the  access  of  mosquitoes. 

Discussion  in  Spanish  between  the  members  of  the  convention 
followed. 

Doctor  Guiteras.  The  gentleman  from  Ecuador  objects  to  this 
last  paragraph.  That  is,  he  desires  to  discuss  it,  in  regard  to  mdemne 
ships. 

The  President.  Then  it  mil  be  necessary  for  him  to  make  some 
motion. 

Doctor  Guiteras.  He  asks  for  an  explanation,  and  I  am  not  able 
to  give  it.  He  asks  whether  a  ship  wall  be  considered  indemne 
which  has  made  a  trip  of,  say,  only  one  day  from  a  port  in  Mexico 
to  a  port  in  Texas,  or  vice  versa — very  close  across  a  frontier — after 
it  has  left  an  infected  port.  Would  5^ou  consider  that  ship  indemne 
because  it  has  had  no  case  or  cases  of  cholera,  yellow  fever,  or  plague 


54  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

on  board  ?  You  see  there  will  liave  been  but  one  day  for  "a  case  of 
ñnj  disease  to  develop. 

The  President.  That  evidently  was  not  considered. 

Doctor  GuiTERAS.  It  was  not  considered  in  the  Paris  conference, 
I  should  say. 

Discussion  in  Spanish  followed. 

Doctor  GuiTERAS.  We  are  ready  for  a  vote  on  the  last  paragraph 
of  article  20. 

The  last  paragraph  of  article  20  was  agreed  to. 

The  President.  Article  20  being  finished,  we  should  now  take  a 
vote  on  the  whole  article,  as  read  and  adopted  by  paragraphs. 

Article  20  as  a  whole  was  agreed  to. 

Doctor  GuiTERAS.  Article  21  reads: 

Akticle  21.  Ships  infected  with  plague  are  to  be  subjected  to  the  following  regulations': 

1.  Medical  visit  (inspection). 

2.  The  sick  are  to  be  immediately  disembarked  and  isolated. 

3.  Other  persons  should  also  be  disembarked,  if  possible,  and  subjected  to  an  observa- 
tion 1  which  should  not  exceed  five  days,  dating  from  the  day  of  arrival. 

Then  there  is  a  footnote  to  explain  what  "observation"  means, 
which  reads  as  follows: 

Q)  The  word  observation  signifies  isolation  of  the  passengers  either  on  board  ship  or  at 
a  sanitary  station  before  being  given  free  pratique. 

Article  21  continues: 

4.  Soiled  linen,  personal  efl'ects  in  use,  the  belongings  of  crew^  and  passengers  which,  in 
the  opinion  of  the  sanitary  authorities,  are  considered  as  infected  should  be  disinfected. 

Then  there  is  a  footnote  explaining  what  the  term  "crew"  means, 
which  reads  as  follows : 

(2)  The  term  crew  is  applied  to  persons  who  may  make,  or  who  have  made,  a  part  of  the 
personnel  of  the  vessel,  and  of  the  administration  thereof,  including  stewards,  waiters, 
"cafedii,"  etc.  The  word  is  to  be  construed  in  this  sense  wherever  employed  in  the  present 
convention. 

Then  the  balance  of  article  21  reads: 

5.  The  parts  of  the  ship  which  have  been  inhabited  by  those  stricken  with  plague,  and 
such  others  as,  in  the  opinion  of  the  sanitaiy  authorities,  are  considered  as  infected  should 
be  disinfected.  • 

6.  The  destruction  of  rats  on  shipboard  should  be  efl'ected  before  or  after  the  discharge 
of  cargo,  as  rapidly  as  possible,  and  in  all  cases  with  a  maximum  delaj^  of  forty-eight  hours, 
care  being  taken  to  avoid  damage  to  meif;handise,  the  vessel,  and  its  machineiy. 

For  ships  in  ballast  this  operation  should  be  performed  immediately  before  taking  on 
cargo. 

Discussion  in  Spanish  followed. 

Article  21  was  read  in  Spanish  by  Doctor  Moore. 

Article  21  was  agreed  to. 

Article  22  was  read  by  Doctor  Guiteras,  as  follows : 

Article  22.  Ships  suspected  of  plague  are  to  be  subjected  to  the  measures  which  are 
indicated  in  Nos.  1,  4,  .5  of  article  21. 

Further,  the  crew  and  passengers  may  be  subjected  to  observation,  which  should  not 
exceed  five  days,  dating  from  the  arrival  of  the  ship.  During  the  same  time  the  disem- 
barkment  of  the  crew  may  be  forbidden,  except  for  reasons  of  duty. 

The  destruction  of  rats  on  shipboard  is  recommended.  This  destruction  is  to  be  efl'ected 
before  or  after  the  discharge  of  cargo,  as  quickly  as  possible,  and  in  all  cases  with  a  maxi- 
mum delay  of  forty-eight  hours,  taking  care  to  avoid  damage  to  merchandise,  ships,  and 
their  machinery. 

For  ships  in  ballast  this  operation  should  be  done,  if  done  at  all,  as  early  as  possible, 
and  in  all  cases  before  taking  on  cargo. 


SECOND    INTERNATIONAL    HANITARY    CONVENTION.  55 

Article  22  was  read  in  Spanish  by  Doctor  Moore. 
,    The  article  as  read  was  agreed  to. 

Doctor  Gaiteras  here  read  article  23  in  exactly  the  form  in  which 
it  appears  in  the  convention. 

Article  23  was  here  read  in  Spanish  by  Doctor  Moore. 

Discussion  in  Spanish  followed. 

Doctor  GuiTERAS.  I  have  merely  called  attention  to  the  fact  that 
they  have  used  "observation"  here  instead  of  "surveillance,"  and 
we  thonght  that  we  had  agreed  in  this  case  that  we  might  use  "sur- 
veillance," because  we  were  speaking  of  an  indemne  ship. 

Further  discussion  in  Spanish  followed. 

Doctor  GuiTEKAS.  We  are  ready  to  vote,  Mr.  President. 

Article  23  as  read  was  agreed  to. 

Doctor  Guiterasread  article  24^  as  follows: 

Article  24.  Wlien  upon  an  indemne  ship  rats  have  been  recogpzed  as  pest  stricken  as 
a  result  of  bacteriological  examination,  or  when  marked  mortality  has  been  established 
among  these  rodents,  the  following  measures  should  be  applied: 

1.  Ships  with  plague-stricken  rats: 

(a)  Medical  visit  (hispection) . 

(b)  Eats  should  be  destroyed  before  or  after  the  discharge  of  cargo,  as  rapidly  as  pos- 
sible, and  in  all  cases  with  a  delay  not  to  exceed  forty-eight  hours ;  the  deterioration  of  mer- 
chandise, vessels,  and  machineiy  to  be  avoided.  Upon  ships  in  ballast  this  operation 
should  be  performed  as  soon  as  possible,  and  in  all  cases  before  taking  on  cargo. 

(c)  Such  parts  of  the  ship  and  such  articles  as  the  local  sanitary  authority  regards  aá 
infected  shall  be  disinfected. 

(d)  Passengers  and  crew  may  be  submitted  to  observation  the  duration  of  which  should 
not  exceed  five  days,  dating  from  the  day  of  arrival,  except  in  exceptional  cases,  where  the 
sanitary  authority  may  prolong  the  observation  to  a  maximum  of  ten  days. 

The  above  paragraph  of  article  24  was  here  read  in  Spanish  by 
Doctor  Moore. 

The  Secretary.  Here  is  the  same  difference  again.  In  the  Eng- 
lish copy  they  have  used  the  word  "observation"  while  in  the 
Spanish  copy  it  is  "surveillance."     That  appears  in  paragraph  (d). 

Doctor  GuiTERAS.  Yes.  There  is  one  correction  to  be  made  here, 
and  one  only.  It  is  a  verbal  correction.  Doctor  McCaw  suggests 
the  substitution  of  the  word  "special"  for  "exceptional"  in  para- 
graph (d).  We  are  now  ready  to  vote  on  the  first  paragraph  of 
article  24. 

Paragraph  No.  1  of  article  24  was  agreed  to. 

Doctor  Guiteras  here  read  paragraph  2  of  article  24,  as  follows: 

2.  Ships  where  a  marked  mortality  among  rats  is  observed: 

(a)  Medical  visit  (iospection) . 

(b)  An  examination  of  rats,  with  a  view  to  determining  the  existence  of  plague,  should 
be  made  as  quickly  as  possible. 

(c)  If  the  destruction  of  rats  is  judged  necessary,  it  shall  be  accomplished  imder  the 
conditions  indicated  above  in  the  case  of  ships  with  plague-stricken  rats. 

(d)  UntU  all  suspicion  may  be  eliminated  the  passengers  and  crew  may  be  submitted  to 
observation,  the  duration  of  which  should  not  exceed  five  days,  counting  from  the  date  of 
arrival,  except  in  special  cases,  when  the  sanitary  authoiity  may  prolong  the  observation  to 
a  maximum  of  ten  days. 

The  second  paragraph  of  article  24  was  here  read  in  Spanish  by 
Doctor  Moore. 

The  second  paragraph  of  the  article  was  agreed  to, 

The  President.  Now,  the  whole  article  should  be  agreed  to. 

The  entire  article  No.  24  was  adopted. 


56  SECOND    INTERÍÍATIONAL    SANITARY    CONVENTION. 

Doctor  Guiteras  read  article  25,  as  follows: 

Aeticle  25.  The  saiiitary  authoiities  of  the  port  must  deliver  to  the  captain,  the  owner, 
or  his  agent,  whenever  a  demand  for  it  is  made,  a  certificate  setting  forth  that  the  meas- 
ures for  the  destruction  of  rats  have  been  efficacious  and  the  reasons  why  these  measures 
have  been  appUed. 

Article  25  was  read  in  Spanish  by  Doctor  Moore. 

Article  25  was  agreed  to. 

Doctor  Guiteras  read  article  26,  as  follows: 

Aeticle  26.  Ships  infected  with  cholera  are  to  be  subjected  to  the  following  regulations: 

1.  Medical  visit  (inspection). 

2.  The  sick  are  to  be  immediately  disembarked  and  isolated. 

3.  Other  persons  ought  also  to  be  disembarked,  if  possible,  and  subjected,  dating  from 
the  arrival  of  the  ship,  to  an  observation,  the  duration  of  which  will  vary  according  to  the 
sanitary  condition  of  the  ship  and  the  date  of  the  last  case,  without,  however,  exceeding 
five  days. 

Doctor  Guiteras.  That  is  expressed  in  the  Spanish  copy,  "the 
duration  of  which  will  vary  according  to  the  sanitary  condition  of 
the  ship  and  the  date  of  the  last  case." 

The  President.  Was  that  change  made  by  our  committee?  As 
I  understand  it,  we  took  that  agreement  that  was  passed  in  Paris, 
and  we  are  to  adapt  it  to  our  needs.  If  that  has  been  changed  by 
the  committee  it  should  be  changed  in  the  English  as  well  as  the 
Spanish. 

Doctor  Guiteras.  I  have  forgotten  how  the  difference  arose. 

The  President.  There  is  a  discrepancy  between  the  English  and 
the  Spanish  texts.     Was  tliis  done  on  purpose? 

Doctor  Guiteras.  In  the  Spanish  ihej  have  eliminated  ''varying 
with  the  sanitary  condition."  What  is  the  use  of  telling  them  that 
when  you  saj  that  it  will  not  exceed  five  days?  We  will  eliminate 
that  in  the  English  copy,  so  as  to  make  it  agree. 

The  President.  Very  well,  do  that,  so  that  they  may  agree. 

Doctor  Guiteras  here  continued  the  reading  of  article  26,  as  follows.: 

3.  Other  persons  ought  also  to  be  disembarked,  if  possible,  and  subjected,  dating  from 
the  arrival  of  the  ship,  to  an  observation,  the  duration  of  which  shall  not  exceed  five  days. 

4.  Soued  linen,  wearing  apparel,  and  personal  effects  of  crew  and  passengers  which,  in 
the  opinion  of  the  sanitary  authority  of  the  port,  are  considered  as  infected  are  to  be  dis- 
infected. 

5.  The  parts  of  the  ship  which  have  been  inhabited  by  persons  sick  with  cholera,  or 
which  are  considered  by  the  sanitary  authority  as  infected,  are  to  be  disinfected. 

6.  The  bilge-water  is  to  be  discharged  after  disinfection.  The  sanitaiy  authority  may 
order  the  substitution  of  good  potable  water  for  that  which  is  contained  in  the  tanks  on 
board. 

The  discharge  or  throwing  overboard  into  the  water  of  a  port  of  dejecta  shall  be  for- 
bidden unless  they  have  been  previously  disinfected. 

Article  26  was  read  in  Spanish  by  Doctor  Moore. 

Article  26  was  agreed  to. 

Doctor  Guiteras  read  article  27,  as  follows: 

Article  27.  Ships  suspected  of  cholera  are  to  be  subjected  to  measures  prescribed  under 
Nos.  1,  4,  5,  and  6  of  article  26. 

The  crew  and  passengers  may  be  subjected  to  an  obsei-vation  which  should  not  exceed 
five  days,  to  date  from  the  arrival  of  the  ship.  It  is  recommended  during  the  same  time  to 
prevent  the  debarkation  of  the  crew  except  for  reasons  of  duty. 

Article  27  was  read  in  Spanish  by  Doctor  Moore. 
Article  27  was  agreed  to. 


HEOOND    IN'J'KRNATIONAL    HANITAKY     CON  VKNTION.  ->  ( 

Doctor  Guiteras  here  read  article  28,  as  follows: 

Article  28.  Ships  indemne  of  cholera  are  to  1)0  admitted  to  free  pratique  immediately, 
whatever  may  be  the  nature  of  their  bill  of  health. 

The  only  regulations  which  the  sanitary  authorities  of  a  port  may  prescribe  in  their  case 
are  the  measures  provided  in  Nos.  1,  4,  and  G  of  article  26. 

The  crews  and  passengers  may  be  submitted,  in  order  to  show  their  state  of  health,  to 
an  observation,  which  should  not  exceed  five  days,  to  be;  computed  from  the  date  when  the 
ship  saued  from  the  infected  port. 

It  is  recommended  that  during  the  same  time  the  debarkation  of  the  crew  be  forbidden 
except  for  reasons  of  duty. 

Compct(^nt  authority  at  the  port  of  arrival  may  always  demand,  under  oath,  a  certificate 
from  the  ship's  surgeon,  oi-  in  the  absen(;e  of  a  surgeon,  from  tlie  captain,  setting  forth  that 
there  has  not  been  a  case  of  cholei'a  upon  the  ship  since  sailing. 

Article  28  was  read  in  Spanish  by  Doctor  Moore. 

Article  28  was  agreed  to. 

Doctor  Guiteras  read  article  29,  as  follows: 

Akticle  29.  Competent  authority  will  take  account,  in  order  to  apply  the  measures  indi- 
cated in  articles  21  to  28,  of  the  presence  of  a  physician  on  board  and  a  disinfecting  apparatus 
in  ships  of  the  three  categories  mentioned  above. 

In  regard  to  plague,  it  will  equally  take  accouat  of  the  installation  on  board  of  apparatus 
for  the  destruction  of  rats. 

Sanitary  authorities  of  such  states  where  it  may  be  convenient  to  make  such  regulations 
may  dispense  with  the  medical  visit  and  other  measures  toward  indemne  .ships  which  have 
on  board  a  physician  specially  conmiissioned  by  their  country. 

Article  29  was  read  in  Spanish  by  Doctor  Moore. 

Article  29  was  agreed  to. 

Doctor  Guiteras  read  article  30,  as  follows : 

Article  30.  Special  measures  may  be  prescribed  in  regard  to  crowded  ships,  notably 
emigrant  ships,  or  any  other  ship  presenting  bad  hygienic  conditions. 

Doctor  GuiTSEAS.  Is  that  correct,  ''bad  hygienic  conditions?" 

Doctor  Geddings.  That  is  proper. 

Doctor  Gatewood.  Doctor  Stiles  suggests  that  you  make  it  read 
^'poor  hygienic  conditions,''  which  sounds  a  little  better. 

Doctor  Geddings.  What  is  the  matter  with  ''unhygienic  condi- 
tions?" 

Article  30  was  read  in  Spanish  by  Doctor  Moore. 

Article  30,  as  read  in  English  by  Doctor  Guiteras,  and  in  Spanish 
by  Doctor  Moore,  was  agreed  to. 

Doctor  Guiteras  here  read  article  31,  as  follows: 

Akticle  31.  Any  ship  not  desiring  to  be  subjected  to  the  obligations  imposed  by  the 
authority  of  the  port  in  virtue  of  the  stipulations  of  the  present  convention  is  ft-ee  to  proceed 
to  sea. 

It  may  be  authorized  to  disembark  its  cargo  after  the  necessary  precautions  shaU  have 
been  taken,  namel)^,  fiist,  isolation  of  the  ship,  its  crew,  and  passengers;  second,  in  regard 
to  plague,  demand  for  information  relative  to  the  existence  of  an  unusual  mortality  among 
rats;  third,  in  regard  to  cholera,  the  discharge  of  the  bilge-water  after  disinfection  and  the 
substitution  of  a  good  potable  water  for  that  which  is  pro^'ided  on  board  the  ship. 

Authority  may  also  be  granted  to  disembark  such  passengers  as  may  demand  it,  upon 
condition  that  these  submit  themselves  to  all  measures  prescribed  by  the  local  authorities. 

Article  31  was  read  in  Spanish  by  Doctor  Moore. 

Article  31  was  agreed  to. 

Doctor  Guiteras  read  article  32,  as  follows: 

Article  32.  Ships  coming  from  a  contaminated  port,  which  have  been  disinfected  and 
which  may  have  been  subjected  to  sanitary  measm-es  applied  in  an  efficient  manner,  shall 
not  undergo  a  second  time  the  same  measures  upon  their  arrival  at  a  new  port,  provided 
that  no  new  case  shall  have  appeared  since  the  disinfection  was  practiced,  and  that  the 
ships  have  not  touched  in  the  meantime  ac  an  infected  port. 


58  SECOND    INTERNATIO]N  AL    SANITARY    CONVEINTION. 

When  a  ship  only  disembarks  passengers  and  their  baggage,  or  the  mails,  without  having 
been  in  conununicatiou  with  term  Jirma,  it  is  not  to  be  considered  as  having  touched  at  a 
port,  provided  that  in  the  case  of  yellow  fever  it  has  not  approached  sufhciently  near  the 
shore  to  permit  the  access  of  mosquitos. 

Ai'ticle  32  -was  read  in  Spanish  by  Doctor  Moore. 

Discussion  in  Spanish  followed. 

The  President.  Has  there  been  any  change  in  the  language? 

Doctor  GuiTERAS.  No;  only  a  change  in  the  wording. 

Article  32  was  agreed  to. 

Doctor  Guiteras  read  article  33,  as  follows: 

Article  33.  Passengers  on  an  infected  ship  have  the  i-ight  to  demand  of  the  sanitary 
authority  of  the  port  a  certificate  showing  the  date  of  their  arrival  and  the  measures  to 
which  they  and  their  baggage  have  been  subjected. 

Article  33  was  read  in  Spanish  by  Doctor  Moore. 

Article  33  was  agreed  to. 

Doctor  Guiteras  read  article  34,  as  follows : 

Article  34.  Packet  boats  shall  be  subjected  to  special  regulations,  to  be  established  by 
mutual  agreement  between  the  countries  in  interest. 

Article  34  was  read  in  Spanish  by  Doctor  Moore. 

Article  34  was  agreed  to. 

Doctor  Guiteras  read  article  35,  as  follows: 

Article  35.  Without  prejudice  to  the  right  which  governments  possess  to  agi'ee  upon 
the  organization  of  common  sanitarj'  stations,  each  country  should  provide  at  least  one  port 
upon  each  of  its  seaboards,  with  an  organization  and  equipment  sufficient  to  receive  a 
vessel,  whatever  may  be  its  sanitaiy  condition. 

When  an  indenme  vessel,  coming  ft-om  an  infected  port,  arrives  in  a  large  mercantile  port, 
it  is  recommended  that  she  be  not  sent  to  another  port  for  the  execution  of  the  prescribed 
sanitary  measures. 

In  every  country  ports  liable  to  the  arrival  of  vessels  from  ports  infected  with  plague, 
cholera,  or  yellow  fever,  should  be  equipped  in  such  a,  manner  that  indemne  vessels  may  there 
undergo  imediately  upon  their  arrival  the  prescribed  measures  and  not  be  sent  for  this  pur- 
pose to  another  port. 

Governments  should  make  declaration  of  the  ports  which  are  open  in  their  territories  to 
arrivals  from  ports  infected  with  plague,  cholera,  or  yeilow  fever. 

Article  35  was  read  in  Spanish  by  Doctor  Moore. 

Discussion  in  Spanish  follow^ed. 

Article  35  was  agreed  to. 

Doctor  Guiteras  read  article  36,  as  follows: 

Article  36.  It  is  recommended  that  in  large  seaports  there  be  established: 

(a)  A  regular  medical  service  and  a  permanent  medical  supervision  of  the  sanitarj'  condi- 
tions of  crews  and  the  inhabitants  of  the  port. 

(b)  Places  set  apart  for  the  isolation  of  the  sick  and  the  observation  of  suspected  persons. 
In  the  Stegomyia  belt  there  must  be  a  building  or  part  of  a  building  screened  against  mosqui- 
tos, and  a  launch  and  ambulance  similarly  screened. 

(c)  The  necessary  installation  for  efficient  disinfection  and  bacteriological  laboratories. 

(d)  A  supply  of  potable  water  above  suspicion,  for  the  use  of  the  port,  and  the  installa- 
tion of  a  system  of  sewerage  and  drainage  adequate  for  the  removal  of  refuse. 

Article  36  was  read  in  Spanish  by  Doctor  Moore. 
•  Article  36  was  agreed  to. 
Doctor  Guiteras  read  as  follows: 

Section  4.  Measures  upon  land  frontiers,  travelers,  railroads,  frontier  zones,  river 
routes. 

Article  37.  Land  quarantines  should  no  longer  be  established,  but  the  governments 
reserve  the  right  to  establish  camps  of  observation  if  they  should  be  thought  necessary  for 
the  temporary  detention  of  suspects. 

Only  persons  presenting  systems  of  plague,  cholera,  or  yellow  fever  should  be  detained 
at  frontiers. 

This  principle  does  not  exclude  the  right  of  each  State  to  close  a  part  of  its  frontier  in  case 
of  necessity. 


SECOND    INTERNATIONAL    HANITAKY    (J(;N  V  KNTK^N.  59 

The  President.  Would  you  leave  the  word  "State"  in  there? 
It  might  be  interpreted  to  mean  each  State  in  the  United  States. 

Doctor  GuiTERAs.  Would  you  object  to  substituting  the  word 
"Government?" 

The  President.  No. 

A  Delegate.  Make  it  read  "country." 

Doctor  Guiteras.  Country,  yes.     Then  it  will  read: 

This  principle  does  not  exclude  the  right  for  each  country  to  close  a  part  of  its  frontier 
in  case  of  necessity. 

Article  37  was  here  read  in  Spanish  by  Doctor  Moore. 
Doctor  Guiteras.  Mr.  Chairman,  I  move  that  the  second  para- 
graph of  this  article  be  omitted,  namely,  that  part  which  reads: 

Only  persons  presenting  symptoms  of  plague,  cholera,  or  yellow  fever  should  Vje  detained 
at  frontiers. 

Doctor  Geddings.  I  second  that  motion. 

Doctor  Guiteras.  I  make  this  motion  because  I  take  it  that  the 
second  paragraph  is  in  contradiction  of  the  first  paragraph  of  this 
article.     The  first  paragraph  of  this  article  reads: 

Land  quarantines  should  no  longer  be  established,  but  the  governments  reverse  the 
right  to  establish  camps  of  observation  if  they  should  be  thought  necessary  for  the  tempo- 
rary detention  of  suspects. 

Now,  after  saying  that  these  camps  of  observation  may  be  estab- 
lished if  it  is  deemed  necessary,  it  declares  that  only  sick  persons  shall 
be  detained,  the  language  being  "only  persons  exhibiting  symptoms 
of  plague,  cholera,  or  yellow  fever  should  be  detained  at  frontiers." 

The  President.  Are  you  ready  for  the  question  on  Doctor  Gui- 
teras's  motion? 

Doctor  Medina.  We  would  like  to  have  it  read  again  in  Spanish. 

The  article  as  amended  was  read  in  Spanish  by  Doctor  Moore. 

Doctor  Medina.  That  is  all  right. 

The  amendment  of  Doctor  Guiteras  was  agreed  to. 

The  President.  The  amendment  is  adopted.  The  question  now 
is  on  the  adoption  of  the  article  as  read. 

Article  37  as  amended  was  agreed  to. 

Article  38  was  read  by  Doctor  Guiteras  as  follows: 

Article  38.  It  is  important  that  travelers  should  be  submitted  to  a  surveillance  on  the 
part  of  the  personnel  of  raikoads,  to  determine  their  condition  of  health. 

Article  38  was  read  in  Spanish  by  Doctor  Moore. 

Article  38  was  agreed  to. 

Doctor  Guiteras  here  read  article  39,  as  follows : 

Article  39.  Medical  intervention  is  limited  to  a  visit  (inspection)  with  the  taking  of 
temperature  of  travelers,  and  the  succor  to  be  given  to  those  actually  sick.  If  this  visit 
is  made,  it  shou.ld  be  combined  as  much  as  possible  -with  the  custom-house  inspection,  to  the 
end  that  travelers  may  be  detained  as  short  a  time  as  possible.  Only  persons  evidently 
sick  should  be  subjected  to  a  searching  medical  examination. 

Article  39  was  read  in  Spanish  by  Doctor  Moore. 

Discussion  in  Spanish  followed,  being  participated  in  by  Doctor 
Lavoreria,  Doctor  Licéaga,  and  Doctor  Alcivar. 

Doctor  Guiteras.  The  question  is,  Mr.  President,  on  the  taking 
of  the  temperature.  Article  39  sa3'-s:  "Medical  intervention  is  lim- 
ited to  a  visit  (inspection)  with  the  taking  of  temperature  of  trav- 
elers, and  the  succor  to  be  given  to  those  actuallv  sick." 


60  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

The  gentleman  from  Peru  would  rather  have  the  taking  of  the 
temperature  limited — or,  rather,  when  it  is  necessary.  Doctor 
Licéaga  insists  that  authority  should  be  given  to  take  the  tempera- 
tures of  ever3'body.  I  am  in  favor  of  reserving  the  authority  to  take 
temperatures. 

The. President.  The  physician  can  do  it  or  not,  if  he  pleases. 

Doctor  GuiTERAS.  Yes,  sir;  but  he  ought  to  have  the  authority 
to  do  it. 

Further  discussion  in  Spanish  followed. 

Doctor  GuiTERAS.  The  amendment  is  withdrawn.  We  are  ready 
for  the  vote. 

Article  39  was  agreed  to. 

Doctor  Guiteras  read  article  40,  as  follows: 

Akticle  40.  As  soon  as  travelers  coming  from  an  infected  locality  shall  have  arrived  at 
their  destination,  it  would  be  of  the  greatest  utility  to  submit  them  to  a  surveillance,  which 
should  not  exceed  ten  or  five  days,  counting  from  the  date  of  departure,  the  time  depending 
upon  whether  it  is  a  question  of  plague  or  cholera.  In  case  of  yellow  fcA'er  the  period  should 
be  six  days. 

Article  40  was  read  in  Spanish  by  Doctor  Moore. 

Article  40  was  agreed  to. 

Doctor  Guiteras  read  article  41,  as  follows: 

Aeticle  41.  Governments  may  reserve  to  themselves  the  right  to  take  particular 
measures  in  regard  to  certain  classes  of  persons,  notably  vagabonds,  emigrants,  and  persons 
travehng  or  passing  the  frontier  in  groups. 

Article  41  was  read  in  Spanish  by  Doctor  Moore. 

Doctor  Gatewood.  In  groups? 

Doctor  Ulloa.  "Groups"  is  all  right. 

Dr.  H.  L.  E.  Johnson.  Is  not  that  meant  to  apply  to  roving  bands 
of  gypsies  and  tramps  ? 

Doctor  Gatewood.  Why  not  put  it  both  ways — bands  and  groups  ? 

The  President.  I  will  call  upon  Doctor  Geddings  to  explain  this. 

Doctor  Geddings.  This  refers  to  vagabonds  traveling  in  parties. 
It  refers  to  tramps  and  gypsies  and  those  who  pass  the  frontier  in 
troupes.     Not  in  a  military  sense. 

The  President.  You  mean  theatrical  troupes? 

Doctor  Geddings.  Yes,  sir;  theatrical  troupes.  A  band  or  group, 
would  be  all  right. 

Doctor  Guiteras.  It  might  be  understood  to  be  military — troops 
of  cavalry,  for  instance. 

Doctor  Ulloa.  Put  it  groups,  then. 

Doctor  Guiteras.  No;  because  groups  may  be  very  small.  I 
think  "bands"  would  be  better. 

Doctor  Geddings.  I  move  to  substitute  "groups." 

Dr.  H.  L.  E.  Johnson.  I  would  suggest  that  we  cover  both  situa- 
tions by  using  both  terms,  and  making  it  read  "bands"  or  "  groups." 
That  would  express  it  properly  in  English.  I  do  not  know  how  it 
would  go  in  Spanish. 

Doctor  Guiteras.  I  think  that  "groups"  is  so  general  that  it  might 
be  applied  to  very  small  groups — a  group,  for  instance,  of  five  persons — 
and  this  certainly  does  not  apply  to  such  small  numbers  as  that.  It 
refers  to  such  large  bands  as  are  difficult  to  handle  and  to  discipline 
and  to  follow.  But  when  it  comes  to  small  bands,  I  do  not  think  it 
intends  to  interfere  with  them.  A  small  group  is  a  carload  of  people. 
Certainly  you   are  not  going   to  interfere  with  them.     The  word 


SECOND    INTKKMaTIONAL    KANITaTíY    CONVENTION.  61 

"bands"  moans  large  groups  moving  without  discipline.  I  do  not 
see  the  necessity  of  using  the  term  "groups." 

The  President.  There  is  a  suggestion,  and  the  motion  is  before  us, 
that  the  word  be  changed  from  "groups"  to  "bands."  1  think  J^octor 
Johnson  has  a  suggestion  to  rjiake. 

Doctor  Johnson.  No,  sir,-  I  withdraw  that  motion  which  I  made. 

Tlie  President.  Then  the  question  is  on  the  motion  of  Doctor 
Geddings. 

The  question  was  taken  upon  the  motion  of  Doctor  Geddings,  and 
the  motion  was  agreed  to. 

Article  41  was  agreed  to. 

Doctor  Guiteras  read  article  42,  as  follows: 

Akticle  42.  Coaches  intended  for  the  transportation  of  passengers  and  mails  should  not 
be  retained  at  frontiers. 

In  order  to  avoid  this  retention  a  system  of  relays  ought  to  be  established  at  frontiers,  with 
transfer  of  passengers,  baggage,  and  mails.  If  one  of  these  carriages  be  infected  or  shall 
have  been  occupied  by  a  person  suffering  from  plague,  cholera,  or  yellow  fever 

Doctor  Guiteras.  No;  I  do  not  accept  yellow  fever  there.  No, 
no.  And  yet,  supposing  a  case  of  yellow  fever  on  a  train,  should  not 
that  car  be  disinfected?  Yes;  a  mosquito  might  have  bitten  the  per- 
son.    Yes;  that  is  right. 

[Continuing  reading] : 

If  one  of  these  carriages  be  infected,  or  shall  have  been  occupied  by  a  person  suffering  from 
plague,  cholera,  or  yellow  fever  it  shall  be  detached  from  the  train  for  disinfection  at  the 
earliest  possible  moment. 

Article  42  was  read  in  Spanish  by  Doctor  Moore. 

Article  42  was  agreed  to. 

Doctor  Guiteras  read  article  43  as  follows : 

Article  43.  Measures  concerning  the  passing  of  frontiers  by  the  personnel  of  railroads  and 
of  the  post-oíñce  are  a  matter  for  agreement  by  the  interested  administrations.  These 
measm'es  should  be  so  arranged  as  not  to  hinder  the  service. 

Article  43  was  read  in  Spanish,  as  above,  by  Doctor  Moore. 

Article  43  was  agreed  to. 
'    Doctor  Gatewood.  What  does  the  word  "administrations"  mean 
there?     Does  it  mean  the  administration  of  the  railroads,  or  of  the 
countries  ? 

Doctor  Guiteras.  It  says  "personnel  of  railroads,  and  of  the 
post-office." 

Doctor  Gatewood.  If  the  railroads  happen  not  to  be  under  govern- 
mental control,  the  matter  might  be  arranged  by  the  railroads,  then, 
according  to  that. 

Dr.  H.  L.  E.  Johnson.  Would  it  not  be  better  to  say,  "agreement 
of  the  countries  interested?" 

The  President.  It  shovdd  be,  really  "the  sanitary  authorities." 

Dr.  H.  L.  E.  Johnson.  It  says  "agreement  by  the  interested 
administrations,"  whereas  I  think  it  should  say  "the  countries 
interested." 

The  Secretary.  I  think  it  should  read  "sanitary  authorities.'' 

Doctor  Guiteras.  I  will  make  it  read,  then,  "sanitary  authorities," 
"a  matter  for  agreement  of  the  sanitary  authorities." 

The  President.  We  have  already  adopted  article  43  ^^ithout  this 
amendment. 

Dr.  H.  L.  E.  Johnson.  In  order  that  we  may  consider  that,  I  move 
that  we  reconsider  the  adoption  of  article  43. 


62  SECOND    INTEENATIONAL    SANITARY    CONVENTION. 

The  motion  was  seconded. 

The  question  on  the  reconsideration  of  article  43  was  taken  and  the 
motion  was  agreed  to. 

The  President.  The  motion  for  reconsideration  of  article  43  has 
been  carried,  and  article  43  is  now  before  you.  Amendments  are  in 
order. 

Dr.  H.  L.  E.  Johnson.  I  move  that  article  43  be  amended  as 
agreed  upon,  and  that  the  amendment  as  proposed  here  be  read. 

Doctor  Guiteras  here  read  article  43,  as  amended,  as  follows: 

Akticle  43.  Pleasures  concerning  the  passing  of  frontiers  by  the  personnel  of  railroads 
and  of  the  post-office  are  a  matter  for  agreement  of  the  sanitary  authorities.  These  meas- 
tures  should  be  so  arranged  as  not  to  hinder  the  service. 

Article  43  as  amended  was  read  in  Spanish  by  Doctor  Moore. 
Upon  motion  of  Dr.  H.  L.  E.  Johnson,  duly  seconded,  article  43  as 
amended  was  agreed  to. 

Doctor  Guiteras  read  article  44  as  follows: 

Article  44.  The  regulation  of  frontier  traffic,  as  well  as  the  adoption  of  exceptional  meas- 
ures of  surveillance,  should  be  left  to  special  arrangement  between  contiguous  states. 

The  Secretary.  The  last  word  in  that  article  should  be  changed  to 
"countries." 

Doctor  Guiteras.  Yes. 

The  President.  Make  it  ''countries." 

Article  44,  as  amended,  was  read  in  Spanish  by  Doctor  Moore. 

Article  44  was  agreed  to. 

Doctor  Guiteras  read  article  45  as  follows: 

Akticle  45.  The  power  rests  with  governments  of  countries  bordering  upon  rivers  to 
regulate  by  special  regulations  the  sanitaiy  regime  of  river  routes. 

Article  45  was  read  in  Spanish  by  Doctor  Moore. 

Ai'ticle  45  was  agreed  to. 

Doctor  Guiteras.  Mr.  President,  there  is  another  article  here  which, 
I  suppose,  will  raise  no  objection  at  all,  but  the  question  as  to  the  title 
of  that  article  is  one  that  I  wish  to  present. 

The  President.  We  have  finished  all  those  articles  which  are  ready 
and  we  will  now  adjourn  until  3  o'clock  p.  m. 

Thereupon  the  convention  took  a  recess  until  3  o'clock  p.  m. 

Afternoon  Session. 

The  convention  was  called  to  order  at  the  conclusion  of  the  recess, 
at  3  o'clock  p.  m.,  by  the  president,  Surgeon-General  Wyman. 

The  President.  If  it  is  agreeable  to  the  convention,  before  we 
proceed  again  with  these  articles  that  we  have  almost  finished,  and 
pending  the  arrival  of  one  or  two  members,  Doctor  Howard  being 
present,  we  will  hear  from  him  now  on  the  distribution  of  the  Stego- 
myia  mosquito. 

Doctor  Howard.  Mr.  President  and  members  of  the  convention,  I 
realize  that  you  are  very  busy  and  have  a  great  many  matters  on  hand, 
and  I  shall  be  as  brief  as  I  possibly  can  be. 

I  wish  to  state  that  in  the  investigation  of  the  yellow-fever  mos- 
quito I  have  been  assisted  by  many  other  men.  M}^  own  investiga- 
tions have  led  me  to  Mexico,  where  I  have  received  the  very  greatest 
f)ossible  courtesy  at  the  hands  of  Doctor  Licéaga,  who  has  given  me 
etters  of  introduction  to  the  people  I  wanted  to  meet  most  in 


SECOND    INTERN ATIONAJ.    SANITARY    (JONVKNTION.  08 

Mexico  and  assisted  me  in  every  possi})le  way.  I  wish  also  to  render 
publicly  my  thanks  to  Doctor  üuiteras  for  the  opportunity  of  seeing 
everything  in  the  ]jas  Animas  Hospital  in  Habana,  and  I  think  that 
it  was  probal)ly  tlu'ough  tlie  kind  words  of  Doctor  Guiteras  that  I 
was  able  to  land  at  all  in  Habana,  because  I  arrived  on  a  steamer 
from  Veracruz,  and  no  one  was  allowed  to  go  off;  but  I  gave  my 
card  to  the  medical  inspector,  and  I  said,  "Give  my  card  to  J)octor 
Guiteras,"  and  there  were  no  more  formalities,  and  I  was  the  only 
person  who  was  allowed  to  go  ashore. 

In  order  to  be  as  brief  as  possible,  I  think  that  I  had  f^etter  read 
an  abstract  of  what  I  intended  to  say,  which  is  short,  and,  I  hope,  to 
the  point.  You  will  observe  that  I  speak  of  myself  in.  this  in  the 
third  person. 

Doctor  Howard  here  read  his  abstract.     (See  Appendix,  p.  214.) 

The  President.  We  have  on  our  programme  a  very  short  paper 
from  Dr.  II.  L.  E.  Johnson,  and  we  will  be  very  glad  to  hear  it  now. 

Dr.  H.  L.  E.  Johnson  read  the  paper  referred  to,  in  English.  (vSee 
Appendix,  p.  217.) 

The  President.  Doctor  McCaw,  of  the  United  States  Army, 
wishes  to  make  the  announcement  to  the  convention  that  during  the 
last  year  there  have  been  published  by  the  .Surgeon-General's  Office 
the  results  of  the  investigations  of  the  Board  of  Army  Officers  during 
the  Spanish-American  war  on  the  spread  of  typhoid  fever  in  camps. 
This  book  has  been  edited  and  gotten  out  finaíl37^  by  the  last  surviving 
member  of  the  board,  Dr.  Victor  C.  Vaughan.  It  is  a  very  voluminous 
and  heavy  book,  in  two  volumes,  one  volume  consisting  of  an  atlas 
and  diagrams  and  the  other  volume  being  a  book  of  statistics.  The 
work  is  not  of  great  value  to  the  practitioner — it  is  too  large  for  the 
ordinary  library;  but  it  is  of  great  interest  to  those  interested  in 
public  health.  On  behalf  of  the  Surgeon-General  of  the  Army  I 
would  say  that  I  mil  present  to  every  member  of  this  conference  a 
copy  of  this  work  if  they  will  give  me  the  address  to  wliich  they  wish 
it  sent.  I  can  send  it  by  mail  to  anyone  in  the  United  States,  either 
to  the  legations  or  anywhere  else.  Í  think  perhaps  if  it  were  sent  to 
South  American  countries  it  would  be  likely  to  be  lost  in  the  mail. 
I  would  be  very  glad  if  anyone  who  desires  a  copy  would  let  me  know. 

The  announcement  of  Doctor  McCaw  was  translated  into  Spanish 
by  the  secretary. 

Doctor  Guiteras.  I  move  that  the  thanks  of  the  convention  be 
transmitted  to  the  Surgeon-General  of  the  United  States  Army  for 
this  kind  offer. 

The  motion  was  seconded,  and  was  agreed  to. 

Doctor  Guiteras.  Is  the  paper  of  Doctor  Howard  open  for  dis- 
cussion, or  can  any  remarks  be  made? 

The  President.  It  would  be  very  acceptable  to  have  remarks 
made  upon  it. 

Doctor  Guiteras.  First,  in  respect  to  the  biting  of  the  Stegomyia 
late  in  the  afternoon,  or  whether  biting  in  the  heated  hours  of  the 
day,  perhaps  attracted  by  the  odor  of  perspiration.  There  is  a 
strong  argument  against  admitting  that  view  of  one  of  the  gentlemen 
quoted  by  Doctor  Howard,  and  that  is  that  the  mosquitoes  avoid 
negroes ;  and  if  there  is  a  strong  odor  of  perspiration  to  be  found  any- 
where, it  is  that  which  is  to  be  found  in  negroes.  So  that  I  do  not 
believe  that  the  odor  of  perspiration  attracts  mosquitoes. 


64  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Relntive  to  the  frequency  of  biting,  undoubtedly  tlie  period  given 
by  one  of  the  gentlemen,  five  or  six  da^^s,  is  too  long.  The  other 
estimate,  forty-eight  hours,  is  correct.  The  female  Stegomyia  will 
bite  every  fortj-eight  hours. 

But  tlie  question  I  am  going  to  touch  upon  now  is  not  mentioned 
in  Doctor  Howard's  paper,  but  it  is  certainly  intimately  related  to 
the  question  of  the  distribution  of  the  Stegomyia.  We  want  to 
know  the  geograpliical  distribution  of  the  Stegomyia  and  study  it  so 
thorouglily,  because  we  suppose  that  the  area  over  wliich  the 
Stegomyia  ranges  ^\^ll  correspond  with  the  area  over  which  the  yellow 
fever  is  found,  and  therefore  the  conclusion  can  be  drawn  that  yellow 
fever  will  not  spread  beyond  that  area.  I  want  to  make  a  statement 
that  tliis  is  not  so;  that  I  believe  there  is  j'-ellow  fever  in  districts 
outside  of  the  districts  of  the  Stegomyia  fasciata,  at  least  outside  of  the 
ordinary  distribution.  I  believe,  in  other  words,  that  yellow  fever 
may  be  spread  and  may  be  carried — perhaps  not  a  large  epidemic, 
but  it  may  spread — where  Stegomyia  is  not  found.  In  other  words, 
Stegomyia  may  be  carried  to  such  a  place  as  Atlanta  in  the  early 
spring  and  summer  or  even  farther  north,  when  it  is  warm  enough 
for  it  to  spread.  Two  or  three  females  full  of  eggs  may  be  carried  in 
a  sleeper  to  one  of  these  places  and  they  will  breed  sufficient  mos- 
quitoes by  the  end  of  the  summer — in  August,  for  instance — to  spread 
an  epidemic  of  yellow  fever.  I  believe  such  a  thing  happened  in 
Madrid  not  long  since,  where  a  female  mosquito  was  able  to  breed 
sufficiently  to  make  a  small  epidemic.  I  believe  that  there  is  con- 
siderable danger  in  some  of  the  ports  of  a  small  epidemic,  and  I 
think  none  of  them  are  entirely  free  from  the  danger.  I  believe  that 
such  freedom  is  only  relative,  and  I  may  add  that  Doctor  Finlaj^  is  of 
the  same  opinion. 

The  Secretary.  Just  a  few  remarks  in  coniu-mation  of  what 
Doctor  Guiteras  has  said.  A  few  years  ago  there  was  an  epidemic 
in  Alajuela,  about  12  miles  outside  of  San  José,  in  Costa  Rica,  a 
place  which  is  not  quite  so  high  as  San  José,  but  nearly  so.  San  José 
is  3,868  feet  and  Alajuela  is  3,001  feet  above  the  level  of  the  sea.  Of 
course,  before  the  theory  of  the  mosquito  transmission  of  the  dis- 
ease became  a  doctrine,  we  had  the  idea  that  yeUow  fever  could  not 
develop  in  high  altitudes,  but  nevertheless  there  was  a  very  serious 
epidemic  in  the  city  of  Alajuela,  and  the  government  had  considerable 
trouble  in  eradicating  it.  And  I  believe,  as  Doctor  Guiteras  has 
stated,  that  the  epidemic  might  have  been  due  to  some  mosquitoes 
being  brought  from  Punta  Ai'enas,  which  is  a  port  on  the  Pacific, 
during  the  summer  season  when  they  cart  coffee  from  the  interior  to 
the  port  on  the  Pacific;  and  from  there  the  carts  or  freight  might 
have  brought  some  of  these  mosquitoes.  Some  people  came  from 
the  port  ill  and  developed  yellow  fever  in  Alajuela,  and  the  Stegomyia 
might  have  been  found  there  and  become  contaminated,  and  in  this 
manner  started  the  epidemic. 

The  President.  Are  there  any  other  remarks?  This  is  a  very 
interesting  and  important  subject. 

Doctor  Medina.  I  would  mention  that  I  have  information  also 
that  we  had  two  cases  in  Managua,  quite  a  distance  from  Corinto, 
some  150  miles  away.  We  had  two  cases,  but  both  those  were  of 
passengers  who  had  come  from  Panama.  The  cases  were  developed, 
and  they  died  in  Managua;  but  the  infection  was  not  present,  and 
those  were  the  only  two  cases  that  we  had. 


HEOOND    INTERNATIONAL    SANITARY    CONVENTION.  05 

The  secretary  here  translated  into  Spanish  the  substance  of  the 
preceding  remarks  upon  this  subject. 

Doctor  Licéaga  adclressed  the  convention  in  Spanish. 

The  Secretary.  Doctor  Licéaga  has  said  tliat  he  desires  to  make 
the  following  explanation  on  the  point  under  discussion :  He  says 
that  in  a  high  altitude  in  Mexico,  about  2,000  feet,  where  the  City  of 
Mexico  is  situated,  they  made  the  following  experiment:  They 
brought  some  mosquitoes  from  Veracruz,  which  has  been,  as  we  all 
know,  a  great  focus  for  yellow  fever  for  a  good  many  years  back,  and 
they  succeeded  in  breeding  through  three  generations  the  mosquitoes 
of  the  Stegomyia  fasciata,  and  the  only  difierence  they  found  was  that 
the  mosquitoes  bred  in  Mexico  did  not  last  as  long  as  those  bred  in 
Veracruz. 

Doctor  Licéaga  concluded  by  saying,  very  wisely,  that  this  illus- 
trates the  possibility  of  yellow  fever  developing  in  a  city  at  that 
altitude  if  the  authorities  were  not  careful  enough  in  the  treatment 
they  accord  to  our  friends  the  Stegomyia. 

Doctor  Licéaga  said  that  he  wants  to  thank  Doctor  Howard  kindly 
for  his  expressions  concerning  the  treatment  he  received  in  Mexico. 
He  extends  his  thanks  to  you.  Doctor. 

Doctor  Howard.  May  I  say  a  word  in  reply? 

The  President.  Doctor  Howard. 

Doctor  Howard.  I  am  particularly  interested  in  the  instances  given 
by  Doctor  Ulloa  and  by  Doctor  Licéaga,  and  by  the  generalization 
made  by  Doctor  Guiteras.  The  subject  is  covered  pretty  fully  on 
page  4  of  this  pamphlet,  which  I  understand  was  distributed  among 
the  members  of  the  convention  during  the  sessions  of  the  first  day, 
and  I  speak  there  of  the  danger  of  these  mosquitoes  coming  up  the 
Mississippi  River  and  the  Ohio  River,  and  being  carried  in  steamboats 
and  in  trains,  and  of  the  likelihood  of  epidemics  being  caused  in  that 
way. 

During  the  trip  of  which  I  have  already  spoken,  on  which  my  labors 
were  so  facilitated  by  Doctor  Licéaga's  kindness,  the  highest  point  at 
which  I  found  the  Stegomyia  breeding — I  was  there  in  May,  but  it 
could  have  been  carried  up  there — was  at  Orizaba,  w^liich  is  at  an 
elevation  of  4,500  feet  above  sea  level,  and  it  was  not  an  original 
denizen  there,  as  it  was  at  the  coast.  But  when  the  railroad  was  built 
up  into  the  country  at  Mexico,  it  was  carried  up  farther,  and  then  it 
died  down  a  little  bit,  but  it  finally  established  itself  at  Cordova,  and 
then  finally  at  Orizaba.  The  first  cases  in  Orizaba  were  all  of  persons 
living  in  a  small  radius,  close  around  the  railroad  station.  In  the 
next  epidemic  they  spread  out  a  few  hundred  yards  farther  and  took 
in  another  block  of  houses  a  little  farther  off  from  the  railroad 
station  as  a  center,  and  it  may  be  that  in  course  of  time  thev  will 
establish  themselves  permanently  a  little  farther  ofl'  from  the  railroad 
station.  But  at  any  rate  that  point,  at  Orizaba,  is  the  highest  point 
where  I  found  the  Stegomyia  mosquito  permanently  breeding  in  the 
country  of  Mexico. 

The  secretary  translated  the  remarks  of  Doctor  Howard  in  Spanish. 

The  President.  Are  there  any  further  remarks  on  Doctor  How- 
ard's paper? 

Doctor  Lavoreria  addressed  the  convention  in  Spanish,  his  remarks 
being  translated  into  English  by  the  secretary. 

5610—06 5 


66  SECOND   INTERNATIONAL    SANITAEY    CONVENTION. 

The  Secretary.  Doctor  Lavoreria  says  that  m  Peru  they  have  not 
yellow  fever,  and  they  do  not  have  any  form  that  refers  to  this  disease, 
and  consequently  they  do  not  Ivnow  much  about  the  Stegomyia 
fasciata,  and  they  would  like  to  know  about  what  temperature  is 
requisite  for  the  development  of  the  Stegomyia. 

Doctor  Howard.  Will  jou  ask  him  if  it  is  not  known  in  Callao  ? 

The  secretary  here  addressed  the  question  in  Spanish  to  Doctor 
Lavoreria. 

The  Secretary.  He  says  that  he  does  not  know.  He  says  that 
they  have  it  on  the  coast,  but  that  they  have  not  had  any  yellow  fever 
since  1868. 

The  President.  If  there  is  no  objection,  we  will  now  continue  with 
the  articles  of  the  convention. 

Doctor  GuiTERAS.  The  last  article  is  to  be  designated  'Hransitorj 
disposition,"  if  that  title  is  approved.  This  term  is  official,  and  it  is 
used  in  treaties  officially,  so  that  we  have  adopted  it  for  this  last 
article.     This  reads  as  follows: 

TBANSITORT  DISPOSITION. 

The  Governments  which  may  not  have  signed  the  present  convention  are  to  be  admitted 
to  adherence  thereto  upon  demand;  notice  of  this  adherence  to  be  given  through  diplomatic 
channels  to  the  Government  of  the  United  States  of  America,  and  by  the  latter  to  the  other 
signatory  Governments. 

The  above  clause  was  read  in  Spanish  by  Doctor  Moore. 
The  clause  was  agreed  to. 
Doctor  Guiteras  read  as  follows: 

Made  and  signed  in  the  city  of  Washington  on  the  14th  day  of  the  month  of  October, 
nineteen  hundred  and  five,  in  two  copies,  in  English  and  Spanish  respectively,  which  shall 
be  deposited  in  the  State  Department  of  the  Government  of  the  United  States  of  America, 
in  order  that  certified  copies  thereof,  in  both  English  and  Spanish  may  be  made,  to  transmit 
them  through  diplomatic  channels  to  each  one  of  the  signatory  countries. 

Doctor  Guiteras.  Should  we  not  add  here  at  the  end  of  this  that 
in  case  of  doubt  or  disagreement  the  English  text  should  be  consid- 
ered as  the  standard? 

The  President.  Doctor  Geddings,  do  you  remember  any  such 
wording  ? 

Doctor  Geddings.  No,  sir. 

Doctor  Guiteras.  The  word  has  been  used  in  connection  with  the 
French  language.  It  was  said  that  in  case  of  disagreement  between 
the  two  versions  the  French  text  should  be  considered  as  the  standard. 

Since  we  have  two  languages,  we  must  use  one  or  the  other,  and  the 
committee  has  agreed  to  choose  the  English. 

Discussion  followed. 

The  transitory  disposition  was  again  read  by  Doctor  Guiteras  in 
English,  and  was  then  read  by  Doctor  Moore  in  Spanish. 

The  transitory  disposition  was  agreed  to. 

Doctor  Moore  made  some  remarks  in  Spanish  upon  the  wording  of 
the  transitory  disposition. 

The  Secretary.  Doctor  Moore  proposes  that  the  convention 
should  be  signed  to-day  instead  of  to-morrow. 

Doctor  Guiteras.  Then  the  date  should  be  the  13th  instead  of 
the  14th. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  67 

The  President.  I  think  that  it  would  be,  excellent  if  we  could 
sign  it  to-day,  but  whether  we  can  or  not  depends  on  the  typewriters. 
It  depends  on  whether  they  can  complete  the  typewriting  to-day. 

Doctor  Moore  here  addressed  the  convention  in  Spanish. 

The  Secretary.  Doctor  Moore  says  that  in  the  committee  it  was 
agreed  that  the  convention  should  be  signed  to-day,  and  of  course 
if  it  is  impossible  through  mechanical  difficulties,  it  can  not  be  done, 
but  he  suggests  that  the  date  might  be  left  the  13th,  although  we  do 
not  sign  it  until  to-morrow.  I  am  sorry,  for  Doctor  Moore's  sake, 
that  this  can  not  be  done,  because  the  treaty  to  be  signed  is  an  inter- 
national convention,  and  it  must  be  done  exactly  as  it  is  stated. 
We  can  not  sign  it  to-morrow  saying  that  it  was  signed  to-day, 
because  that  might  invalidate  the  treaty.  You  may  finish  the  con- 
sideration of  the  document,  and  agree  upon  it  entirely;  but  if  you 
can  not  actually  sign  it  to-day,  you  can  not  say  in  the  convention 
that  it  is  signed  to-day. 

Doctor  Moore  here  made  a  remark  in  Spanish. 

The  Secretary.  Doctor  Moore  says  that  his  motion  is  withdrawn. 

The  President.  The  objection  being  withdrawn,  if  you  are  ready 
we  will  have  the  question. 

The  question  was  taken  and  the  transitory  disposition  was  agreed 
to. 

The  President.  It  has  been  suggested  that  a  motion  ought  to  be 
made  to  have  an  editor  for  the  English  copy  and  one  for  the  Spanish 
copy,  to  compare  these  two  documents,  one  in  English  and  one  in 
Spanish,  and  that  the  editors  should  be  authorized  to  make  such 
verbal  changes  as  will  make  the  convention  plain,  without  altering 
the  meaning. 

Doctor  GuiTERAS.  So  that  it  would  all  have  to  be  written  over 
again  ? 

The   President.  No,  not  necessarily. 

Doctor  GuiTERAS.  I  move  that  a  committee  of  two  be  appointed 
to  finally  revise  these  two  copies,  compare  them,  and  make  any  verbal 
arrangement  that  they  may  deem  necessary. 

The  I^resident.  Any  verbal  what  ? 

Doctor  GuiTERAS.  Verbal  change. 

The  President.  Without  altering  the  sense? 

Doctor  GuiTERAS.  Yes,  sir.  '  Without  altering  the  sense. 

The  President.  You  hear  the  motion.     Is  there  a  second? 

The  motion  was  seconded. 

The  motion  was  translated  into  Spanish  by  Doctor  Ulloa. 

The  question  was  taken  and  the  motion  was  agreed  to. 

The  President.  The  motion  is  carried.  How  shall  this  commit- 
tee be  appointed? 

Several  Members.  By  the  President. 

The  President.  I  will  appoint  Doctor  Lavoreria,  the  delegate 
from  Peru,  and  Doctor  Gatewood,  of  the  United  States  Navy, 
respectively,  as  the  Spanish  and  English  editors,  members  of  tms 
committee. 

Doctor  Gatewood.  Mr.  President,  I  would  like  to  say  that  inas- 
much as  the  person  to  whom  I  shall  be  a  companion  in  this  matter 
does  not  speak  English,  under  the  circumstances  it  would  be  almost 
impossible  for  us  to  compare  the  Spanish  and  English  copies,  the 


6y  SECONI)    INTERNATIONAL    SANITARY    CONVENTION. 

committee  consisting  of  two  members,  one  of  whom  speaks  only 
English  and  the  other  sj^eaks  only  Spanish. 

The  Secretary.  Is  not  the  object  really  to  compare  the  two 
copies?  It  is  simply  to  read  them  and  make  some  slight  changes, 
without  changing  the  sense  of  an}^  article. 

Doctor  Gatewood.  The  motion  for  the  appointment  of  the  com- 
mittee said  ''to  compare."  It  seems  to  me  that  there  ought  to  be 
at  least  another  person  on  tliis  committee  who  speaks  both  lan- 
guages.    Would  not  Doctor  Guiteras  serve? 

Doctor  Guiteras.  Very  well,  sir,  I  will  change  my  motion  and 
make  it  that  the  committee  should  be  composed  of  three  members. 

The  motion  was  seconded,  and  it  was  agreed  to. 

The  President.  I  will  appoint  Doctor  Guiteras  as  the  tliird  mem- 
ber of  that  committee. 

Informal  discussion  among  the  members  followed. 

The  President.  Is  there  any  other  business  to  come  before  the 
convention  tliis  afternoon? 

Doctor  Guiteras.  The  continuation  of  the  programme  is  the  only 
business  we  have  now. 

The  President.  The  provisional  programme  has  been  largel^^  gone 
into  in  connection  with  this  convention.  There  is  the  matter  of 
diagnosis  of  maritime  quarantine,  and  of  land  quarantine,  and  of 
local  measures  for  the  eradication  of  disease.  Then  the  third  and 
fourth  headings  are  still  untouched.     They  read  as  follows: 

3.  The  mosquito  in  its  relation  to  yellow  fever  and  malarial  fevers.  Prevention  of  the 
spread  of  yellow  fever  by  the  destruction  and  elimination  of  the  mosquito. 

4.  Discussions  on  sanitation  of  cities  ■with  special  reference  to  the  A^entilation  of  habita- 
tions and  disposal  of  household  wastes. 

I  would  suggest  that  if  your  committee  might  be  with  the  type- 
writers while  they  are  working  on  the  transcription  of  this  conven- 
tion it  might  go  very  much  faster. 

Doctor  Guiteras.  There  are  some  papers  in  connection  with 
plague  and  yellow  fever.  The  end  of  the  programme  concerns  itself 
with  yellow  fever  and  its  transmission  by  the  mosquito. 

The  President.  Then  we  will  have  those  papers.  We  will  pro- 
ceed with  the  programme  as  far  as  we  may.  This  is  merely  a  provi-^ 
sional  programme,  a  tentative  programme,  and  we  have  broken  into 
the  order  of  it  pretty  extensively. 

Doctor  Medina.  I  wish  to  present  a  resolution  before  the  conven- 
tion that,  as  the  Republics  of  San  Salvador  and  Honduras  are  not 
represented  here,  a  copy  of  our  convention  shall  be  sent  to  each  one 
of  these  Governments,  expressing  at  the  same  time  the  pleasure  of 
this  convention  if  they  would  join  with  us  in  making  effective  the 
measures  prescribed.  I  explained  that  to  my  friend  Doctor  Ulloa, 
and  also  to  the  representative  of  Guatemala,  and  they  were  in  favor 
of  it.  Those  Republics  are  not  represented,  and  according  to  our 
treaty  copies  are  to  be  sent  only  to  the  countries  that  have  signed, 
so  that  they  will  not  receive  copies  except  under  some  such  special 
provision  as  this,  and  I  make  the  motion  that  copies  of  the  conven- 
tion be  sent  to  San  Salvador  and  Honduras,  and  also  that  this  con- 
vention should  express  the  pleasure  that  they  would  have  if  those 
two  countries  w^ould  adhere  to  our  convention. 

The  Secretary.  I  desire  to  make  just  a  few  remarks  about  the 
intention  of  Doctor  Medina,  as  he  expressed  it  to  me.     Although  it 


SECOND    INTKIÍNATIONAL    SANITAKY    (CONVENTION.  69 

does  not  seem  to  me  necessary  that  an  exception  should  be  made 
in  these  cases,  nevertheless  the  intentions  of  Doctor  Medina  are 
very  good,  as  he  explained  them  to  me.  As  these  countries  are  so 
near  to  us,  and  as  Ilonduras  is  on  the  (iulf  of  Mexico  and  Salvador 
is  wedged  right  in  between  Guatemala  and  Nicaragua,  if  thi)se  two 
countries  sliould  not  follow  the  regulations  agreed  upon  they  might 
be  a  great  drawback  to  the  carrying  out  of  the  measures  by  the 
other  countries  of  Central  America,  as  they  are  all  connected  by  the 
same  lines  of  steamers;  and  Doctor  Medina  said  he  thought  that 
unless  an  exception  was  made  with  regard  to  those  Republics  they 
might  not  really  have  a  good  understanding  of  what  had  been  done, 
and  that  they  might  not  sign  as  quickly  as  is  desired  by  this  conven- 
tion. When  he  explained  it  to  me  in  that  light  I  agreed  with  him. 
Of  course  it  is  for  the  convention  to  say  whether  it  deems  it  proper. 

Doctor  GuiTERAS.  I  present  an  amendment  to  that  motion,  tnat 
when  the  transactions  of  this  convention  are  published  a  copy  be 
sent  to  all  the  countries  of  the  western  continent.  I  do  not  under- 
stand why  we  should  pick  out  two  countries  and  present  to  them 
especially  the  reports  of  this  convention  and  not  to  the  other 
Republics. 

The  President.  That  is,  not  the  transactions;  it  is  the  convention 
which  we  adopt. 

Doctor  GuiTERAS.  Even  at  that,  I  do  not  see  why  it  should  be 
sent  to  these  two  Republics  and  not  to  the  others.  There  are  nine 
Republics  which  are  not  represented  here. 

Doctor  Medina.  My  idea  in  mentioning  those  two  only  was  that 
they  were  concerned  more  than  the  others,  as  being  right  in  the 
middle  of  Central  America,  it  was  especially  important  that  they 
should  have  these  copies.  If  the  other  Republics  do  not  accept  it  I 
should  be  very  sorry,  but  not  so  much  so  as  in  the  case  of  these  two 
Republics,  because  all  our  efforts  would  be  in  vain  unless  they  did 
accept. 

Doctor  GuiTERAS.  I  make  the  motion  that  the  convention  be  sent 
to  all  the  countries  of  the  western  continent.  I  make  that  motion 
as  an  amendment. 

The  motion  of  Doctor  Guiteras  was  translated  by  the  secretary. 

Doctor  Medina.  I  accept  that  amendment. 

The  Secretary.  The  motion  is  that  a  cop}^  of  this  convention  be 
sent  to  each  of  the  countries  which  are  not  represented  at  this  con- 
vention. 

Doctor  Gatewood.  Are  there  not  other  countries  concerned 
besides  the  Republics  of  South  America?  There  are  the  West  India 
islands  that  might  be  mterested. 

The  President.  This  is  a  convention  of  the  American  Republics. 

Doctor  Gatewood.  I  understand  that;  but  would  there  be  any 
objection  to  sending  the  convention  to  the  other  countries? 

The  President.  If  you  wish  to  make  a  motion  to  amend,  you 
may  do  so. 

Doctor  Gatewood.  I  do  not  wish  to  make  a  motion  if  it  is  alto- 
gether out  of  the  question. 

Doctor  Medina.  I  thmk  it  would  be  impracticable  to  send  copies 
to  those  islands  of  the  West  Indies.  They  belong  to  foreign  countries, 
to  the  other  Government,  and  the  proper  thing  would  be  to  send  it 


70  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

just  to  the  American  Republics,  it  seems  to  me.  They  are  the  only- 
ones  interested. 

The  President.  The  question  is  on  the  motion  of  Doctor  Medina, 
with  the  amendment  of  Doctor  Guiteras. 

Doctor  Medina.  I  will  change  that  motion,  and  say,  instead  of  the 
two  Republics,  to  all  the  Republics  not  represented  here,  and  that  we 
shall  say  to  them  that  we  would  see  with  pleasure  their  adherence  to 
our  convention. 

The  President.  Perhaps  you  had  better  read  it  as  amended. 

Doctor  Medina.  It  will  read  in  this  way,  in  English:  "Doctor 
Medina,  the  representative  from  Nicaragua,  presents  a  motion, 
amended  by  Doctor  Guiteras,  in  the  following  way.  That  this  con- 
ference should  address  officially  all  the  governments  not  repre- 
"  sented  at  this  convention  and  send  a  copy  of  our  convention  to  them, 
at  the  same  time  letting  them  know  that  we  would  receive  with 
pleasure  their  adherence  to  our  treaty  here,  or  would  join  with  us." 

The  Secretary.  I  think  it  would  be  better  that  that  motion 
should  go  to  the  advisory  council  and  be  presented  to-morrow. 

Doctor  Medina.  Very  well. 

The  President.  Is  there  any  other  motion  to  be  offered,  or  is  there 
any  paper  to  be  read  ? 

Doctor  Guiteras.  The  plague  came  first,  but  if  there  is  no  paper  to 
be  read  on  the  plague,  I  will  read  a  paper  on  yellow  fever  in  Cuba. 

Doctor  Licéaga  addressed  the  convention  in  Spanish. 

The  Secretary.  Doctor  Licéaga  wants  me  to  explain  to  the 
delegates  that  they  need  not  be  afraid  about  the  length  of  his  paper — 
which  has  been  printed  and  copies  of  which  you  all  have  in  your 
hands — on  the  plague,  because  he  is  only  going  to  make  a  few  remarks 
about  it,  instead  of  reading  the  paper. 

Doctor.  Licéaga  here  addressed  the  convention  in  Spanish,  extem- 
pore, upon  the  subject  of  the  plague. 

Doctor  Lavoreria  addressed  the  convention  in  Spanish. 

Doctor  Licéaga  responded  to  Doctor  Lavoreria. 

Doctor  Guiteras.  I  would  ask  that,  as  unfortunately  we  have  no 
Spanish  stenographer,  Doctor  Lavoreria  be  requested  to  present  in 
writing  his  remarks  to  be  printed  in  the  transactions. 

Doctor  Licéaga,  of  course,  has  his  paper  printed  in  both  Spanish 
and  English  form,  but  we  have  nothing  left  of  Doctor  Lavoreria's 
remarks  unless  he  will  present  them  in  writing. 

The  President.  Will  Doctor  Lavoreria  write  out  his  remarks  and 
send  them  to  the  secretary  ? 

Doctor  Lavoreria  here  addressed  the  convention  in  Spanish. 

Doctor  Guiteras.  I  will  withdraw  my  motion.  Doctor  Lavoreria 
says  that  he  has  presented  a  report  already  from  his  country,  and 
his  remarks,  or  the  substance  of  them,  are  included  in  that  report. 

The  President.  Doctor  Moore,  have  you  anything  to  say  on  this 
subject? 

Doctor  Moore  addressed  the  convention  in  Spanish. 

The  President.  Will  you  write  out  your  remarks  and  send  them 
in,  Doctor  Moore? 

Doctor  Moore  (speaking  in  English).  I  will  write  them  out. 

The  President.  Are  there  any  further  remarks  upon  this  subject 
of  the  plague?  If  not.  Doctor  Guiteras  has  a  paper  upon  yellow 
fever. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  71 

Doctor  GuiTERAS.  I  have  here  a  report  on  the  yellow  fever  in  Cuba 
since  the  last  meeting.  I  am  sorry  that  I  have  had  to  arrange  this 
report  in  the  shape  of  an  argument  in  support  of  the  view  that 
yellow  fever  is  transmitted  only  by  mosquitoes.  Of  course  this  con- 
vention has  accepted  it  as  a  fact,  but  as  there  are  countries  and  por- 
tions of  countries  in  America  where  this  has  not  been  attempted,  and 
where  certain  of  the  people  are  still  not  prepared  to  accept  it,  I  have 
been  glad  of  the  opportunity  to  repeat  the  arguments  in  favor  of  such 
a  view. 

Doctor  Guiteras  here  read  his  paper,  in  English  (see  Appendix, 
p.  217). 

The  President.  I  am  sure  we  are  all  very  much  indebted  to 
Doctor  Guiteras  for  that  very  interesting  paper.  I  consider  it  a  very 
valuable  paper.     Are  there  any  remarks  upon  this  subject? 

Doctor  Gatewood.  I  move  that  we  adjourn. 

Thereupon,  at  6  o'clock  p.m.,  the  convention  adjourned  until 
to-morrow,  Saturday,  October  14,  1905,  at  10.30  o'clock  a.  m. 


FIFTH  DAY— SATURDAY,  OCTOBER  14. 
Morning  Session. 

The  convention  was  called  to  order  at  10.30  o'clock  a.  m.  by  "the 
president,  Surgeon-General  Wyman. 

The  President.  The  minutes  of  yesterday  will  be  read  by  the 
secretary. 

The  minutes  were  read  by  the  secretary. 

.The  Secretary.  This,  of  course,  is  only  an  abstract  of  the  minutes 
of  the  convention.  The  minutes  will  be  transcribed  in  fidl,  and  will 
be  published  in  full.  This  is  only  an  outline,  to  comply  with  the  con- 
ditions of  the  convention. 

It  was  moved  and  seconded  that  the  minutes  be  approved,  and  the 
motion  was  agreed  to. 

The  President.  The  next  order  of  business  will  be  the  report  of  the 
advisory  council  on  the  resolutions  of  Doctor  Medina  as  they  were  to 
be  put  in  shape. 

Doctor  GuiTERAS.  In  the  name  of  the  council,  I  report  that  the 
resolution  presented  by  Doctor  Medina  is  recommended  to  the  asso- 
ciation, with  the  understanding  that  the  Bureau  of  American  Repub- 
lics will  send  copies  of  the  convention  to  the  governments  of  all  the 
American  Republics. 

The  President.  You  hear  the  resolution  as  presented  by  the 
advisory  council,  to  the  effect  that  the  convention  which  we  are  now 
preparing  regarding  quarantine  and  epidemic  diseases  shall  be  trans- 
mitted through  the  Bureau  of  American  Republics  to  all  the  South 
American  and  Central  American  republics,  whether  they  are  repre- 
sented in  this  convention  or  not.     Are  there  any  remarks? 

The  resolution  was  agreed  to. 

The  President.  Some  of  the  delegates  who  are  very  much  inter- 
ested in  the  matters  that  are  to  come  up  in  completing  our  agreement 
are  not  as  yet  present  this  morning,  and  I  therefore  recognize  Doctor 
Geddings,  who  has  a  few  brief  remarks  to  make  and  a  resolution  to 
present. 

Doctor  Geddings.  Mr.  President,  it  has  been  bi;ought  to  the  atten- 
tion of  this  convention  that  in  the  Comptes  Rendus,  Société  de  Bio- 
logic de  Paris  for,  I  think,  August,  1905,  there  is  a  claim  by  Messrs. 
Marchoux  and  Simon  of  the  French  Commission  of  the  Pasteur  Insti- 
tute of  Paris,  whose  work  in  Rio  de  Janerio  has  received  wide  notice, 
that  they  have  demonstrated  that  the  infected  Stegomyia  produces 
infected  offspring.  Such  a  claim  as  this  is  startling,  although  a  similar 
announcement  was  foreshadowed  in  the  daily  press  of  New  Orleans  as 
a  possible  explanation  of  the  occurrence  of  mild  cases  in  that  city.  I 
have  had  the  pleasure  of  speaking  to  our  esteemed  contemporary, 
Doctor  Guiteras,  to  whom  we  all  look  up  to  in  this  matter,  and  if  it 
meets  his  views,  and  the  views  of  the  convention,  I  think  it  would  be 
of  decided  benefit  to  us  here  to  beg  the  privilege  of  a  few  remarks  from 
Doctor  Guiteras  on  the  point,  to  elicit  his  opinion,  if  he  is  ready  to 
express  one  on  this  doctrine,  and  begging  him  to  foreshadow  in  the 

72 


SECOND    INTKHNA^riONAL    HANITARY    iJONVKNTION.  73 

deep  thought  he  has  given  to  these  matters  the  effect  upon  the  integ- 
rity of  the  doctrine  of  mosquito  transmission  of  yellow  fever  and  its 
possible  effect  upon  public  health  measures;  and  J  tiierefore  beg  to 
move  that,  if  agreeable  to  J)octor  Guiteras  and  to  the  c(jnvention,  he 
should  address  us  on  these  lines. 

The  motion  of  Doctor  Geddings  was  translated  into  Spanish  by  tiie 
secretary. 

Doctor  Guiteras.  I  woidd  be  very  glad  indeed  if  anything  that  I 
may  say  will  assist  in  the  work  that  we  are  all  so  much  interested  in. 
I  was  avvare  of  the  announcement  made  by  the  PVench  Commission  of 
the  Pasteur  Institute  of  this  discovery.  In  their  recent  report  thev 
suggest  that  they  have  found  two  new  methods  of  transmission  of  yel- 
low fever,  to  which  they  l)elieve  importance  should  be  attached. 
These  new  methods  are  the  infection  of  the  eggs  of  infected  Stego- 
Tuyias,  and  the  transmission  of  yellow  fever  through  extremely  mild 
cases  in  the  natives  of  the  yellow-fever  countries.  I  must  say  that  I 
called  attention  to  these  suggestions  and  announcements  of  Marchoux 
and  Simon  at  the  meetings  of  the  New  Orleans  Paris  Medical  Society 
during  my  recent  visit  in  that  city.  The  announcement  as  to  the  trans- 
mission through  the  eggs  of  the  infected  Stegomyia  is  certainly  a  matter 
of  grave  importance ;  but  it  seems  to  me  that  everything  points  to  the 
probability  of  an  error  of  judgment,  or  of  facts,  in  this  announcement 
made  by  those  gentlemen.  I  have  read  their  original  publication,  and 
they  themselves  admit  that  they  have  only  a  single  case — an  experi- 
ment— which  was  of  this  character.  They  raised  eggs  from  infected 
Stegomyias  in  the  twelfth  day  of  their  infection — and  this  is  a  very 
interesting  point,  and  they  insist  upon  that  point,  that  the  eggs  must 
be  laid  when  the  mother  mosquito  is  actively  infected ;  that  is,  is  already 
capable  of  producing  the  disease  by  its  bite — that  is,  on  the  twelfth  day 
after  having  bitten  a  patient  infected  with  yellow  fever.  Therefore 
the  eggs  used  in  their  experiment  were  gathered,  or  were  laid,  on  the 
twelfth  day  after  biting  a  yellow-fever  patient,  and  then  mosquitoes 
were  raised  from  those  eggs,  and  from  several  experiments  tried  they 
succeeded  in  producing  one  single  case  of  yellow  fever  with  the  mos- 
quitoes raised  from  those  eggs.  Now,  to  begin  with,  this  is  a  single 
case.  Of  course  in  the  experiments  of  this  kind  one  case  does  not 
count  for  much,  especially  when  the  experiments  were  being  carried 
out  in  an  infected  locality — in  Rio  de  Janerio — and  when  the  infection 
might  have  come  about  through  the  bite  of  an  infected  mosquito. 
They  themselves  admit  this,  or  consent  that  it  weakens  very  much 
their  point;  that  they  have  only  one  case  to  present. 

Furthermore,  I  have  to  object  to  this  supposed  new  method  of 
transmission  of  yellow  fever  on  other  grounds,  from  experiments  made 
in  Habana.  I  am  sorry  to  say  that  these  experiments  are  not  care- 
fully recorded  experiments  that  will  stand  close  scientific  investiga- 
tion, but  they  certainly  have  some  weight,  and  I  hope  that  Doctor  Car- 
roll, who  has  the  privilege  of  the  ñoor,  will  state  his  part  of  the  experi- 
ments that  I  am  about  to  mention.  I  say  that  we  have  in  Habana 
experiments  performed  which  contradicted  this  statement  of  Mar- 
choux. My  experiments  at  Las  Animas  contradicted  this  new  view  in 
this  wise.  As  a  matter  of  fact,  all  the  mosquitoes  that  we  have  used  in 
our  experimental  station  in  Habana  from  the  beginning,  all  of  them, 
proceeded  from  infected  mosquitoes — that  is,  we  started  with  a  cer- 
tain number  of  mosquitoes  that  we  fed  upon  yellow-fever  patients,  and 


74      SECOND  INTERNATIONAL  SANITAEY  CONVENTION. 

we  infected  them,  and  those  mosquitoes  kept  laying  eggs,  and  in  that 
way  we  kept  up  our  breed  of  mosquitoes  at  Las  Animas  Hospital. 
Now,  these  mosquitoes  were  always  fed  by  nonimmunes.  There  were 
two  of  them  that  were  constantly  putting  their  arms  into  the  jar  con- 
taining these  mosquitoes,  so  that  they  would  be  fed,  and  would  lay 
eggs.  So  that  we  were  constantly  making  the  experiment  without 
taking  speci-al  note  of  the  experiment.  But  on  two  occasions  I  remem- 
ber calling  the  attention  of  several  gentlemen  to  this  and  saying, 
"There  is  a  mosquito  raised  from  infected  mosquitoes,  fed  by  nonim- 
munes, raised  from  eggs  laid  by  infected  females,  and  yet  they  are  not 
going  to  contract  the  disease."  Therefore  it  is  not  transmitted  in  the 
case  of  Stegomyia  as  it  is  in  the  case  of  Texas  fever  with  the  tick.  I 
called  the  attention  several  times  of  visitors  and  friends  to  this, 
although  we  did  not  take  any  note  of  it.  I  believe  the  same  thing  will 
be  stated  to  you  by  Doctor  Carroll.  I  believe  they  did  the  same 
thing;  that  they  saw  several  times  nonimmunes  being  bitten  by  mos- 
quitoes raised  from  the  eggs  of  infected  mosquitoes — such  mosquitoes' 
as  are  mentioned  by  Marchoux  and  Simon. 

And  finally  it  seems  to  me  that  if  this  were  true — that  the  infection 
of  yellow  fever  could  be  transmitted  from  the  mother  mosquito  to 
the  eggs — that  it  would  have  been  absolutely  impossible  to  cause  the 
disappearance  of  yellow  fever  from  Habana,  as  we  have  done.  I 
would  certainly  give  up  all  hope  of  eradicating  yellow  fever  from  the 
earth,  which  I  now  entertain  in  a  lively  manner,  if  that  were  possible. 
It  seems  to  me  impossible  to  combat  the  disease  if  you  have  such  an 
active  way  of  propagation  of  the  disease,  which  lies  entirely  beyond 
your  control,  as  the  innumerable  eggs  that  misquotoes  lay  during  their 
lives — eggs  that  should  all,  according  to  this  view,  be  capable  of  pro- 
ducing infected  mosquitoes. 

There  is  another  point  that  is  implied  in  this  statement  of  Mar- 
choux— at  least  I  think  it  is  implied — as  to  the  yellow  fever  transmit- 
ted in  this  manner,  that  is  transmitted  by  mosquitoes  raised  from 
supposed  infected  eggs,  and  that  is  that  the  yellow  fever  so  transmit- 
ted IS  a  mild  type  of  the  disease.  Now,  it  seems  to  me  this  is  a  funda- 
mental error.  If  the  yellow  fever  transmitted  in  that  manner  would 
be  a  mild  form  of  the  disease,  I  think  yellow  fever  would  have  died 
out  over  the  earth  long  ago  of  itself.  There  would  have  been  a  proc- 
ess of  natural  vaccination  of  the  disease;  because  I  believe  all  of 
you  will  admit  that  the  cases  produced  from  such  eggs  ought  to  be 
much  more  numerous  than  those  produced  directly  from  the  infected 
mothers,  because  a  mother  can  only  produce  in  her  life  of  150  days, 
biting  every  three  days,  50  cases  of  yellow  fever,  whereas  that  mos- 
quito will  lay  400  or  500  eggs — perhaps  several  hundred  eggs — from 
which  several  hundred  mosquitoes  would  arise,  which  would  all  of 
them  produce  mild  vaccinating  cases  of  yellow  fever,  so  that  we 
would  have  the  mother  mosquito  producing  only  50  cases  and  we 
would  have  this  constant  process  of  vaccination  with  mild  cases 
going  on  tln-ough  the  human  race,  and  the  disease  would  have  died 
out  through  vaccination  in  nature. 

These  are  the  objections  that  I  raise  against  the  statement  made 
by  Marchoux  and  Simon. 

Doctor  Guiteras  here  repeated  his  remarks  in  Spanish. 

The  President.  We  would  like  to  hear  from  Doctor  Carroll,  of  the 
United  States  Army. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  75 

Doctor  Carroll.  I  agree  most  heartily  with  what  Doctor  Guiteras 
has  said  on  this  subject.  I  do  not  think  it  is  safe  to  accept  the  state- 
ment of  these  gentlemen  upon  one  unconfirmed  experiment,  because 
we  can  bring  forward  an  experiment  made  for  the  purpose  of  deter- 
mining that  very  point.  Alter  we  had  about  completed  our  work  in 
one  ot  these  places  we  placed  a  number  of  mosquitoes,  hatched  out 
from  the  eggs  laid  by  infected  insects,  in  a  jar,  and  we  had  a  nonim- 
mune place  his  hand  in  this  jar,  and  he  was  bitten  by  30  or  40  insects. 
We  did  not  expect  any  result,  and  no  result  followed. 

Our  insects  were  not  obtained  in  quite  the  way  Doctor  Guiteras  has 
indicated.  Our  stock  was  obtained  from  insects  obtained  on  the 
outside.  Our  first  stock  was  obtained  from  those  insects  which  we 
^ot  from  Doctor  Finlay .  Our  second  stock  was  largely  obtained  from 
insects  at  Santa  Clara  Barracks. 

Doctor  Guiteras,  And  it  is  quite  possible  that  among  those  there 
ought  to  have  been  infected  mosquitoes'? 

Doctor  Carroll.  Yes;  I  am  willing  to  admit  that. 

Doctor  Guiteras.  It  is  probable. 

Doctor  Carroll.  These  insects  were  hatched  out  and  raised  in  the 
post  laboratory,  and  it  was  only  afterwards  that  they  were  taken  to 
the  special  laboratory  where  our  infected  mosquitoes  were  kept,  and, 
once  infected,  their  progeny  were  kept  in  the  mosquito  house;  that 
is,  the  house  kept  specially  for  the  infected  mosquitoes. 

I  think  this  experiment  to  which  Doctor  Guiteras  refers  is  like  many 
others  in  the  scientific  world.  We  can  not  accept  them  until  we  receive 
confirmation.  It  is  evident  that  the  fullest  precautions  were  not 
taken,  and  it  is  unsafe  to  accept  them. 

And  then,  as  Doctor  Guiteras  says,  if  we  were  to  accept  the  possi- 
bility of  infection  of  the  progeny  of  infected  mosquitoes  it  is  quite  evi- 
dent that  the  disinfection  of  infected  dwellings  will  not  stamp  out  the 
disease  as  fully  as  it  was  stamped  out  in  Habana.  I  think  Doctor 
Liceaga  might  give  us  some  interesting  remarks  on  that  question, 
resulting  from  his  experience  in  Mexico. 

Doctor  Guiteras.  I  will  try  to  put  briefly  in  Spanish  the  substance 
of  this,  as  this  is  a  question  in  which  some  of  our  Latin  American  col- 
leagues may  assist  us  with  their  opinions. 

Doctor  Guiteras  here  translated  into  Spanish  the  preceding  remarks 
of  himself  and  Doctor  Carroll. 

Doctor  Liceaga  addressed  the  convention  in  Spanish. 

The  Secretary.  The  remarks  of  Doctor  Liceaga  are  to  the  effect 
that  he  congratulates  Doctor  Guiteras  for  the  excellent  explanation 
that  he  has  given  of  the  subject  in  question,  w^hich  he  considers  not 
only  as  a  contradiction  of  the  information  given  by  Marchoux  and 
Simon,  of  the  commission  to  Brazil,  but  he  goes  a  little  further  and  says 
that  it  should  not  only  be  called  a  contradiction,  but  that  the  expres- 
sions of  Doctor  Guiteras  have  really  given  the  lie  to  these  gentlemen 
for  having  affirmed  something  based  only  on  one  case.  He  put  the 
question  as  to  the  effect,  and  on  that  he  says  that  to  his  knowledge 
there  is  no  acute  disease  whose  infection  is  transmitted  by  the  off- 
spring or  b}^  the  eggs  of  insects.  He  confirms  the  opinion  of  Doctor 
Guiteras  that  if  the  opinion  of  Doctors  Simon  and  Marchoux  were 
true  the  disappearance  of  yellow  fever  from  Habana  in  such  an  effect- 
ive manner  as  it  took  place  would  have  been  utterly  impossible.  He 
says  that  the  experiments  and  the  opinions  of  Doctors  Guiteras  and 


76  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Carroll  are  enough,  in  his  estimation,  to  convince  us  of  the  fallacy  of 
the  opinion  manifested  by  the  doctors  of  the  Brazil  commission. 

He  insisted  upon  this  other  ])oint.  He  says  that  one  argument 
that  might  be  used  against  this  opinion  is  the  admission  of  Doctors 
Marchoux  and  Simon  to  the  eft'ect  that  they  consider  their  point 
rather  weak  because  they  only  had  one  case  out  of  their  experiments, 
and  besides,  that  they  could  not  say  to  a  certainty  that  the  mosquito 
infected  had  conveyed  the  disease;  that,  as  Doctor  Guiteras  said,  the 
experiment  was  conducted  in  a  place  infected  with  yellow  fever, 
where  the  biting  b}^  a  mosquito  infected  was  an  easy  matter. 

Doctor  Licéaga  finished  by  remarking  that  this  weak  point  in  the 
announcement  of  Doctor  Marchoux  and  Doctor  Simon  was  in  very 
plain  contradiction  to  the  points  assured  by  the  work  of  Doctor  Car- 
roll, Doctor  Guiteras,  Doctor  Reed,  and  all  the  other  gentlemen  who 
experimented  in  Habana,  and  who,  while  at  the  beginning  the}"  could 
not  .state  the  facts  with  certainty,  yet  through  experiments,  thorough 
and  long  continued,  and  resulting  in  the  prevention  of  yellow  fever, 
had  established  their  opinions  as  a  certainty. 

The  President.  We  have  with  us  the  head  of  the  medical  depart- 
ment of  the  Marine-Hospital  Service,  and  I  would  like  to  ask  his  opin- 
ion on  this. 

Doctor  Stiles.  I  agree  thoroughly  with  Doctor  Guiteras  and 
Doctor  Carroll  that  there  is  no  reason  why  we  should  become  fright- 
ened at  this  announcement  in  Paris.  But,  in  justice  to  our  French 
colleagues,  w^e  should  recall  one  very  important  statement  in  their 
article,  namely,  that  such  a  method  of  transmission  is  exceptional. 
That  is  their  claim.  They  do  not  set  this  forth  as  being  a  regular 
method  of  transmission,  but  they  merely  say  that  such  a  method  of 
transmission  is  exceptional,  and  in  tliis  claim  I  see  nothing  contra- 
dictory to  the  statements  brought  forward  by  our  good  friends. 
Doctor  Carroll  and  Doctor  Guiteras.  It  is  perfectly  possible  that 
they  may  have  made  fifty  or  one  hundred  experiments  in  Cuba  of  tliis 
kind,  and  have  had  them  all  negative,  but  that  is  negative  evidence. 
Now,  we  must  bear  in  mind  the  fact  that  we  have  had  at  least  half  a 
dozen  diseases  which  may  be  transmitted  from  one  generation  to  the 
next  through  insects.  I  am  by  no  means  of  the  opinion  that  we 
should  immediately  accept  these  statements  that  have  just  reached 
us  from  Paris,  but  I  believe  we  should  hold  our  minds  open  for  further 
proof.  It  is  a  little  dangerous  to  condemn  a  statement  offhand  like 
this.  Take,  for  instance,  malaria.  It, is  now,  according  to  Schau- 
dinn,  demonstrated  that  malaria  may  be  transmitted  from  one  gen- 
eration of  mosquitoes  to  another.  Pehrin  disease  is  hereditary  in  the 
silkworm.  We  have  the  fiagellat  diseases  in  flies  so  transmitted. 
We  have  two  diseases  in  an  owl  of  Germany  which,  it  is  claimed,  may 
be  hereditary  in  the  intermediate  host,  namely,  Culex.  Now,  until 
we  know  just  what  the  parasite  of  yellow  fever  is,  it  seems  to  me  difli- 
cult  to  make  any  definite  statement  that  this  can  not  be  hereditary 
in  the  mosquito.  It  seems  to  me  not  improbable  that  the  parasite 
of  yellow  fever  will  turn  out  eventually  to  be  an  organism  more  or  less 
closely  allied  to  the  parasites  of  the  same  general  class  of  diseases  as 
those  that  I  have  mentioned,  namely,  an  organism  belonging  some- 
where in  between  the  flagellats  and  the  sporozoa.  I  might  also  refer 
to  Texas  fever  in  cattle  and  hemoglobinuria  in  dogs — the  canine 
plasmosis — in  way  of  comparison. 


SECOND    IN'I'KRNATIONAi.    SANI'J'AKY     (JON VKNTION.  77 

In  view  of  the  fact  that  we  know  a  number  of  diseases  are  trans- 
mitted by  heredity  in  the  intermediate  host,  I  bcHeve  it  is  too  early 
to  come  down  too  heavily  on  this  French  announcement.  We  should 
simply  hold  our  minds  ojxui,  in  a  receptive  mood,  and  if  our  col- 
leagues can  demonstrate  h(>rodity  in  this  disease,  as  has  been  dismon- 
strated  in  other  diseases,  let  us  do  thcjn  the  justice  to  recall  tiiat  they 
do  not  state  that  this  is  a  common  method  of  transmission.  They 
state  it  distinctly  to  bo  an  exce])tional  method. 

The  remarks  of  Doctor  vStiles  were  translated  into  Sj)anis])  by  the 
secretary. 

The  Secretary.  Several  of  the  members  inquire.  Doctor  Stiles, 
if  you  said  that  malaria  belonged  to  the  diseases  transmissible  by 
heredity  in  the  intermediate  host. 

Doctor  Stiles.  Yoís;  the  parasite  of  malaria  is  claimed  by  Schau- 
dinn  to  be  transmissible  from  the  female  mosquito  to  the  next  gener- 
ation. That  was  published  in  1894  by  the  Imperial  Health  Office  of 
Germany.  The  parasite  has  been  found  passing  from  one  generation 
to  the  next.  There  were  no  clinical  cases  based  on  such  heredity, 
but  the  parasite  was  found  passing  through  the  egg. 

The  President.  Doctor  Guiteras  has  an  important  matter  to 
bring  before  the  convention. 

Doctor  Guiteras.  Mr.  Chairman,  I  wish  to  introduce  a  series  of 
articles,  to  be  added  to  the  convention  already  agreed  upon  at  our  last 
meeting,  which  articles  should  be  numbered  28a,  28b,  28c,  and  28d, 
so  as  not  to  break  the  order  of  the  numbers  as  they  are  found  in  the 
French  edition  and  in  order  that  they  may  not  be  placed  at  tlie  end, 
^s  I  had  at  first  thought  of  doing,  where  they  will  appear  very  awk- 
wardly. I  would  place  them  in  the  midst  of  the  articles  where  they 
properly  belong,  following  article  28,  and  call  them  ''28a,"  ''28b," 
"  28c,"  and  "  28d."     There  are  four  of  these  articles. 

The  Secretary.  You  had  better  call  them  additional  articles. 
That  is  the  only  way  to  do  it. 

Discussion  in  Spanish  followed. 

Doctor  Guiteras.  I  move  that  the  following  additional  articles 
be  introduced,  following  the  last  article  agreed  upon  at  our  previous 
meeting.  The  last  article  was  numbered  45,  so  tha,t  these  four 
articles  will  be  numbered  46. 

The  President.  They  are  headed  "Additional  articles  relating  to 
yellow  fever? " 

Doctor  Guiteras.  They  are  headed  that  way- — "Additional  articles 
relating  to  yellow  fever." 

The  President.  I  will  ask  Doctor  Moore  to  take  the  Spanish  copy 
of  these  additional  articles,  as  he  did  with  the  first  part  of  the  conven- 
tion, and  read  them  in  Spanish  as  we  proceed. 

Doctor  Guiteras  read  as  follows: 

Article  46.  Ships  infected  with  yellow  fever  are  to  be  subjected  to  the  following 
regulations : 

1.  Medical  visit  (inspection). 

2.  The  sick  are  to  be  immediately  disembarked,  protected  by  netting  against  the  access 
of  mosquitoes,  and  transferred  to  ühe  place  of  isolation  in  an  ambulance  or  a  litter  similarly 
screened. 

The  above  part  of  article  46  was  read  in  Spanish  by  Doctor  Moore. 
The  President.  Shall  we  vote  on  this  by  paragraphs,  or  shall  we 
have  the  whole  article  read  all  through? 
Al  short  discussion  followed. 


78  SECOND    INTERNATIONAL    SANITABY    CONVENTION. 

The  President.  We  will  read  this  article  through,  paragraph  b 
paragraph,  and  anyone  who  has  any  question  to  ask  will  please  as 
it  at  the  time,  or  it  anj^one  has  any  objection  to  make  or  anj'^  motion 
to  make,  after  it  has  been  read  in  English  and  Spanish,  let  him  make 
it,  or  if  there  are  any  comments  to  be  made  they  can  be  made.  We 
will  go  on  and  read  every  paragraph  until  we  have  finished  the  article, 
and  then  we  will  vote  on  the  article. 

The  remarks  of  the  president  were  translated  into  Spanish  by 
Doctor  Ulloa. 

Doctor  Guiteras  continued  the  reading  of  the  article,  46  as  follows: 

3.  Other  persons  should  also  be  disembarked,  if  possible,  and  subjected  to  an  observation 
of  six  days,  dating  from  the  day  of  arrival. 

The  above  was  read  in  Spanish  by  Doctor  Moore. 

The  President.  It  should  be  borne  in  mind  now  that  if  there  is 
any  alteration  in  phraseology,  either  in  the  Spanish  or  the  English 
language,  attention  should  be  called  to  it  at  the  present  time,  other- 
wise the  copies  as  read  will  go  to  the  transcribers. 

The  secretary  translated  the  remarks  of  the  president  into  Spanish; 

Doctor  Guiteras  continued  the  reading  of  article  46,  as  follows: 

4.  In  the  place  set  apart  for  observation  there  shall  be  screened  apartments  or  cages 
where  anyone  presenting  an  elevation  of  temperature  above  37.6°  C.  shall  be  screened 
until  he  may  be  carried  in  the  manner  indicated  above  to  the  place  of  isolation. 

5.  The  ship  shall  be  moored  at  least  600  feet  from  the  inhabited  shore. 

Doctor  Barnet  addressed  the  convention  in  Spanish. 

Doctor  Guiteras.  Doctor  Barnet  suggested  that  in  the  Spanish 
copy  we  state  200  meters,  as  the  metric  system  is  used  in  Latin 
countries,  and  200  meters  is  the  equivalent  of  600  feet. 

Doctor  Geddings.  I  would  suggest  making  it  200  meters  in  both 
languages,  because  600  feet  is  not  the  exact  equivalent,  though  it  is 
approximately  so,  of  200  meters. 

Doctor  Guiteras.  It  is  not  any  less 

Doctor  Geddings.  No,  sir;  it  is  rather  more. 

The  President.  We  wiU  substitute  ^'200  meters"  for  "600  feet," 
then. 

Doctor  Guiteras.  Then  it  will  read: 

5.  The  ship  shall  be  moored  at  least  200  meters  from  the  inhabited  shore. 

Doctor  Guiteras  continued  the  reading  of  article  46,  as  follows: 

6.  The  ship  shall  be  fumigated  for  the  destruction  of  mosquitoes  before  the  discharge  of 
cargo,  if  possible.  If  a  fumigation  be  not  possible  before  the  discharge  of  the  cargo,  the 
health  authorities  shall  order,  either — 

(a)  The  employment  of  immune  persons  for  discharging  the  cargo,  or 

(b)  If  nonimmunes  be  employed  they  shall  be  kept  under  observation  during  the  dis- 
charging of  cargo  and  for  six  days,  to  date  from  the  last  day  of  exposure  on  board. 

The  President.  We  will  now  vote  on  article  46  as  a  whole.  This 
is  to  be  article  46,  in  lieu  of  the  closing  formal  article  of  the  conven- 
tion as  we  had  it  yesterday,  and  the  closing  article  will  have  to  be 
changed  to  another  number. 

Article  46  was  agreed  to.  - 

Doctor  Guiteras  read  article  47,  as  foUows: 

Article  47.  Ships  suspected  of  yellow  fever  are  to  be  subjected  to  the  measures  which 
are  indicated  in  Nos.  1,  3,  and  5  of  the  preceding  article;  and  if  not  fumigated  the  cargo 
shaU  be  discharged  as  directed  under  subparagraph  (a)  or  (b)  of  the  same  article. 


SECOND    INTERNATIONAL    HANITAKY    CONVENTION.  79 

The  above  was  read  by  Doctor  Moore  in  S¡)ani.sh. 
Doctor  Barnett  addressed  the  convention  in  Spanish,  his  remarks 
not  being  translated. 

Article  47  was  agreed  to. 

Doctor  Guiteras  read  article  48,  as  follows : 

Article  48.  Ships  immune  from  yellow  fever,  cominji  from  an  infected  port,  after  the 
medical  visit  (inspection),  shall  bo  admitted  to  free  pratique,  provided  the  duration  of  the 
trip  has  exceeded  six  days. 

If  the  trip  be  shorter,  the  ship  shall  be  considered  as  suspected  until  the  completion  of  a 
period  of  six  days,  dating  from  the  day  of  departure. 

If  a  casa  of  yellow  fever  develop  during  the  period  of  observation,  the  ship  shall  be 
considered  as  infected.    . 

The  President.  In  the  first  line  of  this  article,  as  I  have  it  before 
me  here,  the  term  ''indemne"  is  .used  instead  of  ''immune." 

Doctor  Guiteras.  I  have  it  "indemne"  in  my  copy. 

The  President.  You  read  it  "immune." 

Doctor  Guiteras.  Certainly  we  would  call  a  ship  "indemne"  that 
came  from  an  infected  port  and  had  nothing  to  do  with  yellow  fever, 
would  we  not?  We  would  not  call  a  ship  coming  from  the  St.  Law- 
rence River,  for  instance,  from  the  north,  a  suspected  vessel.  That 
Would  be  an  indemne  vessel,  coming  from  an  uninfected  port. 

Doctor  Geddings.  It  is  the  ship  coming  from  an  infected  port, 
not  having  had  cases  at  the  port  of  departure,  or  en  route,  which  is 
meant  here. 

Doctor  Guiteras.  What  do  we  call  a  ship  that  is  entirely  free  ?  It 
is  not  in  the  convention,  anyway. 

The  President.  It  is  just  a  ship.     [Laughter.] 

Doctor  Guiteras  here  again  read  article  48,  as  above,  changing  the 
word  "immune"  to  "indemne." 

Article  48  was  read  in  Spanish  by  Doctor  Moore. 

Article  48  was  agreed  to. 

Doctor  Guiteras  read  article  49,  as  follows : 

Article  49.  All  persons  who  can  prove  their  immunity  to  yellow  fever  to  the  satisfac- 
tion of  the  health  authorities  shall  be  permitted  to  land  at  once. 

Article  49  was  read  in  Spanish  by  Doctor  Moore. 

Article  49  was  agreed  to. 

The  President.  The  typewritten  copies  of  the  agreement  which 
we  have  just  voted  upon,  article  by  article,  are  now  ready.  I  will 
ask  Doctor  Gatewood  to  read  the  copy  in  the  English  language  and 
Doctor  Lavoreria  to  read  the  copy  in  Spanish,  article  by  article,  the 
idea  being  that  if  there  is  any  technical  flaw  in  either  copy,  or  if 
there  is  anything  obscure  in  the  phraseology,  or  anything  ungram- 
matical  in  the  language,  attention  should  be  called  to  it  immediately, 
and  let  it  be  corrected  on  the  floor  of  the  convention,  because  this 
will  be  the  final  copy  which  will  be  signed  by  us.  In  this  way  it  is 
obvious  that  the  greatest  care  will  have  been  exercised  that  the 
unaltered  copies  in  Spanish  and  English  are  actually  signed  by  the 
members  of  this  convention.  The  work  of  typewTiting  the  copies  is 
nearly  completed,  and  we  can  commence  with  the  first  pages  of  the 
copies  in  both  Spanish  and  English,  and  the  last  pages  will  be  finished 
so  that  we  will  not  be  delayed. 

The  remarks  of  the  president  were  translated  into  Spanish  by  the 
secretary. 

The  preamble  was  here  read  in  English  by  Doctor  Gatewood. 


80  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Dr.  H.  L.  E.  Johnson  having  been  designated  in  the  preamble  of 
the  convention  as  "a  member  of  the  American  Medical  Association," 
Doctor  Johnson  requested  that  this  might  be  changed  to  ''  a  member 
of  the  Board  of  Directors  of  the  American  Medical  Association." 

The  above  alteration  was  agreed  to. 

The  reading  of  the  final  draft  of  the  convention  was  continued  by 
Doctor  Gatewood  in  English  and  Doctor  Lavoreria  in  Spanish  until 
1.20  p.  m.,  when  the  convention  took  a  recess  until  2.30  o'clock  p.  m. 

Afternoon  Session, 

The  convention  met,  pursuant  to  adjournment,  Surgeon-General 
Wyman,  the  president,  in  the  chair. 

The  President.  The  convention  will  come  to  order  and  we  will 
continue  with  the  reading  of  the  articles.     We  are  now  on  article  8. 

The  reading  of  t]p.e  convention  in  English  and  Spanish  was  con- 
tinued. 

The  President.  There  is  an  inquiry  with  regard  to  the  "Inter- 
national Sanitary  Councils,"  mentioned  in  article  10.  This  conven- 
tion has  an  international  sanitary  bureau,  but  whether  that  term 
''councils"  is  intended  to  be  more  broad  and  to  relate  to  any  othef 
councils,  or  rather  to  the  several  national  councils,  I  do  not  know. 

Doctor  Geddings.  The  International  Sanitary  Councils  mentioned 
in  that  convention  are  the  International  Sanitary  Council  of  Con- 
stantinople, and  the  Quarantine  and  Sanitary  Council  of  Egypt. 

The  President.  Then  it  includes  also  our  International  Sanitary 
Bureau  ? 

Doctor  Guiteras.  Yes,  sir. 

Doctor  Geddings.  We  left  it  in  advisedly,  believing  that  these 
notifications  should  be  made  in  this  way  to  the  Central  and  South 
American  Republics,  and  to  the  United  States,  and  the  International . 
Sanitary  Bureau. 

The  President.  We  are  not  dealing  with  the  foreign  countries. 
Doctor  Geddings,  is  that  your  understanding? 

Doctor  Geddings.  That  was  my  understanding — that  it  was 
simply  left  in  order  not  to  change  the  text,  but  the  International 
Sanitary  Bureau  of  this  convention  was  included  within  the  meaning 
of  that  paragraph. 

The  President.  There  is  nowhere  else,  in  this  convention,  so  far 
as  it  has  been  read,  where  reference  is  made  to  "International  Sani- 
tary Councils"  other  than  those  of  the  American  Republics. 

Doctor  Geddings.  That  is  correct. 

The  President.  Then  why  should  we  bring  it  in  here?  It  is  a 
little  confusing.  I  do  not  know  how  that  appeals  to  the  other  mem- 
bers of  the  convention,  but  I  think  it  is  a  point  that  ought  to  be 
considered — whether  we  shall  change  it  to  "  International  Sanitary 
Bureau"  or  not. 

Doctor  Geddings.  I  move  that  we  change  it  in  that  way. 

The  motion  was  seconded. 

The  President.  It  is  moved  and  seconded  that  the  words  "Inter- 
national Sanitary  Bureau,"  meaning  the  bureau  established  by  this 
convention,  be  substituted  for  the  words  "  International  Sanitary 
Councils." 

The  question  was  taken,  and  the  motion  was  agreed  to. 


SECOND    INTERNATIONAL    SANITARY    (JONV  KNTION.  81 

The  reading  of  the  convention,  article  })y  article,  in  French  and 
Spanish,  was  continued  down  to  the  end  of  article  21,  when  Doctor 
Licéaga  addressed  the  convention  in  Spanish,  his  remarks  heing 
translated  by  Doctor  Ulloa.  Doctor  Liceaga  said  that  it  having 
been  determined  in  the  former  session  that  a  distance  of  200  meters 
should  be  inserted,  the  last  part  of  article  20,  whicli  leaves  it  to  the 
sanitary  authorities  to  fix  the  distance  that  a  ship  sliould  be  com- 
pelled to  anchor  from  the  shore,  should  })e  clianged. 

Doctor  Medina.  It  was  placed  at  the  minimum,  so  that  any 
larger  distance  could  be  settled  by  the  authorities. 

Discussion  in  Spanish  between  Doctor  Liceaga,  Doctor  Medina, 
and  Doctor  Moore  followed. 

The  Secretary.  It  says ''at  least  200  meters."  Doctor  Liceaga 
is  satisfied  with  that. 

Doctor  Gatewood.  In  this  footnote,  in  regard  to  the  word  "crew," 
is  that  provision  in  the  Spanish  copy  to  the  effect  that  the  word  is 
to  be  construed  ^n  the  manner  defined  in  this  note  wherever  it 
occurs  in  the  present  convention? 

The  Secretary.  Yes;  it  is  in  the  Spanish  copy.     That  is  all  right. 

The  reading  of  the  convention  in  English  and  Spanish  was  con- 
tinued down  to  the  end  of  article  33. 

The  President.  There  is  one  point  I  want  cleared  up — about  a 
ship  not  being  subject  to  a  second  disinfection?  I  would  like  to 
know  whether  that  interferes  with  our  disinfection  of  what  we  call 
''via"  vessels?  Does  that  section  relate  to  all  diseases,  or  only  to 
some  ? 

Article  33  was  again  fead  by  Doctor  Gatewood  in  English. 

The  President.  Would  not  that  prevent  the  redisinfection  of  a 
vessel  in  a  southern  port? 

Discussions  in  English  and  Spanish  followed. 

The  President.  Very  well;  go  on. 

Doctor  Gatewood  here  read  article  34  in  English. 

A  Delegate.  I  would  like  to  ask  what  is  the  definition  of  the 
word  "packet." 

The  President.  That  is  a  term  taken  from  the  Paris  convention. 
Was  that  discussed  there?     Doctor  Geddings  can  tell  us. 

Doctor  Geddings.  For  example,  those  boats  which  ply  between 
ports  of  British  America  and  northern  ports  of  the  United  States, 
which  we  exempt  by  our  regulations  from  ineasures  relative  to  bills 
of  health,  are  packet  boats.  There  are  packet  boats  which  ply 
across  the  lakes. 

Doctor  Gatewood.  And  packet  boats  across  the  English  Channel, 
from  Calais  to  Dover.  If  you  will  look  in  the  dictionary  you  will 
find  some  such  definition  as  this:  "Packet  boat.  Originally,  a  vessel 
employed  by  government  to  carry  dispatches  or  mails,  and  therefore 
having  a  military  or  naval  signification;  hence,  applied  to  any  boats 
carrying  materials  that  have  a  regular  day  of  sailing." 

The  trans- Atlantic  liners  would  come  under  that. 

Doctor  Ulloa.  Here  is  the  definition  in  Webster's  Dictionary: 

Packet.  Originally,  a  vessel  employed  by  government  to  convey  dispatches  and  mails; 
hence,  a  vessel  employed  in  carrying  mails,  passengers,  and  goods;  a  mail  boat. 

5610—06 6 


82  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Doctor  Gatewood.  There  you  have  it. 

The  President.  Is  there  any  harm  in  leaving  it  in  there,  with 
that  understanding? 

Doctor  Gatewood.  Packets  are  mail  boats. 

The  President.  That  is  evidently  intended  to  apply  to  ports  not 
distant  from  one  another. 

Doctor  Gatewood.  My  idea  is  that  a  packet  is  a  boat  that  makes 
one  or  two  trips  a  day,  and  therefore  runs  within  a  small  radius  of 
the  place  of  departure.  But  a  ferryboat,  not  carrying  mails  and 
not  carrying  dispatches,  would  not  come  under  that  definition. 

The  Secretary.  We  call  them  "  barcos  de  cabotaje  "  in  Spanish. 
They  make  communication  between  different  ports  of  the  same 
country. 

Doctor  Gatewood.  If  it  is  between  different  ports  of  the  same 
countr}^,  why  do  you  put  this  in  here:  "Packet  boats  shall  be  sub- 
jected to  special  regulations,  to  be  established  by  mutual  agreement 
between  the  countries  in  interest?"  • 

The  Secretary.  That  is  so. 

The  President.  It  seems  to  me  you  might  leave  it  as  it  is. 

Doctor  Gatewood  here  read  article  35  in  English. 

Doctor  Lavoreria  here  read  article  35  in  Spanish. 

A  discussion  in  Spanish  followed  between  Doctor  Moore  and 
Doctor  Guiteras,  which  was  not  translated  into  English. 

The  reading  of  the  convention  in  Spanish  and  English  was  con- 
tinued down  to  the  end  of  article  41. 

Doctor  Gatewood  read  in  English  as  follows : 

Article  42.  Coaches  intended  for  the  transportation  of  passengers  and  mails  should  not 
be  retained  at  frontiers. 

The  President.  That  word  "retained  "  was  changed  to  "  detained," 
was  it  not? 

Doctor  Geddings.  No,  no;  it  was  left  ''retained,"  after  a  discus- 
sion.    We  decided  to  leave  it  in  that  way. 

The  reading  of  the  convention  in  English  and  Spanish  was  con- 
tinued down  to  the  end  of  article  48. 

Doctor  Geddings.  In  regard  to  the  second  paragraph  of  article  48, 
the  section  before  us  states: 

Ships  indemne  from  yellow  fever,  coming  from  an  infected  port,  after  the  medical  visit 
(inspection),  shall  be  admitted  to  free  pratique,  provided  the  duration  of  the  trip  has 
exceeded  six  days. 

The  quarantine  regulations  of  the  United  States  cover  the  same 
idea,  but  go  further,  that  if  the  duration  of  a  trip  exceeds  five  days, 
and  i&  less  than  ten  days,  the  same  procedure  would  obtain;  but  if 
the  voyage  is  more  than  ten  dsLjs  the  sliip  shall  be  disinfected  and 
held  under  observation.  That  rule  of  conduct  is  based  upon  the 
fact  that  if  a  mild  case  of  yellow  fever  occurs  on  board,  it  may  have 
sufficiently  recovered  to  permit  the  individual  to  pass  a  satisfactory 
medical  inspection,  but  the  case  may  have  infected  Stegomyia 
mosquitoes  which  are  on  board  and  give  rise  to  further  trouble.  It 
was  suggested  when  this  article  was  in  course  of  consideration  this 
morning  that  some  such  provision  should  be  put  in,  but  there 
appeared  to  be  reasons  why  it  should  not  be  done,  and  without  any 
wish  to  make  a  reserve  on  the  part  of  the  United  States,  I  think  it  is 
only  fair  to  state  that  in  cases  coming  under  that  category  the  United 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  88 

States  will  have  to  fall  back  upon  or  take  refuge  in  a  general  pro- 
vision of  the  convention  allowing  sjiecial  regulations  to  be  made  to 
meet  special  circumstances,  in  the  discretion  of  the  sanitary 
authorities. 

Doctor  Gate  WOOD.  Can  you  do  that  when  that  is  a  specific  state- 
ment there? 

Doctor  GuiTERAS.  With  respect  to  the  fact  of  the  necessity  of 
disinfection  in  these  cases,  it  must  be  remembered  that  the  action 
taken  by  the  United  States  evidently  does  not  refer  to  what  we  have 
defined  here  as  "indemne  ships,"  in  connection  with  yellow  fever. 
We  have  made  a  special  definition  of  indemne  ships  in  connection 
with  yellow  fever,  in  which  definition  it  is  stated  that  the  shin  has 
not  been  in  such  proximity  to  the  shore  as  to  make  it  possible  for 
mosquitoes  to  have  access  to  the  said  ship.  Therefore  there  can  be 
no  mosquitoes  in  an  indemne  ship  such  as  we  have  defined.  The 
ships  that  are  treated  on  the  tenth  or  twelfth  day  by  the  United 
States  authorities,  very  properly — I  mean  by  fumigation — -are  not 
the  indemne  ships  that  we  have  defined  here.  There  are  ships  that 
may  have  infected  mosquitoes.  But  these  can  not  have  them, 
because  it  says  definitely  that  they  must  have  anchored  a  sufficient 
distance  from  the  shore  not  to  have  received  infected  mosquitoes. 
So  that  I  do  not  see  that  the  United  States  need  change  in  the  least 
its  present  policy  in  respect  to  such  ships. 

The  President.  Is  that  satisfactory.  Doctor  Geddings  ? 

Doctor  Geddings.  With  that  explanation  the  paragraph  mil  be 
perfectly  satisfactory. 

Doctor  GuiTERAS.  This  explanation  goes  on  record,  I  suppose. 

The  President.  It  goes  on  the  record.  The  stenographer  is 
taking  everything  in  full.     All  that  has  been  said  goes  in  the  minutes. 

The  reading  of  the  convention  article  by  article  in  English  and 
Spanish  was  resumed  by  Doctor  Gatewood  and  Doctor  Lavoreria 
and  was  completed  to  the  end  of  the  "transitory  disposition." 

Discussion  in  Spanish  between  Doctor  Barnet  and  Doctor  Lavo- 
reria followed. 

The  Secretary.  Doctor  Lavoreria  has  made  a  motion  that  instead 
of  sa5ring  there  that  a  copy  should  be  sent  to  each  country  repre- 
sented, it  should  be  put  that  copies  in  both  English  and  Spanish 
should  be  sent  to  each  of  the  signatory  countries  to  this  convention. 

Doctor  Barnet  (speaking  in  English).  Because  the  English  is  the 
the  standard  one. 

The  President.  Yes;  that  is  right. 

Discussion  in  Spanish  followed. 

Doctor  GuiTERAS.  Doctor  Licéaga  has  made  a  motion  which  I 
will  translate  into  English. 

Doctor  Licéaga  moved  that  instead  of  saying  that  the  English  copy 
may  or  shall  serve  as  the  base  or — what  is  it  ? 

Doctor  Geddings.  The  standard. 

Doctor  GuiTERAS.  Yes;  the  standard;  that  we  say  that  in  case  of 
doubt  the  English  mterpretation  shall  stand,  or  be  the  standard. 

The  Secretary.  No,  no;  that  the  English  copj^  shall  prevail — 
that  the  interpretation  of  the  English  copy  shall  prevail. 

Doctor  GuiTERAS.  Yes;  that  the  interpretation  of  the  English 
copy  shall  prevail. 


84  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Doctor  Gatewood.  Then  it  will  read: 

Artici^e  50.  It  is  agreed  that  in  the  event  of  a  diü'erence  of  interpretation  of  the  Enghsh 
and  Spanish  text  the  interpretation  of  the  Enghsh  text  ^\■ill  prevail. 

Doctor  GuiTERAS.  That  is  right. 

The  President.  If  there  is  no  objection,  that  change  will  be  made. 
Then  I  think  the  words  ''in  both  English  and  Spanish"  should  be 
inserted  in  the  last  clause  of  the  transitory  disposition,  so  that  it  will 
read — 

in  order  that  certified  copies  thereof,  in  both  Enghsh  and  Spanish,  may  be  made  to  transmit 
them  through  diplomatic  channels  to  each  one  of  the  signatory  couuti'ies. 

Is  that  agreed? 

The  President.  That  is  agreed  to.  There  was  no  objection  and 
there  is  none. 

I  believe  that  the  convention  as  now  prepared,  in  both  the  Spanish 
and  the  English  languages,  has  been  read  and  approved,  article  by 
article.  It  now  becomes  necessary  to  adopt  the  convention  in  its 
entirety.     I  await  a  motion  to  that  effect. 

Doctor  Johnson.  I  move  you,  Mr.  President,  that  the  convention 
as  read  and  adopted,  article  b}^  article,  m  English  and  Spanish  be 
adopted  by  the  convention  in  its  entirety. 

Doctor  GuiTERAS.  I  second  the  motion. 

The  secretary  translated  the  motion  in  Spanish. 

The  convention  was  agreed  to  in  its  entirety. 

The  President.  It  is  adopted.     [Great  applause.l 

Doctor  Medina  addressed  the  convention  in  Spanish. 

The  Secretary.  Doctor  Medina  makes  a  motion  to  the  effect  that 
this  convention  shall  be  published  and  copies  thereof  sent  to  the 
different  delegates.  I  have  the  pleasure  to  inform  Doctor  Medina 
that  its  publication  has  already  been  decided  and  that  we  are  going 
to  have  copies  ready  for  the  delegates  as  soon  as  it  can  be  done,  and  as 
the  majority  of  the  delegates  are  going  to  New  York  they  may  call  at 
my  office  or  send  to  my  address  and  I  will  remit  them  as  many  copies 
as  they  like — about  ten  each,  if  they  desire  it. 

The  President.  Does  Mr.  Fox  wish  the  privilege  of  the  floor? 

Mr.  Fox.  Mr.  Chairman,  I  think  as  the  Bureau  of  the  American 
Republics  exists  for  the  purpose  of  carrying  out  the  wishes  of  the 
convention  of  the  American  Republics,  we  would  much  rather  be  the 
medium  of  transmitting  these  copies  and  also  seeing  that  they  are 
printed  and  arranged. 

The  Secretary.  Of  course  they  shall  print  the  copies.  My  sug- 
gestion was  meant  simply  for  the  convenience  of  the  delegates. 

Doctor  Licéaga  addressed  the  convention  in  Spanish. 

The  Secretary.  Doctor  Licéaga  says  that  the  object  is  not  to 
procure  the  official  copies.  Official  copies  will  be  sent  by  the  Bureau 
of  the  American  Republics. 

I  have  no  desire  to  interfere  with  the  Bvireau  of  the  American 
Republics;  but  my  idea  was  simply  to  accommodate  the  different 
representatives,  so  that  they  might  formulate  their  reports  to  the 
different  countries. 

Mr.  Fox.  I  assure  you  that  the  Bureau  will  take  it  up  immediately 
and  have  them  printed. 

The  Secretary.  This  is  simply  to  accommodate  the  delegates, 
because  they  are  going  away  very  soon  and  they  wish  to  formulate 
their  reports  to  their  respective  governments. 


SECOND    INTERNATIONAL    HANITARY    CONVKNTION.  85 

Mr.  Fox.  I  understand,  then. 

The  President.  There  are  now  some  resolutions  whieh  have  been 
reported  to  the  advisory  council,  and  Doctor  Moore  will  read  thism. 

The  resolutions  in  question  were  read  in  vSpanish  by  Doct()r  Moore. 

The  resolutions  were  then  read  in  English  by  Doctor  Guiteras,  as 
follows : 

Whereas  tlie  Republic  of  Mexico  and  the  Panama  Canal  Zone,  by  tlie  a])plicati()n  of  the 
mosquito  doctrine  to  public  sanitation,  are  nearing  rapidly  the  dcsidcratuni  of  the  final 
extinction  of  yellow  fever;  and 

Whereas  tlie  Republic  of  Cuba,  by  the  application  of  the  same  methods,  has  continued  to 
maintain  its  territory  free  from  yellow  fevei- ;  and 

Whereas  as  through  lack  of  preparation  to  apply  these  methods  the  spread  of  yellow  fever 
has  been  permitted  in  certain  countries;  and 

Whereas  in  the  city  of  New  Orleans  an  epidemic  which  had  been  unfortunately  allowed 
by  the  State  authorities  to  take  a  firm  foothold  lias  been  held  in  check,  and  has  been  gradu- 
ally reduced  by  the  application  of  the  said  methods  in  the  midst  of  the  largest  nonimmune 
population  that  was  ever  exposed  to  yellow  fever:  Therefore  be  it 

Resolved,  That  this  convention  sees  in  these  results  a  liirthor  confirmation  of  the  view  that 
yellow  fever  is  naturally  transmitted  only  by  the  bite  of  infected  mosquitoes. 

2.  That  the  convention  is  of  opinion  that  an  efficient  plan  of  defense  against  the  propaga- 
tion of  yellow  fever  at  the  beginning  of  an  epidemic  can  be  easily  established  upon  the  basis 
of  this  doctrine. 

3.  That  the  successful  carrying  out  of  such  plan  depends  upon  a  thorough  understanding 
of  'the  mosquito  doctrine  by  the  people,  and  upon  the  support  that  they  may  give  to  the 
prompt  and  frank  reporting  and  the  proper  handling  of  the  first  cases,  and  of  all  suspicious 
cases. 

4.  That  the  convention  expresses  its  censure  of  the  sanitary  authorities  that  do  not  report 
in  due  time  the  presence  of  yellow  fever  in  their  territory. 

5.  That  the  congratulations  of  the  convention  be  extended  to  the  Republics  of  Mexico 
and  Cuba  and  to  the  Canal  Zone  of  Panama  for  the  success  attained,  and  also  to  the  Public 
Health  and  Marine-Hospital  Service  for  the  brilliant  work  done  in  New  Orleans;  and  be  it 
further 

6.  Resolved,  That  in  the  opinion  of  this  convention  all  maritime  quarantine  and  the  man- 
agement of  all  epidemics  that  threaten  to  extend  to, neighboring  States  and  countries 
should  be  placed  in  the  hands  of  the  national  health  authorities. 

The  President.  This  is  reported  favorably  by  the  advisor}^  council. 

Dr.  H.  L.  E.  Johnson.  I  move  the  adoption  of  the  resolution  that 
has  been  read,  as  reported. 

Discussion  in  Spanish  followed,  participated  in  b}^  Doctor  Lavor- 
eria,  Doctor  Moore,  Doctor  Guiteras,  Doctor  Medina,  and  Doctor 
Ulloa. 

Doctor  Guiteras.  Mr.  Chairman,  the  gentleman  who  has  been 
addressing  the  convention  in  Spanish  is  in  favor  of  softening  the 
expressions  made  use  of  in  this  resolution  respecting  New  Orleans. 
It  is  stated  in  the  resolution : 

Whereas  in  the  city  of  New  Orleans  an  epidemic  which  has  been  unfortunately  allowed  by 
the  State  authorities  to  take  a  firm  foothold,  etc. 

He  believes  that  that  should  not  be  made  so  harsh.  I  claim  that 
this  is  no  direct  accusation  and  it  has  no  effect  of  censure  passed  spe- 
cifically against  the  city  of  New  Orleans,  but  it  is  simply  the  statement 
of  a  fact,  that  the  authorities  in  New  Orleans  allowed  this  epidemic 
to  spread  as  it  has  spread.  And  anyone  who  has  traveled  through 
that  southern  country,  who  has  seen  all  those  towns  in  the  State  of 
Louisiana,  who  has  seen  the  towns  in  the  State  of  Florida  infected  by 
yellow  fever  because  the  people  went  into  the  city  of  New  Orleans  on 
excursions  to  enjoy  life  there  and  came  back  with  the  infection  of 
yellow  fever,  certainly  will  not  feel  like  softening  this  declaration  in 
any  way. 


86  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

The  Secretary.  The  point  raised  is  a  veiy  dehcate  one,  reall}^. 
Several  of  us  who  are  delegates  to  tliis  convention  have  offices  of  a 
diplomatic  nature  in  tliis  countiy,  and  we  must  be  careful  in  emit- 
ting any  opinion  that  might  be  construed  as  censuring  the  authori- 
ties of  any  part  of  the  country  where  we  represent  our  countries. 
Although  from  a  scientific  point  of  view  I  am  entirely  in  accordance 
with  Doctor  Guiteras,  I  should  like,  as  the  delegate  from  Costa  Rica, 
to  try  to  put  this  as  mildly  as  possible,  because  New  Orleans  is  a 
part  of  the  United  States.  Although  the  point  is  covered  by  the 
congratulations  extended  to  the  Marine-Hospital  Service,  which 
really  in  tliis  matter  represents  the  National  Government,  still  the 
authorities  of  New  Orleans  might  take  note  of  these  resolutions  and 
consider  that  tliis  was  a  reflection  on  them.  I  should  like  to  con- 
sider this  a  little  more  and  see  if  we  can  not  resolve  something  that 
would  put  us  in  a  good  light.  I  would  suggest  the  following  amend- 
ment.    It  reads  here —  r  ■  '^^ 

Wliei'eas  in  the  city  of  New  Orleans  an  epidemic,  which  had  been  unfortunately  allowed 
by  the  State  authorities  to  take  a  firm  foothold. 

I  should  strike  out  the  words  "allowed  by  the  State  authorities," 
and  would  propose  the  following  wording: 

Whereas  in  the  city  of  New  Orleans  an  epidemic  unfortunately  took  a  firm  foothold,  etc. 

In  that  way  we  cover  the  same  ground  without  mjuring  anybody. 

Doctor  GuiTERAS.  You  will  have  to  word  it  in  this  way,  "which 
unfortunately  took  a  foothold?" 

The  Secretary.  Yes. 

The  secretary  here  translated  into  Spanish  the  preceding  remarks 
in  English. 

The  President.  I  believe  the  motion  to  amend  has  been  made 
plain  in  Spanish  and  English? 

The  Secretary.  Yes,  sir. 

The  President.  The  convention  is  oi^en  to  remarks  upon  that 
resolution. 

Doctor  Barnet  addressed  the  convention  in  Spanish. 

Doctor  Lavoreria  addressed  the  convention  iii  Spanish. 

The  Secretary.  Doctor  Barnet  adds  a  strengthening  argument  to 
the  proposition  of  the  committee,  mentioning  the  fact  that  on  account 
of  bubonic  plague  in  San  Francisco  the  local  authorities  of  San  Fran- 
cisco were  very  strongly  censured  by  the  meeting  held  at  New  Haven, 
Conn.,  and  that  the  censure  there  was  a  great  deal  stronger  than 
that  proposed  here  to-daj^. 

Doctor  Lavoreria  has  answered  Doctor  Barnet  in  a  manner  which 
I  take  as  mj  own  also,  and  I  will  try  to  convey  to  you  his  idea  fully, 
because  it  conveys  my  own  also. 

It  is  true  that  the  censure  was  a  very  strong  one  at  that  Connecti- 
cut conference,  but  we  must  also  remember  that  that  conference  was 
held  in  the  United  States  and  by  physicians  of  the  United  States. 
That  is  so,  is  it  not? 

The  President.  Yes;  that  is  true. 

The  Secretary.  And  it  was  not  an  official  conference.  Here  it  is 
different.  We  come  here  representing  foreign  countries — different 
countries — and  we  do  not  want  to  reflect  on  the  United  States  in 
any  way.  We  have  to  treat  with  the  United  States,  and  we  want  to 
treat  with  them  as  courteously  as  possible. 


SECOND    INTERNATIONAL    HANITAKY    CONVENTION.  87 

Doctor  Gatewood.  I  move  an  amendment  to  the  amendment 
offered  by  the  representative  from  Costa  Rica,  tliat  the  wording  be 
put  in  this  way:  • 

Whereas  in  the  city  of  New  Orleans  an  epidemic,  which  obtained  a  footliohl  under  local 
authority,  has  been  liekl  in  check,  etc. 

The  Secretary.  I  am  sorry  not  to  agree  to  accept  the  amend- 
ment. I  should  hke  to  put  my  amendment  as  I  proposed  it  before 
the  convention.  The  majority  will  decide  this  question,  and  of 
course  it  may  not  adopt  my  amendment;  but  I  will  say  that  I  will 
not  vote  in  any  other  way. 

Doctor  Gatewood.  The  way  I  have  put  it  it  will  simply  say  that 
an  epidemic  existed  there  under  local  authority. 

The  President.  How  does  Doctor  Ulloa's  motion  read  ? 

Doctor  Gatewood.  He  leaves  out  the  word  ''unfortunately"  only. 

Doctor  Ulloa.  This  is  the  amendment  as  I  propose  it: 
Whereas  in  the  city  of  New  Orleans  an  epidemic  unfortunately  took  a  fmn  footholdj  etc. 

That  is  the  amendment  that  I  propose. 

The  President.  Doctor  Ulloa's  amendment  has  not  been  seconded, 
I  believe. 

Dr.  H.  L.  E.  Johnson.  I  will  second  the  motion  of  Doctor  Ulloa. 
I  see  the  propriety  of  it. 

The  President.  Doctor  Ulloa's  motion  has  now  been  seconded. 

Doctor  Gatewood  has  suggested  an  amendment  to  that  amend- 
ment, and  Doctor  Gatewood' s  amendment  has  not  been  accepted  by 
Doctor  Ulloa. 

Doctor  Gatewood.  My  amendment  is  simply  to  strike  out  the 
word  "unfortunately"  and  to  say  "obtained  a  foothold  in  New 
Orleans."     I  will  leave  that  out  then. 

The  President.  Then  the  motion  before  the  house  is  on  the  adop- 
tion of  the  amendment  of  Doctor  Ulloa. 

Doctor  Ulloa  translated  the  precedmg  discussion  into  Spanish. 

Doctor  Ulloa.  Doctor  Moore  now  has  the  idea,  and  has  put  it 
into  the  Spanish  version. 

Doctor  Moore  here  read  the  part  of  the  resolutions  in  question, 
with  Doctor  Ulloa's  amendment  in  Spanish. 

Doctor  Ulloa.  That  is  right. 

Doctor  Ulloa's  amendment  was  agreed  to. 

The  President.  The  question  is  now  on  the  adoption  of  the  reso- 
lutions, on  motion  of  Doctor  Johnson,  seconded  by  Doctor  Medina, 
I  believe. 

The  remarks  of  the  president  were  translated  into  Spanish  by  the 
secretary. 

The  resolutions  were  adopted. 

Doctor  Moore  addressed  the  convention  in  Spanish. 

Doctor  Guiteras.  Doctor  Moore,  the  president  of  the  advisory 
council,  asks  me  to  translate  a  resolution  presented  by  the  council 
which  is  to  the  effect  that  the  thanks  of  the  convention  be  extended 
to  Doctor  Ulloa  for  his  uniform  courtesy  and  his  assistance  to  the 
delegates,  both  on  the  floor  of  the  convention  and  during  the  visit 
to  the  President  of  the  United  States. 

The  President.  You  have  heard  the  motion.  As  president  of  the 
convention,  I  add  my  testimony  as  to  the  kindness  and  unfailing 


ho  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

courtesy  and  accuracy  of  Doctor  Ulloa's  services,  and  I  would  sug- 
gest that  those  who  are  in  favor  of  this  resolution  will  signify  it  by 
rising.» 

The  members  of  the  convention  unanimously  arose.  [Applause.] 
The  Secretary.  Gentlemen,  I  thank  j^ou  from  the  bottom  of  my 
heart  for  this  great  honor  jo\i  have  conferred  upon  me.  I  have  tried 
my  best  to  .comply  with  the  duties  that  j^ou  put  upon  my  shoul- 
ders when  you  elected  me  your  secretar}-.  I  do  not  care  how  much 
I  work,  and  I  reall}"  do  not  care  if  I  really  had  had  to  work  five  times 
as  much  as  I  have,  when  I  experience  the  great  satisfaction  that  you 
have  given  me  to-day.  That  is  the  best  price  for  all  my  work,  and 
nothing  would  pay  me  more  than  to  see  you  satisfied  witli  the  little  I 
have  done.  ^ 

I  have  the  honor  to  submit  to  the  consideration  of  my  esteemed 
colleagues  of  this  sanitary  convention  the  following  resolutions: 

Resolved,  That  a  vote  of  thanks  be  extended  by  the  International  Sanitary^  Convention 
of  the  American  Kepublics  to  His  Excellencj'  Theodore  Koosevelt,  the  President  of  the 
United  States  of  America,  for  his  valued  cooperation  to  the  success  of  this  conference  and 
for  the  high  meaning  of  the  expressions  of  the  cordial  address  with  which  he  greeted  the 
delegates  to  this  convention  at  the  reception  he  accorded  to  them  at  the  White  House  on 
the  12th  instant. 

Resolved,  That  a  vote  of  thanks  be  extended  to  the  honorable  the  Secretary  of  State,  and 
to  the  honorable  the  Acting  Secretary  of  the  Treasury,  for  their  addresses  of  welcome  at  the 
inauguration  of  this  convention. 

Resolved,  That  a  vote  of  thanks  be  extended  to  the  Hon.  Gonzalo  de  Quesada,  minister 
plenipotentiary  ft-om  Cuba. 

Resolved,  That  a  vote  of  thanks  be  extended  to  Director  Fox,  as  representing  the  Bureau 
of  the  American  Kepublics,  for  his  attentions  to  the  delegates  and  for  the  arrangements 
made  for  their  entertainment. 

Resolved,  That  an  expression  of  our  sincere  appreciation  be  given  to  our  highly  esteemed 
president,  Surgeon-General  Wyman,  for  his  kind  treatment  and  for  the  eificient  manner  in 
which  he  has  complied  with  his  official  duties. 

Resolved,  That  a  vote  of  thanks  be  extended  to  the  Cosmos  Club  and  to  the  press  of  the 
city  of  Washington  for  the  courteous  manner  in  which  they  have  treated  us  during  our  stay 
at  this  capital. 

Resolved,  That  a  vote  of  thanks  be  extended  in  the  name  of  the  delegates  from  the  Spanish 
American  Republics  to  the  delegates  from  the  United  States  for  their  hospitality  and  excel- 
lent fellowship. 

The  President.  Who  presents  those  resolutions? 

The  Secretary.  Myself.  And  I  will  have  to  act,  if  you  will  allow 
me,  as  chairman  at  this  moment,  because  Surgeon-General  Wyman 
does  not  like  to  put  them  before  you,  as  one  refers  to  himself. 

Doctor  Lavoreria  addressed  the  convention  in  Spanish. 

The  Secretary.  Doctor  Lavoreria  suggests  that  these  resolutions 
be  not  discussed,  but  that  they  be  adopted  by  acclamation. 

Doctor  Guiteras.  By  a  rising  vote? 

The  Secretary.  Yes;  by  a  rising  vote. 

Doctor  Barnet  addressed  the  convention  in  Spanish. 

The  Secretary.  Doctor  Barnet  makes  a  suggestion  which  I  accept 
most  heartily,  and  which  will  correct  w^hat  was  reall}^  an  involuntary 
omission  on  my  part,  namely,  to  include  in  the  vote  of  thanks  the 
Bankers'  Association  of  the  District  of  Columbia. 

The  resolutions  were  agreed  to. 

The  President.  We  will  now  begin  the  formal  signing  of  the  con- 
vention. Two  copies  have  been  prepared,  one  in  English  and  one  in 
Spanish,  and  the  delegates  from  each  one  of  the  Republics  will  be 
expected  to  sign.     The  roll  of  the  Republics  will  be  called  in  alpha- 


SECOND    ÍNTEKNATIONAL    SANITARY    CONVENTION.  89 

betical  order,  and  it  is  the  understanding  that  each  delegate  will 
sign  his  name  and  say  "From  such  and  such  a.Repul)lic." 

Doctor  GuiTERAs.  Will  the  roll  be  called  alphabetically  according 
to  the  English  or  the  Spanish  names  of  the  Jíepublics'í  Jt  will  make  a 
considerable  diiference  in  the  order  in  wliich  the  liepu})lics  come. 

The  Seceetary.  Doctor  Guiteras  makes  a  very  important  sug- 
gestion. In  English  the  United  States  comes  in  one  of  tne  last  places 
on  the  roll,  while  in  Spanish  the  name  of  the  United  States  begins  with 
the  letter  E. 

It  was  moved  by  Dr.  H.  L.  E.  Johnson  that  the  States  be  called  ac- 
cording to  the  alphabetical  order  in  each  language;  that  is,  that  for 
the  signatures  to  the  English  version  the  names  of  the  Republics  be 
called  in  English,  and  for  the  signatures  to  the  Spanish  version  the 
names  should  be  called  in  the  order  of  the  names  in  Spanish. 

The  Secretary  translated  the  suggestion  into  Spanish. 

The  President.  It  has  been  suggested  by  Doctor  Geddings,  who 
is  somewhat  familiar  with  these  procedures,  that  it  is  not  necessary 
to  put  in  the  name  of  the  Republic  at  all.  I  presume  that  is  what 
Doctor  Johnson  was  about  to  suggest.  The  names  are  already  in 
there  as  those  of  the  delegates  from  the  respective  Republics,  and 
all  we  have  to  do  is  to  sign  our  respective  names. 

The  remarks  of  the  president  were  translated  into  Spanish  by  the 
secretary. 

Dr.  H.  L.  E.  Johnson.  I  am  going  to  supplement  your  suggestion 
by  adding  that  they  sign  in  the  order  in  which  they  appear  in  the  pre- 
amble. The  names  are  mentioned  there,  one  after  another,  and  it 
would  be  better  to  have  them  appear  as  they  appear  there.  The 
Spanish  corresponds  to  the  English,,  and  the  English  is  to  be  the 
standard. 

Upon  examination  it  was  found  that  the  order  of  the  Republics 
was  the  same  in  both  the  Spanish  and  the  English  copies. 

The  signing  of  the  convention  by  the  delegates  was  now  commenced 
and  concluded. 

The  President.  The  convention  will  come  to  order.  There  are 
three  delegates  who  have  not  affixed  theis  names  to  this  agreement. 
They  are  the  delegates  from  Uruguay  and  Venezuela,  and  one  dele- 
gate from  the  United  States,  Doctor  Kennedy,  who  was  obliged  to 
leave  the  city,  as  he  said  the  other  day  he  thought  he  would  very 
likely  be  obliged  to  do.  But  it  seems  very  desirable  that  we  should 
eventually  have  the  signatures  of  these  three  delegates  to  the  con- 
vention, and  your  president  awaits  an  expression  of  the  wish  of  the 
convention  as  to  the  method  to  be  pursued  to  secure  these  signatures. 
Has  anybody  a  motion  to  make  as  to  how  thej  should  be  secured  ? 

The  Secretary.  I  make  a  motion  to  the  effect  that  we  leave  tliis 
document  in  charge  of  Mr.  Fox,  Director  of  the  Bureau  of  American 
Republics,  to  secure  the  signatures  of  these  tlii-ee  delegates  to  the 
document,  and  as  soon  as  he  secures  them  to  forward  the  document 
to  the  Secretary  of  State,  as  agreed  upon  by  this  convention. 

Doctor  Ulloa  here  translated  this  motion  into  Spanish. 

The  motion  was  seconded. 

The  motion  was  agreed  to. 

The  President.  I  wish  to  say  that  the  copies  of  this  agreement 
will  be  printed  for  the  use  of  the  delegates  as  speedily  as  possible. 
The  work  will  be  begun  Monday  morning,  and  we  expect  to  be  able 


90  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

to  furnish  you  with  copies  in  the  Enghsh  and  Spanish  both;  but 
these  copies  are  not.  to  be  considered  as  official  copies.  They  are 
simply  copies  for  your  indi^adual  use.  The  official  copies  will  be 
printed  later  on  and  furnished  to  you. 

The  remarks  of  the  president  were  translated  by  the  secretary  into 
Spanish. 

The  President.  Gentlemen,  the  work  for  which  this  convention 
was  assembled  is  about  completed.  Before  parting  it  will  be  agree- 
able to  aU,  I  have  no  doubt,  that  we  should  hear  from  each  delegate 
to  the  convention  a  short  word  of  congratulation  or  expression  of 
the  pleasure  that  has  been  experienced  or  any  comments  that  may 
seem  pertinent  to  the  individual  who  makes  the  address.  We  pro- 
pose to  call  on  each  delegate,  according  to  the  alphabetical  order  of 
the  Republics,  as  named  in  the  agreement. 

The  remarks  of  the  president  were  translated  by  the  secretary  into 
Spanish. 

The  President.  I  will  first  call  upon  Dr.  Eduardo  O.  Moore,  the 
delegate  from  Chile. 

Doctor  Moore  addressed  the  convention  in  Spanish.      [Applause.] 

The  Secretary.  I  am  requested  to  give  an  interpretation  of  the 
very  well-put  remarks  of  Doctor  Moore,  of  Chile.  I  will  make  an 
extract  of  it,  and  I  request  him  to  tell  me  if  I  leave  anything  out. 

Doctor  Moore  expressed  his  astonishment  at  the  results  obtained 
at  this  convention.  He  says  that  he  never  expected  to  do  so  much 
work,  and  of  such  an  efficient  nature  as  we  have  done.  He  says  that 
when  he  came  from  his  country  he  thought  that  he  was  coming  to  a 
congress  or  a  convention  the  same  as  the  last  one  we  had  in  Washing- 
ton, but  in  this  one  we  have  achieved  very  high  results,  and  of  a  very 
important  nature,  and  the  signing  of  this  convention  is  a  great  step 
toward  the  accomplishment  of  the  object  of  these  meetings.  He  says 
that  he  has  never  signed  any  document  of  this  sort  that  has  pleased 
him  more  than  the  present  one,  and  he  hopes  that  we  may  meet 
again  soon;  and  he  hopes  every  one  of  us  will  be  at  Mexico  during 
the  next  convention,  with  the  certainty  that  we  will  have  a  splendid 
time,  and  a  very  cordial  reception,  such  as  it  is  customary  for  the 
Mexicans  to  afford.     [Applause.] 

The  President.  We  will  next  hear  from  the  Republic  of  Costa 
Rica,  represented  by  our  distinguished  secretary.  Dr.  D.  Juan  J. 
Ulloa,  ex-vice-president,  ex-minister  of  the  interior  of  Costa  Rica,  and 
ex-president  of  the  medical  faculty  of  Costa  Rica. 

Doctor  Ulloa.  Mr.  President  and  members,  it  gives  me  the 
greatest  pleasure  to  express  to  you,  in  a  few  words,  my  high  appre- 
ciation of  your  merits  as  scientific  men  and  of  your  qualities  as  fellow- 
men.  I  never  was  prouder  myself  before,  and  I  am  proud  of  myself 
now  because  I  am  here  among  you.  I  am  proud  of  myself  because 
when  I  leave  Washington  to-night — or  to-morrow,  or  whenever  I  do 
leave — I  will  be  authorized  to  say  that  I  was  a  member  of  the  Second 
International  Convention  of  the  American  Republics,  and  that  I  was 
one  of  those  who  signed  the  convention  which  is  going  to  be  of  such 
high  meaning  to  all  our  Republics,  the  convention  which  in  the  esti- 
mation of  anyone  who  thinks  rightly  means  the  greatest  achievement 
that  we  could  attain.  It  means  security  to  health,  it  means  facility 
to  commerce,  and  it  means  destruction  to  unwarranted  and  ignorant 


SECOND    INTERNATIONAL    HANITAKY    CONVENTION.  91 

quarantine  measures.     It  means  pro^-ess  of  the  twentieth  century, 
and  it  means  death  to  if^norance  in  matters  relating  to  public  health. 

Gentlemen,  in  the  name  of  Costa  Kica,  J  tjiank  all  of  you  for  your 
cooperation.  I  thank,  sincerely,  my  distinjiuished  friend  Doctor 
Wyman,  all  the  delegates  from  the  United  vStates,  and  all  the  other 
delegates  from  the  Spanish-American  Jief)ublics. 

In  parting,  I  do  not  want  to  say  good-bye;  1  want  to  emV^race  you 
all  and  say  ''Au  revoir."  And  I  second  the  words  of  Doctor  Moore, 
hoping  that  nothing  will  stand  in  our  way  so  as  to  meet  again  in  the 
country- of  our  beloved  friend.  Doctor  Licéaga.  I  know  that  after 
the  very  fine  time  that  we  have  had  here,  even  if  we  have  worked  a 
little  hard,  we  are  going  to  have  a  lovely  time  also  in  Mexico,  and  I 
only  hope  that  these  two  years  that  are  to  come  will  hurry  up  and 
pass  away  so  as  to  go  to  Mexico  City  quickly.     [Applause.] 

The  President.  The  next  is  the  Republic  of  Cuba.  I  hardly  know 
what  to  say  in  introducing  our  great  and  good  friend.  Doctor  Guiteras, 
whose  name  is  international  in  regard  to  all  the  matters  that  have 
been  before  tliis  convention.  His  kindly  personality,  his  great 
scientific  achievements,  his  great  interest  in  all  these  matters,  has 
been  a  powerful  influence  in  this  convention,  and  I  call  upon  Dr.  D. 
Juan  Guiteras  for  remarks. 

Doctor  Guiteras.  Mr.  President,  I  thank  you  very  much,  and  I 
have  only  to  sa}^  that  I  am  proud  also,  like  Doctor  Moore,  to  have 
been  able  to  put  my  signature  to  this  document,  and  I  think  as  the 
years  go  on  every  one  of  us  will  feel  more  and  more  proud  of  the 
work  that  we  have  done.  I  congratulate  the  convention  for  the 
effort  they  have  made  to  bring  this  task  to  a  successful  termination. 
[Applause.] 
y  Doctor  Guiteras  repeated  his  remarks  in  Spanish.     [Applause.] 

The  President.  Will  Doctor  Guiteras  kindly  explain  to  those  who 
speak  English  only,  the  substance  of  what  Doctor  Ulloa  said  in 
English,  briefly?  I  think  they  would  be  glad  to  hear  it.  Not  in  full, 
but  briefly. 

Doctor  Guiteras.  I  wish  I  had  thought  of  doing  so  while  he  was 
delivering  it.  It  impressed  me  very,  very  deeply,  and  I  am  usually 
better  at  saying  things  for  other  people  than  for  myself. 

The  preceding  response  of  Doctor  Ulloa  was  here  translated  into 
Spanish  by  Doctor  Guiteras. 

The  secretary  addressed  the  convention  in  Spanish. 

The  Secretary.  Concerning  the  resolutions  that  have  been  offered, 
thanking  those  who  have  shown  us  courtesies,  I  have  just  had  the 
honor  to  make  the  motion  in  Spanish,  extending  those  thanks  also 
to  Mr.  Fox,  of  the  Bureau  of  American  Republics. 

The  President.  We  would  like  also  to  hear  from  the  distinguished 
representative  of  the  cliief  executive  of  the  sanitary  department  of 
Habana,  Dr.  Henry  B.  Barnet. 

Doctor  Barnet  addressed  the  convention  in  Spanish.      [Applause.] 

The  President.  The  Republic  of  Ecuador;  Dr.  Miguel  Alcivar. 
Doctor  Alcivar  will  excuse  me  if  I  do  not  get  the  Spanish  just  right, 
but  we  all  know  who  you  are,  no  matter  how  I  pronounce  your  name. 

Doctor  Alcivar  here  addressed  the  convention  in  Spanish.  His 
remarks  were  not  translated. 

The  President  We  are  fortunate  in  having  vdih  us  at  tliis  con- 
vention the  minister  from  the  Dominican  Repubhc,  who  is  also  a 


92  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

delegate  to  this  convention,  and  we  would  like  to  hear  from  him. 
Señor  Don  Emilio  Joubert. 

Señor  Joubert  here  addressed  the  convention  in  Spanish.  His 
remarks  were  not  translated.      (See  Appendix,  p.  192.) 

The  President.  I  am  sure  we  are  all  glad  to  hear  from  Mr.  Joubert, 
and  I  take  this  occasion  to  say  that  when  the  call  of  the  Republics  was 
held  he  was  not  present,  but  he  afterwards  informed  me  that  he  would 
present  a  report  in  accordance  with  the  reports  from  the  other 
Republics  as  to  sanitary  conditions,  and  later  on  promised  that  he 
would  send  it  in  in  writing,  and  I  am  sure  we  would  be  very  glad  to 
receive  it,  as  well  as  his  remarks  which  he  has  just  made,  if  lie  will 
put  them  in  writing.  And  I  hope  that  it  will  be  understood,  broadly, 
by  those  who  speak  in  Spanish,  that  we  will  be  glad  to  have  them 
transmit  their  remarks  to  the  Director  of  the  Bureau  of  American 
Republics,  and  that  they  will  be  printed  in  the  proceedings  of  to-day 
in  both  English  and  Spanish.  Director  Fox,  I  am  sure,  will  have 
them  translated  for  us. 

I  next  call  upon  the  United  States.  I  will  make  my  few  remarks 
at  the  close,  as  I  bid  you  good-bye,  and  I  will  call  now  upon  Asst.  Surg. 
Gen.  H.  D.  Geddings. 

Doctor  Geddings.  Mr.  President  and  gentlemen,  I  am  sure  that  I 
would  voice  the  sentiments  of  the  delegates  of  the  United  States  in  say- 
ing that  the  recollection  of  this  convention  must  ever  be  a  source  of 
pride  and  pleasure,  when  we  remember  that  the  work  on  which  we  have 
been  engaged  all  this  week,  and  which  we  have  brought  to  a  conclu- 
sion tliis  evening,  is  one  that  marks  a  new  departure  on  the  Western 
Continent.  And  it  would  be  impossible  to  part  without  saying  how 
much  gratification  has  been  given  me  by  the  good  spirit,  the  fraternal 
feeling,  and  the  spirit,  to  use  an  Americanism,  of  give  and  take,  which 
has  characterized  the  transactions  of  this  congress.  To  have  met 
so  many  distinguished  men  from  various  countries  has  been  a  source 
of  unspeakable  pleasure,  and  I  voice — I  reecho — the  sentiments  of 
Doctor  Ulloa,  whom  we  have  all  learned  to  esteem  so  highly,  in  saying 
that  the  years  that  intervene  between  now  and  the  meeting  in  the 
Republic  of  Mexico,  under  the  protection  and  patronage  of  Doctor 
Licéaga,  can  not  roll  around  too  rapidly. 

Good-bye  is  always  a  hard  word  to  say,  but  the  good  feelings  of  the 
delegates  from  the  United  States  accompany  those  gentlemen  who 
return  to  homes  foreign  to  us.     [Applause.] 

The  President.  I  will  call  now  upon  a  representative  of  our  great 
United  States  Army — of  the  Medical  Department  of  it^ — Dr.  Walter 
D.  McCaw,  major,  surgeon  in  the  United  States  Army. 

Doctor  McCaw.  Mr.  President  and  gentlemen,  as  a  member  of  the 
United  States  Army  I  feel  a  particular  pride  in  having  been  permitted 
to  take  a  part  in  such  an  important  convention  as  this.  Our  little 
military  force  is  so  much  of  the  people  and  for  the  people  that  it  is 
interested,  of  course,  as  all  other  citizens,  in  the  questions  of  public 
health  of  this  and  the  neighboring  countries.  I  know  that  they  will 
be  pleased  that  even  a  humble  representative  of  their  body  has  had 
the  privilege  of  putting  his  signature  to  the  important  articles  of  this 
convention  adopted  to-day. 

I  would  like  to  say,  with  the  others,  that  I  look  forward  over  the 
intervening  years  to  the  time  of  the  meeting  which  will  take  place  in 
Mexico;  but  I  am  afraid  that  the  prospects  of  the  pleasurable  stay 


SECOND  intí:knati<>nal  sanitary  convention.  93 

in  that  city  will  be  so  ^reat  ainon^  the  members  of  the  Army  that  I 
shall  find  many  formidable  competitors  for  the  position.  1  only  hope 
that  I  shall  win  in  tbe  race. 

A  few  of  us  have  taken  in  the  past  an  important  part  in  the  sanita- 
tion of  the  American  Continent.  We  liope  to  do  sometbirif^  in  the 
future  when  called  upon.  In  the  meantime,  we  stand  by  and  look 
with  applause  at  theniagtiiiicant  work  that  is  bein<jj  (h)ne  l)y  the  gov- 
ernments of  this  and  the  otluir  countries,  and  we  will  f(;el  our  full 
share  in  the  thrill  of  victory  when  it  is  said  that  yellow  fever  is  no 
more  and  that  plague  and  cholera  can  not  be  introduced  into  the 
countries  of  America.     [Applause.] 

The  President.  I  scarcely  need  to  introduce  to  you  the  next 
delegate  from  the  United  States,  whose  services  have  been  so  marked 
in  this  convention;  I  take  pleasure  in  calling  upon  Dr.  J.  D.  Gate- 
wood,  of  the  United  States  Navy. 

Doctor  Gatewood.  Mr.  President  and  gentlemen,  being  a  plain  man 
and  not  an  orator,  I  am  afraid  that  I  shall  appear  at  some  disadvan- 
tage among  such  remarkable  speakers  as  I  have  heard  here  this  after- 
noon. I  feel  that  I  have  been  dignified — although  a  plain  man — in 
being  among  you  as  the  representative  of  the  Medical  Department  of 
the  United  States  Navy.  The  Navy  is  particularly  interested  in  all 
matters  relating  to  quarantine,  in  all  matters  relating  to  international 
quarantine,  inasmuch  as  it  visits  the  ports  of  all  countries.  I  have  sat 
here,  taking  only  a  very  humble  part  in  the  work  that  you  have  per- 
formed, but  being  an  individual  who  visits  and  representing  a  number 
of  individuals  who  are  constantly  visiting,  countries  that  you  repre- 
sent here,  I  feel  that  I  can  very  appropriately  congratulate  you  on  the 
important  work  you  have  accomplished  here  during  this  convention. 
As  we  are  all  about  to  leave,  having  finished  up  this  work,  and  are 
about  to  scatter  in  various  directions  over  the  earth,  I  can  only  say 
that  I  hope  when  you  leave  this  city  of  Washington,  and  when  you 
leave  this  country  of  the  United  States  of  America,  you  will  all  go 
away  with  the  most  pleasant  recollections,  and  also  with  the  sense  of 
duty  well  performed  at  this  convention. 

I  hope  that  we  shall  all  meet  again  in  other  parts  of  the  world.  I 
have  the  prospect  of  meeting  you  all,  and  I  look  forward  to  it  with 
the  greatest  pleasure  imaginable.  I  congratulate  you  all  on  the  work 
you  have  done  here,  and  I  wish  you  all  good-bj^e,  with  the  sincere 
hope  that  we  shall  meet  again.     [Applause.] 

The  President.  I  will  now  call  upon  that  delegate  of  the  United 
States  who  is  here  in  the  capacity  not  only  of  a  representative  of  the 
great  American  Medical  Association,  which  is  the  association  of 
physicians  of  the  United  States — the  emphasis  on  "the"  meaning  that 
it  is  tlie  largest  and  most  powerful  body  of  physicians  in  the  United 
States*— but  who  is  also  a  member  of  the  board  of  trustees,  the  very 
important  body  which  guides  the  destinies  of  that  association.  I 
call  upon  Dr.  H.  L.  E.  Johnson. 

Dr.  H.  L.  E.  Johnson.  Mr.  President  and  delegates  of  the  conven- 
tion, I  feel  it  a  great  honor,  indeed,  to  be  selected  to  be  a  member 
of  this  organization.  I  appreciate  very  thoroughly  the  amount  of 
good  that  the  other  gentlemen  have  done,  and  it  is  a  great  pleasure 
to  me  to  be  present  here  and  to  meet  my  old  friends  of  foreign  coun- 
tries, whom  I  have  met  and  known  for  years,  and  the  hospitalities 


9-1:  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

of  whose  homes  I  have  enjoyed,  in  many  instances,  iji  their  own 
countries,  and  t9  feel  that  we  brothers  have  come  together  again. 

I  hope  that  we  may  all  meet,  as  we  stand  here,  in  Mexico  again 
and  experience  the  beautiñil  hospitality  and  enjoy  the  pleasures 
and  beautiful  scenery  and  the  personal  attention  in  wliich  we  were 
so  fortunate  wliile  we  were  in  Mexico  in  1897. 

The  fruits  of  this  convention  I  tliink  can  not  be  overestimated. 
We  have  practically  sown  the  seed  of  good  health  throughout  the 
United  States,  and,  joining  with  the  other  members  of  the  conven- 
tion who  have  done  the  same  work  in  other  countries,  we  represent 
now  a  united  body  for  mutual  protection  against  disease,  which  is 
to-day  the  highest  principle  of  medical  movement. 

I  feel  sure  that  as  a  few  months  or  years  pass  by  the  diseases  which 
have  stood  in  the  way  of  the  completion  of  the  Panama  Canal, 
which  we  might  term  the  ideal  of  the  President  of  the  United  States 
to  accomplish,  will  be  removed  and  that  the  great  good  to  this  coun- 
try which  is  expected  in  health,  wealth,  and  prosperity  will  flow 
from  it,  and  that  we  will  have  those  mutual  benefits  wliich  are  ex- 
pected with  our  brothers  of  the  Latin- American  countries.  I  feel 
sure  that  by  the  removal  of  these  disease-producing  foci  we  will 
in  the  future  to  a  large  extent  divert  our  travel  from  the  foreign 
countries  on  the  other  side  to  become  better  acquainted  with  our 
brothers  on  this  side. 

I  feel  it  one  of  the  greatest  pleasures  and  honors  of  my  life  to  have 
been  a  member  of  tliis  body,  and  last,  but  not  least,  to  have  met 
once  more  the  lovely  friends  and  brothers  to  whom  I  am  so  much 
devoted  and  whom  no  one  can  appreciate  more.     [Applause.] 

The  President.  The  Republic  of  Guatemala,  Señor  Don  Joaquin 
Yela. 

The  Secretary.  He  is  not  present. 

The  President.  The  Republic  of  Mexico.  And  when  we  men- 
tion the  name  of  Mexico  the  word  Licéaga  follows  it  in  this  conven- 
tion. Doctor  Licéaga  is  one  of  the  original  progenitors,  I  was  going 
to  say,  of  this 'convention.  He  took  an  active  interest  at  the  very 
start,  and  at  the  conference  of  American  States  held  in  the  city  of 
Mexico  in  1890  and  1891  he  was  most  active  in  bringing  about  the 
resolutions  wliich  called  forth  this  convention.  As  I  said  on  the 
opening  day  of  this  convention,  it  was  through  his  personality  and 
active  interest,  Ms  scientific  knowledge  and  administrative  force, 
that  on  the  part  of  Mexico  all  the  measures  were  taken  which  were 
necessary  to  prevent  the  recurrence  of  the  yellow  fever  after  the 
epidemic  of  1902,  and  I  found  in  Ifini  a  very  able  advocate  and 
assistant  in  carrying  forward  the  measures  which  I  desired,  and 
others  desired,  to  have  executed  in  the  United  States.  So  that 
Mexico  and  the  United  States  worked  practically  side  by  sicfce  and 
hand  in  hand  in  the  elimination  of  the  fever  at  that  time,  and  were 
successful. 

I  call  upon  Doctor  licéaga  to  address  the  convention.     [Applause.] 

Doctor  Licéaga  addressed  the  convention  in  Spanish.  His  re- 
marks were  not  translated. 

The  President.  I  next  have  the  honor  to  call  upon  the  delegate 
from  Nicaragua,  than  whom  no  more  earnest  member  we  have  had 
in  tlfis  convention  in  all  that  relates  to  sanitation  and  all  that  relates 
to  quarantine  protection  between  our  various  Republics.  I  call, 
therefore,  upon  Dr.  D.  J.  L.  Medina.     [Applause.] 


SECOND    INTEKNA'J'IONAL    HANI'I'ARY    (X>N  V  KN'IION.  1)5. 

Doctor  Medina.  Mr.  President,  first  I  will  thank  you  for  your 
kind  words.  Secondly,  I  will  Aay  in  the  name  oí"  the  Republic  of 
Nicaragua,  which  I  have  the  honor  to  represent,  that  I  am  sure  my 
colleagues  will  receive  with  delight  the  words  of  this  convention, 
and  not  only  will  the  action  of  the  convention  be  accepted,  but  we 
will  do  all  that  is  in  our  power  to  carry  on  the  practical  work  to  a 
successful  and  faithñil  realization. 

Next  I  will  thank  all  my  fellows  in  this  convention.  It  has  been 
a  pleasure  to  me  for  us  to  be  all  together  here,  all  working  with  such 
a  brotherly  feeling,  which  really  makes  us  forget  all  the  harshness 
that  an  American  man  has  to  go  through  in  life.  It  is  not  often  that 
we  have  the  opportunity  to  meet  such  a  company  of  fellows  with 
such  a  friendly  feeling  as  that  which  has  been  exhibited  here  and  in 
which  this  convention  has  discharoed  its  duties.  I  hope  that  we 
will  soon  meet  again,  as  all  of  my  colleagues  have  expressed  the  hope 
of  meeting  in  Mexico. 

There  may  be  some  people  who  think  that  we  have  overestimated 
the  work  of  this  convention  and  who  may  have  criticised  it.  I  think 
that  the  work  of  this  convention  will  he  fully  appreciated  in  this 
matter,  but  not  to-day.  The  work  of  this  week  of  this  convention 
here  I  am  sure  will  be  a  monument  in  days  to  come,  because  others 
will  follow,  will  improve  it,  and  will  carry  on  to  success  that  which 
may  be  out  of  our  reach  to-day. 

I  hope  to  meet  you  all  in  Mexico,  and  in  closing  I  wish  only  to 
express  my  sincerest  respect  for  Doctor  Licéaga,  who  really  has 
been  the  shining  member  of  this  convention.     [Applause.] 

The  President.  I  am  sure  we  were  all  very  much  pleased  to  learn 
that  we  had  a  delegate  from  Peru  at  this  convention.  You  will 
remember  that  Peru  was  not  represented  at  the  first  convention, 
and  when  I  received  a  call  from  Doctor  Lavoreria  I  was  very  much 
delighted,  because  I  had  heard  of  him  from  some  of  my  ofíicers  in 
Panama  and  I  laiew  of  his  high  reputation  in  his  own  country,  and 
I  was  delighted  to  know  that  Peru  was  to  be  represented,  particu- 
larly as  the  relations  between  Peru  and  the  other  Republics,  and 
especially  the  United  States,  are  becoming  more  intimate. 

Our  relatio'ns  are  becoming  closer;  we  are  being  drawn  nearer 
together  in  these  matters  and  are  dependent  more  upon  one  another 
than  we  were  formerly,  and  I  wish  to  say  that  the  authorities  of  Peru 
have  shown  their  disposition  to  do  everything  that  is  possible  in 
the  elimination  of  plague  and  the  other  epidemic  diseases.  In  other 
words,  they  are  in  the  ÍTont  rank,  and  I  call  upon  the  distinguished 
representative,  Doctor  Lavoreria.     [Applause.] 

Doctor  Lavoreria  addressed  the  convention  in  Spanish.  [Ap- 
plause.] 

Doctor  Lavoreria' s  remarks  were  not  translated.    • 

The  President.  We  have  had  with  us  during  the  convention 
the  genial  presence  of  the  charge  d'  aft'aires  of  Uruguay  and  we  would 
liJie  to  hear  from  him.  I  am  informed  that  he  is  not  here  at  the 
present  time. 

The  representative  of  the  Republic  of  Venezuela  is  not  here  with 
us  at  the  present  time,  although  he  has  been  in  the  hall  a  number  of 
times. 

We  have  with  us  two  distinguished  gentlemen  who  have  been 
invited  to  the  privileges  of  the  floor,  and  I  would  like  to  call  upon 
Doctor  Carroll,  of  the  United  States  Army. 


96  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Doctor  Carroll.  Mr.  President  and  gentlemen  of  the  convention, 
I  beg  to  be  permitted  to  express  ni}"  sincere  thanks  for  the  great 
honor  and  privilege  that  has  been  accorded  me  of  being  present  at 
the  proceedings  of  this  convention.  I  assure  you  that  I  have  found 
them  both  interesting  and  instructive,  and  their  results  are  so  far- 
reaching  that  we  can  onl}^  conjecture  the  ultimate  outcome.  I 
rejoice  with  you  in  the  results  that  have  been  accomplished  so  far, 
and  I  rejoice  particularly  because  I  feel  that  we  can  look  forward 
now  with  almost  absolute  certainty  to  the  accomplishment  in  the 
near  future  of  the  absolute  extinction  of  the  yellow  fever  from  the 
North  American  continent  and  later  from  the  whole  continent, 
which  means  practically  the  universe. 

The  time  has  flown  so  rapidly,  and  it  is  now  so  late,  that  it  would 
not  be  proper  for  me  to  detain  you  any  longer.  I  desire  again  to 
express  my  great  appreciation  of  the  honor  that  has  been  conferred 
upon  me.     [Applause.] 

The  President.  I  will  call  now  upon  Doctor  Stiles,  the  medical 
zoologist  of  the  Public  Health  and  Marine-Hospital  Service. 

Doctor  Stiles.  jVIt.  President  and  gentlemen,  I  am  sure  I  voice 
the  sentiments  of  my  colleagues  in  the  hygienic  laboratory,  to  whom 
you  extended  the  courtesies  of  the  floor,  when  I  thank  you  very 
much  for  the  instructive  time  that  we  have  had  in  these  meetings 
here  during  tliis  week.  It  has  been  instructive  to  us  from  various 
points  of  view.  In  a  laboratory  we  naturally  work  primarily  upon 
theoretical  grounds,  and  it  is  of  great  value  to  us  to  come  into  con- 
tact with  the  class  of  men  whose  experience  leads  them  into  the 
broader  lines  of  administrative  work.  It  is  a  great  satisfaction  to 
us,  further,  to  see  practical  deductions  from  our  laboratory  works 
put  upon  paper  by  a  class  of  men  capable  of  understanding  their 
bearing  upon  the  public  health.  Such  deductions  can  be  utilized 
only  by  men  who  have  a  very  broad  view  of  administrative  work, 
combined  with  a  deep  insight  into  the  theoretical  work  of  the 
laboratory. 

Speaking  personally,  I  have  had  another  great  satisfaction  in 
being  here — -namely,  not  as  a  physician,  but  as  a  zoologist.  It  has 
been  my  conviction  for  a  ^ood  many  years  past  thai  there  are  a 
number  of  problems  in  medicine  which  should  be  attacked  from  the 
zoological  standpoint.  Already  a  number  of  diseases  have  been 
cleared  up,  or  partially  cleared  up,  by  working  on  zoological  lines. 
Curiously  enough,  it  has  not  been,  as  a  rule,  the  zoologists  who  have 
brought  out  these  facts,  but  the  physicians  have  invaded  the  zoolog- 
ical field  and  have  discovered  the  zoological  principles  and  zoological 
facts  •which  zoologists  themselves  had  overlooked.  It  is  always, 
therefore,  a  great  pleasure  for  a  professional  zoologist  to  acknowledge 
the  debt  that  zoology  owes  to  medicine  in  showing  the  zoologist 
just  how  important  zoology  is  to  medicine. 

Personally,  also,  I  have  had  great  satisfaction  in  attending  these 
meetings  from  an  entirely  different  point  of  view — nsuneij,  the 
inspiration  which  a  young  man  receives  from  personal  association 
with  men  so  much  his  seniors  in  experience,  in  years,  and  in  practical 
work  accomplished. 

And,  finally,  there  is  one  other  example  that  has  been  set  to_  me 
here.  Some  of  us  in  the  laboratory  are  sometimes  a  little  anxious 
about  working  too  hard  in  one  week,  for  fear  we  may  lose  too  much 


8EC0ND    INTEKNATIONAL    HANITAKY    CO» VENTION.  97 

of  our  flesh.  As  I  look  around  the  room  I  think  how  hard  the  mem- 
bers of  this  conference  have  worked,  and  yet  I  do  not  note  that 
there  has  been  any  groat  reduction  in  the  circumference  of  my  good 
friend,  Dr.  II.  L.  E.  Johnson,  or  of  my  good  friend  from  the  Army, 
or  of  our  worthy  president. 

I  wish  to  thank  you  very  much  indeed  for  having  extended  the 
courtesies  of  the  floor  to  me,  and  in  the  absence  of  my  colleagues, 
Doctor  Anderson  and  Doctor  Hunt,  I  will  speak  in  their  names  also. 
[Applause.] 

The  President.  Gentlemen,  there  is  one  more  gentleman  whom 
I  wish  to  address  this  convention  for  as  long  as  he  likes — one  to 
whom  we  are  greatly  indebted  for  the  preparation  for  and  assistance 
in  the  conduct  of  this  convention.  He  stands  there  now,  on  guard 
over  that  sacred  document  which  we  have  just  signed.  [Laughter.] 
Although,  literally  speaking,  he  is  sitting,  he  is  still  on  guard,  and  I  am 
sure  we  will  all  be  glad  to  hear  from  the  Hon.  W.  C.  Fox,  Director 
of  the  Bureau  of  the  American  Republics. 

Mr.  Fox.  Mr.  President  and  gentlemen,  the  hour  is  really  so  late 
that  I  do  not  think  I  should  detain  you,  but  I  wish  to  extend  my 
sincere  thanks  and  the  thanks  of  the  Bureau  for  the  courteous 
remarks  that  have  been  made  about  us,  and  to  assure  you  further 
that  what  we  have  done  has  been  only  a  duty,  and  one  which  we 
have  been  but  too  glad  to  perform.  The  Bureau  has  certain  func- 
tions, and  I  believe  this  occasion  has  demonstrated  that  these 
functions  are  worthy.  I  recall  that  when,  upon  the  opening  day  of 
this  convention  I  had  the  honor  of  escorting  the  honorable  Secretary 
of  State  down  to  this  hall,  in  coming  down  in  the  carriage  he  talked 
over  a  few  matters,  and  I  said  to  him  then  that  I  did  not  know  what 
practical  results  would  come  out  of  this  convention  nor  did  I  know 
what  practical  results  would  come  out  of  the  work  of  the  Bureau. 
He  said  to  me,  "Do  not  worry  about  that.  You  are  a  good  deal 
in  the  position  of  a  lawyer  making  an  argument  to  the  court.  The 
argument  may  be  very  good  or  it  may  be  indifi^erent,  but  as  long 
as  you  are  making  that  argument  you  keep  the  court's  attention 
on  the  case."  And  I  think  that  is  what  you  are  doing;  and  I  am 
very  glad  that  I  have  had  opportunity,  in  a  small  way,  to  have 
been  of  some  little  assistance  to  you  distinguished  gentlemen  in 
completing  this  magnificent  piece  of  work.     [Applause.] 

The  President.  The  minutes  of  this  meeting  of  to-day  will  have 
to  be  approved  by  some  one  after  the  final  adjournment  of  the 
convention,  and  before  adjourning  it  would  be  competent  for  some 
one  to  make  a  motion  that  the  president  and  the  secretary  be  author- 
ized to  approve  the  minutes,  or  to  make  some  provision,  in  any 
manner  that  seems  fit  and  proper  to  the  convention,  for  the  approv- 
ing of  the  minutes  of  to-day. 

Dr.  H.  L.  E.  Johnson.  I  move  you,  sir,  that  the  minutes  be 
referred  to  the  president  and  secretary  for  their  approval  and  that 
their  approval  be  the  approval  of  the  convention. 

The  motion  was  seconded. 

The  question  was  taken,  and  the  motion  was  agreed  to. 

The  President.  Gentlemen   of   the    convention    [Applause],    the 

moment  has  arrived  when  we  are  about  to  adjourn,  to  meet  again 

in  the  Third  International  Sanitary  Convention  of  the  American 

Republics  in  the  City  of  Mexico  two  years  hence.     A  valedictory  is 

5610—06 7 


98  SECOND   INTERNATIONAL   SANITARY    CONVENTION. 

supposed  to  be  an  address  carefully  thought  out,  carefully  prepared. 
As  you  are  aware,  the  business  of  this  convention  has  been  so  serious, 
so  engaging,  that  it  has  been  practically  impossible  for  me  to  pre- 
pare an  address  which  I  think  would  be  worthy  of  tliis  occasion. 
So  I  am  simply  about  to  bid  you  adieu  with  the  expression  of  the 
thoughts  that  come  into  my  mind  at  the  moment.  And,  reviewing 
the  work  of  the  past  week,  I  feel  that  there  is  much  with  regard  to 
which  congratulations  are  in  order  to  each  and  every  member  of 
this  convention.  We  have  made  one  another's  acquaintance  in  a 
way  in  which  it  has  never  been  made  before.  Now,  when  we  see 
the  papers  or  read  the  journals  or  magazines  of  the  different  coun- 
tries represented  by  this  convention  the  thoughts  of  each  one  of 
us  will  revert  to  the  faces  that  are  here  now.  We  will  each  associate 
the  others  with  the  countries  which  they  represent,  and  we  will 
therefore  have  a  deeper  and  more  personal  reeling  toward  the  nations 
which  are  represented  here. 

I  feel  that  we  have  had  a  very  successful  time,  judged  from  the 
standpoint  of  social  intercourse.  We  have  learned  to  know  one 
another,  we  have  learned  to  appreciate  the  high  attainments  of 
the  individual  members  of  this  convention,  and  we  have  learned  to 
appreciate  the  kindly  thoughts  and  the  kindly  expressions  which 
have  been  so  constant  thi'oughout  the  past  week. 

We  are  also  to  be  congratulated  upon  the  evidences  of  scientific 
attainment  which  have  been  so  manifest  in  the  proceedings  of  this 
convention.  I  do  not  know  whether  it  has  occurred  to  you,  as  it 
has  occurred  to  me,  that  one  of  the  reasons  that  we  have  met  with 
such  success  in  our  deliberations  and  our  conclusions  is  the  fact 
that  the  Republics  taking  part  in  this  convention  are  represented 
by  men  of  high  education — finished,  cultivated  gentlemen.  That 
fact  has  made  it  comparatively  easy  for  us  to  agree  upon  these  great 
principles  which  we  have  put  into  form  and  which  we  hope  to 
emphasize  by  administration. 

Again,  we  are  to  be  congratulated  upon  the  great  international 
effect  of  such  a  convention  as  we  have  held.  Aside  from  medicine 
and  sanitation,  such  conventions  as  this  bring  nations  nearer  together, 
which  is  one  of  the  aims  and  is  the  great  trend  of  modern  thought. 
Peru  and  Chile  no  longer  seem  as  far  off  as  they  did  ten  years  ago 
to  us,  and  I  trust  the  Uinted  States  does  not  appear  as  far  off  to 
you  gentlemen  as  it  used  to.  So  that  we  are  an  element  in  the 
progress  of  civilization,  in  the  establishment  of  the  brotherhood  of 
m.an,  which  I  think  is  the  highest  aim  that  can  be  sought  by  any 
organization  or  by  individuals  working  in  a  convention  or  working 
individually. 

Personally  I  wish  to  extend  to  each  and  every  one  of  you  my 
thanks  for  your  very  courteous  treatment  of  your  president.  There 
has  not  been  one  ripple  of  unpleasantness  throughout  the  whole 
week.  I  have  felt  that  in  my  efforts  to  conduct  the  convention  I 
have  had  the  sympathetic  support — the  sympathy  and  the  support — 
of  every  one  of  you,  for  without  both  the  convention  could  not 
have  been  a  success  so  far  as  my  presidency  was  concerned;  and  I 
want  to  renew  my  thanks  and  to  express  my  great  appreciation  of 
the  fact  that  I  was  reelected  to  the  presidency  of  this  Second  Inter- 
national Sanitary  Convention  of  the  American  Republics,  a  con- 
vention which  I  believe  will  go  into  history  as  the  beginning  of  great 


SECOND    INTERN A.TION AL    SANITARY '  CONVENTION.  99 

things  for  the  Western  Hemisphere,  great  advances  in  the  Western 
Hemisphere,  advances  in  sanitation,  advances  in  relieving  commerce 
of  many  of  its  unduly  restrictive  measures,  advances  in  good  sani- 
tation, which  adds  so  much  to  the  public  health  and  prosperity  of 
nations. 

I  will  now  wish  you  all  a  fond  farewell.  By  "fond  farewell"  I 
mean  that  in  going  away  you  carry  with  you  the  loving  thoughts  of 
the  American  delegates  and  of  myself ;  that  we  look  forward  to  the 
third  convention  in  the  City  of  Mexico  with  the  greatest  of  pleasure. 
And  we  sympathize  with  the  remark  that  was  made  by  one  of  the 
delegates,  to  the  effect  that  he  wished  that  the  time  might  be  short 
between  this  convention  and  the  next. 

With  these  few  remarks  I  bid  you  farewell,  and  I  declare  the 
Second  General  International  Sanitary  Convention  of  the  American 
Republics  at  an  end.     [Applause.] 


APPENDIX. 


101 


APPENDIX. 


SECOND  GENERAL  INTERNATIONAL  SANITARY  CONVENTION. 


CONVENTION  AD  REFERENDUM  CONCLUDED  AT  THE  SECOND 
GENERAL  INTERNATIONAL  SANITARY  CONVENTION  OF  THE 
AMERICAN  REPUBLICS,  IN  WASHINGTON,  ON  OCTOBER  14, 
1905. 

The  Presidents  of  the  Republics  of  Chile,  Costa  Rica,  Cuba,  Dominican  Republic,  Ecuador, 
Guatemala,  Mexico,  Nicaragua,  Peru,  United  States  of  America,  and  Venezuela,  having 
found  that  it  is  useful  and  convenient  to  codify  all  the  measures  destined* to  guard  the  pub- 
lic health  against  the  invasion  and  propagation  of  yellow  fever,  plague,  and  cholera,  have 
designated  as  their  delegates,  to  wit: 

Republic  of  Chile,  Señor  Dr.  D.  Eduardo  Moore,  professor  of  the  medical  faculty,  hos- 
pital physician; 

Republic  of  Costa  Rica,  Señor  Dr.  D.  Juan  J.  Ulloa,  ex-vice-president,  ex-minister  of  the 
interior  of  Costa  Rica,  ex-president  of  the  medical  faculty  of  Costa  Rica; 

Republic  of  Cuba,  Señor  Dr.  D.  Juan  Guiteras,  member  of  the  superior  board  of  health 
of  Cuba,  director  of  the  "Las  Animas"  Hospital,  professor  of  general  pathology  and  trop- 
ical medicine  of  the  University  of  Habana,  and  Señor  Dr.  D.  Enrique  B.  Barnet,  executive 
chief  of  the  health  department  of  Habana,  member  and  secretary  of  the  superior  board  of 
health  of  Cuba ; 

Republic  of  Ecuador,  Señor  Dr.  D.  Serafín  S.  Wither,  charge  d'affaires  and  consul-general 
of  Ecuador  in  New  York,  and  Señor  Dr.  D.  lliguel  H.  Alcivar,  member  of  the  superior 
board  of  health  of  Guayaquil,  professor  of  the  medical  faculty  and  surgeon  of  the  General 
Hospital  of  Guayaquil; 

Republic  of  the  United  States  of  America,  Dr.  Walter  Wyman,  Surgeon-General  of  the 
Public  Health  and  Marine-Hospital  Service  of  the  United  States;  Dr.  H.  D.  Geddings, 
Assistant  Surgeon-General  of  the  Public  Health  and  Marine-Hospital  Service  of  the  United 
States  and  representative  of  the  United  States  at  the  sanitary  convention  of  Paris;  Dr. 
J.  F.  Kennedy,  secretary  of  the  board  of  health  of  the  State  of  Iowa;  Dr.  John  S.  Fulton, 
secretary  of  the  board  of  health  of  the  State  of  Maryland;  Dr.  Walter  D.  McCaw,  major, 
surgeon  in  the  United  States  Army;  Dr.  J.  D.  Gatewood,  surgeon  in  the  United  States 
Navy;  Dr.  H.  L.  E.  Johnson,  member  of  the  American  Medical  Association  (member  of 
the  board  of  ti-ustees) ; 

Republic  of  Guatemala,  Señor  Dr.  D.  Joaquin  Yela,  consul-general  of  Guatemala  in  New 
York; 

Republic  of  Mexico,  Señor  Dr.  D.  Eduardo  Licéaga,  president  of  the  superior  council  of 
health  of  Mexico,  director  and  professor  of  the  National  School  of  Medicine,  member  of  the 
Academy  of  Medicine; 

Republic  of  Nicaragua,  Señor  Dr.  D.  J.  L.  Medina,  member  of  the  Second  Pan-American 
Medical  Congress  of  the  city  of  Habana  in  1901 ; 

Republic  of  Peru,  Señor  Dr.  D.  Daniel  Eduardo  Lavorería,  professor  of  the  medical  fac- 
ulty, member  of  the  National  Academy  of  Medicine,  physician  of  the  "Dos  de  Mayo" 
Hospital,  chief  of  the  division  of  hygiene  of  the  ministry  of  fomento ; 

Dominican  Republic,  Señor  D.  Emilio  C.  Joubert,  minister  resident  in  Washington; 

Republic  of  Venezuela,  Señor  D.  Nicolás  Veloz-Goiticoa,  charge  d'affaires  of  Venezuela, 

Who,  having  made  an  interchange  of  their  powers  and  found  them  good,  have  agreed  to 
adopt,  ad  i  ef erendum,  the  following  propositions : 

103 


104  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

CHAPTER  I. 

REGULATIONS  TO  BE   OBSERVED  BY  THE  POWERS   SIGNATORY  TO  THE  CONVENTION   AS  SOON 
AS   PLAGUE,  CHOLERA,  OR   YELLOW   FEVER   MAY    APPEAR   IN   THEIR   TERRITORY. 

Section  I. — Notification  and  subsequent  communications  to  other  countries. 

Article  I.  Each  Government  should  immediately  notify  other  Governments  of  the  first 
appearance  in  its  territory  of  authentic  cases  of  plague,  cholera,  or  yellow  fever. 

Art.  II.  This  notification  is  to  be  accompanied,  or  very  promptly  followed,  by  the  fol- 
lo^ving  additional  information: 

1.  The  neighborhood  where  the  disease  has  appeared. 

2.  The  date  of  its  appearance,  its  origin,  and  its  form. 

3.  The  number  of  established  cases  and  the  number  of  deaths. 

4.  For  plague — the  existence  among  rats  or  mice  of  plague,  or  of  an  unusual  mortality; 
for  yellow  fever — the  existence  of  Siegomyia  fasciata  in  the  locality. 

5.  The  measures  taken  immediately  after  the  first  appearance. 

Art.  III.  The  notification  and  the  information  prescribed  in  Articles  I  and  II  are  to  be 
addressed  to  diplomatic  and  consular  agents  in  the  capital  of  the  infected  country;  but 
this  is  to  be  construed  as  not  preventing  direct  communication  between  officials  charged 
with  the  public  health  of  the  several  countries. 

For  countries  which  are  not  thus  represented,  they  are  to  be  transmitted  directly  by  tele- 
graph to  the  Governments  of  such  countries. 

Art.  IV.  The  notification  and  the  information  prescribed  in  Articles  I  and  II  are  to  be 
followed  bj^  further  communications  dispatched  in  a  regular  manner  in  order  to  keep  the 
Governments  informed  of  the  progress  of  the  epidemic. 

These  communications,  which  are  to  be  made  at  least  once  a  week,  and  which  are  to  be 
as  complete  as  possible,  should  indicate  in  detail  the  precautions  taken  to  prevent  the 
extension  of  the  disease. 

They  should  set  forth,  first,  the  prophylactic  measures  taken  relative  to  sanitary  or  med- 
ical inspection,  to  isolation,  and  disinfection;  second,  the  measures  taken  relative  to  depart- 
ing vessels  to  prevent  the  exportation  of  the  disease,  and,  especially  under  the  circumstances 
mentioned  in  paragraph  4  of  Article  II  of  this  section,  the  measures  taken  against  rats  and 
mosquitoes. 

Art.  V.  The  prompt  and  faithful  execution  of  the  preceding  provisions  is  of  the  very 
first  importance. 

The  notifications  only  have  a  real  value  if  each  Government  is  warned  in  time  of  cases 
of  plague,  cholera,  or  yellow  fever  and  of  suspicious  cases  of  those  diseases  supervening  in 
its  territory.  It  can  not,  then,  be  too  strongly  recommended  to  the  various  Governments  to 
make  obligatory  the  declaration  of  cases  of  plague,  cholera,  or  yellow  fever,  and  of  giving 
information  of  all  unusual  mortality  of  rats  and  mice,  especially  in  ports. 

Art.  VI.  It  is  understood  that  neighboring  countries  reserve  to  themselves  the  right  to 
make  special  arrangements  with  a  view  of  organizing  a  service  of  direct  information  between 
the  chiefs  of  administration  upon  the  frontiers. 

Section  II. — Conditions  showing  a  given  territorial  area  to  be  infected  or  to  have  been  freed 

from  infection. 

Art.  VII.  Information  of  a  first  case  of  plague,  cholera,  or  yellow  fever  does  not  justify 
against  a  territorial  area  where  it  may  appear  the  application  of  the  measures  prescribed 
in  Chapter  II,  as  hereinafter  indicated. 

Upon  the  occurrence  of  several  nonimported  cases  of  plague  or  a  nonimported  case  of 
yellow  fever  or  when  cases  of  cholera  form  a  focus  the  area  is  to  be  declared  infected. 

Art.  VIII.  To  limit  the  measures  to  the  affected  regions  alone,  Governments  should  only 
apply  them  to  persons  and  articles  proceeding  from  the  contaminated  or  infected  areas. 

By  the  word  "area"  is  understood  a  well-determined  portion  of  territory  described  in  the 
information  which  accompanies  or  follows  notification;  thus,  a  province,  a  state,  "a  gov- 
ernment," a  district,  a  department,  a  canton,  an  island,  a  conmaune,  a  city,  a  quarter  of  a 
city,  a  village,  a  port,  a  "polder,"  a  hamlet,  etc.,  whatever  may  be  the  extent  and  popula- 
tion of  these  portions  of  territorj'. 

But  this  restriction,  limited  to  the  infected  area,  should  only  be  accepted  upon  the  formal 
condition  that  the  Government  of  the  infected  country  shall  take  the  necessary  measures, 
1,  to  prevent,  unless  previously  disinfected,  the  exportation  of  articles  named  in  1  and  2  of 
Article  XII  coming  from  the  contaminated  area;  and  2,  measures  to  prevent  the  extension 
of  the  epidemic;  and  provided  further,  that  there  be  no  doubt  that  the  sanitaiy  authori- 
ties of  the  infected  country  have  faithfully  complied  with  Article  I  of  this  convention. 


SECOND    INTERNATIONAL   SANITAKY    CONVENTION.  105 

When  an  area  is  infected,  no  restrictive  measure  is  to  be  taken  against  departures  from 
this  area  if  these  departures  have  occurred  five  days,  at  least,  before  the  beginning  of  the 
epidemic. 

Art.  IX.  That  an  area  should  no  longer  be  considered  as  infected,  oificial  proof  must  be 
furnished : 

First,  that  there  has  been  neither  a  death  nor  a  new  case  of  plague  or  cholera  for  five  days 
after  isolation,^  death,  or  cure  of  the  last  plague  or  cholera  case.  In  the  case  of  yellow  fever 
the  period  shall  be  eighteen  days,  but  each  Government  may  reserve  the  right  to  extend 
this  period. 

Second,  that  all  the  measures  of  disinfection  have  been  applied;  in  the  case  of  plague, 
that  the  precautions  against  rats  have  been  observed,  and  in  the  case  of  yellow  fever  that 
the  measures  against  mosquitoes  have  been  executed. 

CHAPTER  II. 

MEASURES    OF    DEFENSE    BY    OTHER    COUNTRIES    AGAINST    TERRITORIES    DECLARED    TO    BE 

INFECTED. 

Section  I. — Publication  of  prescribed  measures. 

Art.  X.  The  Government  of  each  country  is  obliged  to  immediately  publish  the  meas- 
ures which  it  believes  necessary  to  take  against  departures  either  from  a  country  or  from  an 
infected  territorial  area. 

The  said  Government  is  to  communicate  at  once  this  publication  to  the  diplomatic  or 
consular  agent  of  the  infected  country  residing  in  its  capital,  as  well  as  to  the  International 
Sanitary  Bureau. 

The  Government  shall  be  equally  obliged  to  make  known  through  the  same  channels  the 
revocation  of  these  measures  or  modifications  which  may  be  made  in  them. 

In  default  of  a  diplomatic  or  consular  agency  in  the  capital,  communications  are  made 
directly  to  the  Government  of  the  country  interested. 

Section  II. — Merchandise — Disinfection — Importation  and  transit — Baggage. 

Art.  XL  There  exists  no  merchandise  which  is  of  itself  capable  of  transmitting  plague, 
cholera,  or  yeUow  fever.  It  only  becomes  dangerous  in  case  it  is  soiled  by  pestous  or 
choleraic  products,  or,  in  the  case  of  yeUow  fever,  when  such  merchandise  may  harbor 
mosquitoes. 

Art.  XII.  No  merchandise  or  objects  shall  be  subjected  to  disinfection  on  account  of 
yellow  fever,  but  in  cases  covered  by  the  previous  article  the  vehicle  of  transportation  may 
be  subjected  to  fumigation  to  destroy  mosquitoes.  In  the  case  of  cholera  and  plague  dis- 
infection should  only  be  apphed  to  merchandise  and  objects  which  the  local  sanitary 
authority  considers  as  infected. 

Nevertheless,  merchandise  or  objects  enumerated  hereafter  may  be  subjected  to  disin- 
fection or  prohibited  entry,  independently  of  all  proof  that  they  may  or  may  not  be 
infected: 

1.  Body  linen,  wearing  apparel  in  use,  clothing  which  has  been  worn,  bedding  already 
used. 

When  these  objects  are  transported  as  baggage,  or  in  the  course  of  a  change  of  residence 
(household  furniture),  they  should  not  be  prohibited,  and  are  to  be  subjected  to  the  regula- 
tions prescribed  by  Article  XIX. 

Baggage  left  by  soldiers  and  sailors  and  returned  to  their  country  after  death  are  con- 
sidered as  objects  comprised  in  the  first  paragraph  of  No.  1  of  this  article. 

2.  Rags,  and  rags  for  making  paper,  with  the  exception,  as  to  cholera,  of  rags  which  are 
transported  as  merchandise  in  large  quantities  compressed  in  bales  held  together  by  hoops. 

New  chppings  coming  directly  from  spinning  mills,  weaving  mills,  manufactories  or 
bleacheries,  shoddy,  and  clippings  of  new  paper,  should  not  be  forbidden. 

Art.  XIII.  In  the  case  of  cholera  and  plague  there  is  no  reason  to  forbid  the  transit 
through  an  infected  district  of  merchandise  and  the  objects  specified  in  Nos.  1  and  2  of  the 
preceding  article  if  they  are  so  packed  that  they  can  not  have  been  exposed  to  infection  in 
transit. 

In  like  manner,  when  merchandise  or  objects  are  so  transported  that  in  transit  they  can 
not  come  in  contact  with  soiled  objects,  their  transit  across  an  infected  territorial  area 
should  not  be  an  obstacle  to  their  entry  into  the  country  of  destination. 

o  The  word  "isolation"  signifies  isolation  of  the  patient,  of  the  persons  who  care  for  him, 
and  the  forbidding  of  visits  of  all  other  persons,  the  physician  excepted.  By  isolation  in 
the  case  of  yellow  fever  is  understood  the  isolation  of  the  patient  in  an  apartment  so  screened 
as  to  prevent  the  access  of  mosquitoes. 


106  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Art.  XrV'.  The  entry  of  merchandise  and  objects  specified  in  Nos.  1  and  2  of  Aiiicle  XII 
should  not  be  prohibited  if  it  can  be  sliown  to  the  authorities  of  the  country  of  destination 
that  thev  were  shipped  at  least  five  days  before  the  beginning  of  the  epidemic. 

Art.  XV.  The  method  and  place  of  disinfection,  as  well  as  the  measures  to  be  employed 
for  the  destruction  of  rats  and  mosquitoes,  are  to  be  fixed  by  authority  of  the  country  of 
destination,  upon  arrival  at  said  destination.  These  operations  should  be  performed  in 
such  a  manner  as  to  cause  the  least  possible  injury  to  the  merchandise. 

It  devolves  upon  each  country  to  determine  questions  relative  to  the  payment  of  damages 
resulting  from  disinfection  or  from  the  destruction  of  rats  or  mosquitoes. 

If  taxes  are  levied  by  a  sanitary  authority,  either  directly  or  through  the  agency  of  any 
company  or  agent,  to  insure  measiires  for  the  destruction  of  rats  and  mosquitoes  on  board 
ships,  the  amount  of  these  taxes  ought  to  be  fixed  by  a  tarifl"  published  in  advance,  and 
the  result  of  these  measures  should  not  be  a  soiu-ce  of  profit  for  either  State  or  sanitary 
authorities. 

Art.  XVI.  Letters  and  correspondence,  printed  matter,  books,  newspapers,  business 
papers,  etc.  (postal  parcels  not  included),  are  not  to  be  submitted  to  any  restriction  or  dis- 
infection. In  case  of  yellow  fever  postal  parcels  are  not  to  be  subjected  to  any  restrictions 
or  disinfection. 

Art.  XVII.  Merchandise  arriving  by  land  or  by  sea  should  not  be  detained  perma- 
nently at  frontiers  or  in  ports. 

Measures  which  it  is  permissible  to  prescribe  with  respect  to  them  are  specified  in 
Article  XII. 

Nevertheless,  when  merchandise,  arriving  by  sea  in  bulk  (vrac)  or  in  defective  packages, 
is  contaminated  by  pest-stricken  rats  during  the  passage  and  is  incapable  of  being  disin- 
fected, the  destruction  of  the  germs  may  be  assured  by  putting  said  merchandise  in  a  ware- 
house for  a  period  to  be  decided  by  the  sanitary  authorities  of  the  port  of  arrival. 

It  is  to  be  understood  that  the  apphcation  of  this  last  measure  should  not  entail  delay 
upon  any  vessel  nor  extraordinary  expenses  resulting  from  the  want  of  warehouses  in  ports. 

Art.  XVIII.  When  merchandise  has  been  disinfected  by  the  apphcation  of  the  meas- 
ures prescribed  in  Article  XII,  or  put  temporarily  in  warehouses  in  accordance  with  the 
third  paragraph  of  Ai'ticle  XVII,  the  ovraer  or  his  representative  has  the  right  to  demand 
from  the  sanitaiy  authority  which  has  ordered  such  disinfection  or  storage  a  certificate 
setting  forth  the  measures  taken. 

Art.  XEX.  Baggage.  In  the  case  of  soiled  linen,  bed  clothing,  clothing,  and  objects 
fornaing  a  part  of  baggage  or  furniture  coming  ft'om  a  territorial  area  declared  contaminated, 
disinfection  is  only  to  be  practiced  in  cases  where  the  sanitary  authority  considers  them  as 
contaminated.     There  shaU  be  no  disinfection  of  baggage  on  account  of  yellow  fever. 

Section  III. — Measures  in  ports  and  at  maritime  frontiers. 

Art.  XX.  Classification  of  ships.  A  ship  is  considered  as  infected  which  has  plague, 
cholera,  or  yellow  fever  on  board,  or  which  has  presented  one  or  more  cases  of  plague  or 
cholera  within  seven  days  or  a  case  of  yellow  fever  at  any  time  during  the  voyage. 

A  ship  is  considered  as  suspected  on  board  of  which  there  have  been  a  case  or  cases  of 
plague  or  cholera  at  the  time  of  departure  or  during  the  voyage,  but  no  new  case  within 
seven  days;  also  such  ships  as  have  lain  in  such  proximity  to  the  infected  shore  as  to 
render  them  liable  to  the  access  of  mosquitoes. 

The  ship  is  considered  indemne  which,  although  coming  from  an  infected  port,  has  had 
neither  death  nor  case  of  plague,  cholera,  or  yellow  fever  on  board,  either  before  departure, 
during  the  voyage,  or  at  the  time  of  arrival,  and  which  in  the  case  of  yellow  fever  has  not 
lain  in  such  proximity  to  the  shore  as  to  render  it  liable,  in  the  opinion  of  the  sanite"' 
authorities,  to  the  access  of  mosquitoes. 

Art.  XXI.  Ships  infected  with  plague  are  to  be  subjected  to  the  following  regulations: 

1.  Medical  visit  (inspection). 

2.  The  sick  are  to  be  immediately  disembarked  and  isolated. 

3.  Other  persons  should  also  be  disembarked,  if  possible,  and  subjected  to  an  observation,» 
which  should  not  exceed  five  days  dating  from  the  day  of  arrival. 

4.  Soiled  linen,  personal  effects  in  use,  the  belongings  of  crew  i>  and  passengers  which,  in 
the  opinion  of  the  sanitary  authorities  are  considered  as  infected,  should  be  disinfected. 

o  The  word  "observation"  signifies  isolation  of  the  passengers,  either  on  board  ship  or  at 
a  sanijtary  station,  before  being  given  free  pratique. 

6 The  term  "crew"  is  applied  to  persons  who  may  make  or  who  have  made  a  part  of  the 
personnel  of  the  vessel  and  of  the  administration  thereof,  including  stewards,  waiters, 
"  cafedji,"  etc.  The  word  is  to  be  construed  in  this  sense  wherever  employed  in  the  present 
convention. 


SECOND    INTERNATIONAL    HANITAKY    CONVENTION.  107 

5.  The  parts  of  the  ship  which  have  been  inhabited  by  those  stricken  with  plague,  and 
such  others  as,  in  the  opinion  of  the  sanitary  authorities  are  considered  as  infected,  should 
be  disinfected. 

6.  The  destruction  of  rats  on  shipboard  should  be  effected  before  or  after  the  discharge  of 
cargo  as  rapidly  as  possible,  and  in  all  cases  with  a  maximum  delay  of  forty-eight  hours, 
care  being  taken  to  avoid  damage  of  merchandise,  the  vessel  and  its  machinery. 

For  ships  in  ballast  this  operation  should  be  performed  immediately  before  taking  on 
cargo. 

Ab,t.  XXII.  Ships  suspected  of  plague  are  to  be  subjected  to  the  measures  which  are 
indicated  in  Nos.  1,  4,  and  5  of  Article  XXI. 

Further,  the  crew  and  passengers  may  be  subjected  to  observation,  which  should  not 
exceed  five  days,  dating  from  the  arrival  of  the  ship.  During  the  same  time  the  diserabark- 
ment  of  the  crew  may  be  forbidden,  except  for  reasons  of  duty. 

The  destruction  of  rats  on  shipboard  is  recommended.  This  destruction  is  to  be  effected 
before  or  after  the  discharge  of  cargo,  as  quickly  as  possible,  and  in  all  cases  with  a  maximum 
delay  of  forty-eight  hours,  taking  care  to  avoid  damage  to  merchandise,  ships  and  their 
machinery. 

For  ships  in  ballast  this  operation  should  be  done,  if  done  at  all,  as  early  as  possible,  and 
in  all  cases  before  taking  on  cargo. 

Art.  XXIII.  Ships  indemne  from  plague  are  to  be  admitted  to  free  pratique  immediately, 
whatever  may  be  the  nature  of  their  bill  of  health. 

The  only  regulation  which  the  sanitary  authorities  at  a  port  of  arrival  may  prescribe  for 
them  consists  of  the  following  measures: 

1.  Medical  visit  (inspection). 

2.  Disinfection  of  soiled  linen,  articles  of  wearing  apparel,  and  the  other  personal  effects 
of  the  crew  and  passengers,  but  only  in  exceptional  cases,  when  the  sanitary  authorities  have 
special  reason  to  believe  them  infected. 

3.  Without  demanding  it  as  a  genéfal  rule,  the  sanitary  authorities  may  subject  ships 
coming  from  an  infected  port  to  a  process  for  the  destruction  of  the  rats  on  board  before  or 
after  the  discharge  of  cargo.  This  operation  should  be  done  as  soon  as  possible,  and  in  all 
cases  should  not  last  more  than  twenty-four  hours,  care  being  taken  to  avoid  damaging 
merchandise,  ships  and  their  machinery,  and  without  interfering  with  the  passing  of 
passengers  and  crew  between  the  ship  and  the  shore.  For  ships  in  ballast  this  procedure, 
if  practiced,  should  be  put  in  operation  as  soon  as  possible,  and  in  aU  cases  before  taking  on 
cargo. 

When  a  ship  coming  from  an  infected  port  has  been  subjected  to  a  process  for  the  destruc- 
tion of  rats,  this  process  should  only  be  repeated  if  the  ship  has  touched  meanwhile  at  an 
infected  port  and  has  been  alongside  a  quay  in  such  port,  or  if  the  presence  of  sick  or  dead 
rats  on  board  is  proven. 

The  crew  and  passengers  may  be  subjected  to  a  surveillance,  which  should  not  exceed  five 
days,  to  be  computed  from  the  date  when  the  ship  sailed  from  the  infected  port.  The 
landing  of  the  crew  may  also,  during  the  same  time,  be  forbidden  except  for  reasons  of  duty. 

Competent  authority  at  the  port  of  arrival  may  always  demand,  under  oath,  a  certifi- 
cate of  the  ship's  physician,  or  in  default  of  a  physician,  of  the  captain,  setting  forth  that 
there  has  not  been  a  case  of  plague  on  board  since  departure  and  that  no  marked  mortality 
among  the  rats  has  been  observed. 

Akt.  XXIV.  When  upon  an  indemne  ship  rats  have  been  recognized  as  pest  stricken  as 
a  result  of  bacteriological  examination,  or  when  a  marked  mortality  has  been  established 
among  these  rodents,  the  following  measures  should  be  applied: 

1.  Ships  with  plague-stricken  rats : 
(a)  Medical  visit  (inspection). 

(6)  Rats  should  be  destroyed  before  or  after  the  discharge  of  cargo  as  rapidly  as  possible, 
and  in  aU  cases  with  a  delay  not  to  exceed  forty-eight  hours :  the  deterioration  of  merchan- 
dise, vessels  and  machinery  to  be  avoided.  Upon  ships  in  ballast,  this  operation  should  be 
performed  as  soon  as  possible,  and  in  all  cases  before  taking  on  cargo. 

(c)  Such  parts  of  the  ship  and  such  articles  as  the  local  sanitary  authority  regards  as 
infected  shall  be  disinfected. 

(d)  Passengers  and  crew  may  be  submitted  to  observation,  the  duration  of  which  should 
not  exceed  five  days,  dating  from  the  day  of  arrival,  except  in  special  cases,  where  the 
sanitary  authority  may  prolong  the  obsei-vation  to  a  maximum  of  ten  days. 

2.  Ships  where  a  marked  mortality  among  rats  is  obsei-ved : 
(a)  Medical  visit  (inspection). 

(6)  An  examination  of  rats,  with  a  view  to  determining  the  existence  of  plague,  should  be 
made  as  quickly  as  possible. 

(c)  If  the  destruction  of  rats  is  judged  necessary,  it  shall  be  accomplished  under  the 
conditions  indicated  above  in  the  case  of  ships  with  plague-stricken  rats. 

{d)  Until  all  suspicion  may  be  eliminated,  the  passengers  and  crew  may  be  submitted  to 
observation,  the  duration  of  which  should  not  exceed  five  days,  counting  from  the  date  of 


lUb  SEC02ÍD    IKTEENATIONAL    SANITARY    CONVENTION. 

arrival,  except  in  special  cases,  when  the  sanitary  authority  may  prolong  the  observation 
to  a  maximum  of  ten  days. 

Art.  XXV.  The  sanitary  authorities  of  the  port  must  deliver  to  the  captain,  the  owner, 
or  his  agent,  whenever  a  demand  for  it  is  made,  a  certificate  setting  forth  that  the  measures 
for  the  destioiction  of  rats  have  been  efficacious  and  indicating  the  reasons  why  these 
measures  have  been  applied. 

Art.  XXVI.  Ships  infected  wnth  cholera  are  to  be  subjected  to  the  following  regulations: 

1.  Medical  visit  (inspection). 

2.  The  sick  are  to  be  immediately  disembarked  and  isolated. 

3.  Other  persons  ought  also  to  be  disembarked,  if  possible,  and  subjected,  dating  from 
the  arrival  of  the  ship,  to  an  observation  the  duration  of  which  shall  not  exceed  five  days. 

4.  Soiled  linen,  wearing  apparel,  and  personal  ell'ects  of  crew  and  passengers  which,  in  the 
opinion  of  the  sanitary  authority  of  the  port,  are  considered  as  infected,  are  to  be  disinfected. 

5.  The  parts  of  the  ship  which  have  been  inhabited  by  pei-sons  sick  with  cholera,  or  which 
are  considered  by  the  sanitaiy  authority  as  infected,  are  to  be  disinfected. 

6.  The  bilge  water  is  to  be  discharged  after  disinfection. 

The  sanitary  authority  may  order  the  substitution  of  good  potable  water  for  that  which  is 
contained  in  the  tanks  on  board. 

The  discharge  or  thromng  overboard  into  the  water  of  a  port,  of  dejecta,  shall  be  forbid- 
den unless  they  have  been  previously  disinfected. 

Art.  XXVII.  Ships  suspected  of  cholera  are  to  be  subjected  to  measures  prescribed  under 
Nos.  1,  4,  5,  and  6  of  Article  XXVI. 

The  crew  and  passengers  may  be  subjected  to  an  observation,  which  should  not  exceed 
five  days,  to  date  from  the  arrival  of  the  ship.  It  is  i-ecommended  during  the  same  time  to 
prevent  the  debarkation  of  the  crew  except  for  reasons  of  duty. 

Art.  XXVIII.  Ships  indemne  of  cholera  are  to  be  admitted  to  free  pratique  immediately, 
whatever  may  be  the  nature  of  their  biU  of  health. 

The  only  regulations  which  the  sanitary  authorities  of  a  port  may  prescribe  in  their  case 
are  the  measures  provided  in  Nos.  1,  4,  and  6  of  Article  XXVI. 

The  crews  and  passengers  may  be  submitted,  in  order  to  show  their  state  of  health,  to  an 
observation,  which  should  not  exceed  five  days,  to  be  computed  from  the  date  when  the 
ship  sailed  from  the  infected  port. 

It  is  recommended  that  during  the  same  time  the  debarkation  of  the  crew  be  forbidden 
except  for  reasons  of  duty. 

Competent  authority  at  the  port  of  arrival  may  always  demand,  under  oath,  a  certificate 
from  the  ship's  surgeon,  or,  in  the  absence  of  a  surgeon,  from  the  captain,  setting  forth  that 
there  has  not  been  a  case  of  cholera  upon  the  ship  since  sailing. 

Art.  XXIX.  Competent  authority  will  take  account,  in  order  to  apply  the  measures 
indicated  in  Articles  XXI  to  XXVIII,  of  the  presence  of  a  physician  on  board  and  a  disin- 
fecting apparatus  in  ships  of  the  three  categories  mentioned  above. 

In  regard  to  plague,  it  will  equally  take  account  of  the  installation  on  board  of  apparatus 
for  the  destruction  of  rats. 

Sanitary  authorities  of  such  countries,  where  it  may  be  convenient  to  make  such  regula- 
tions, may  dispense  mth  the  medical  visit  and  other  measures  toward  indemne  ships  which 
have  on  board  a  physician  specially  conomissioned  by  their  country. 

Art.  XXX.  Special  measures  may  be  prescribed  in  regard  to  crowded  ships,  notably 
emigrant  ships,  or  any  other  ship  presenting  bad  hygienic  conditions. 

Art.  XXXI.  Any  ship  not  desiring  to  be  subjected  to  the  obligations  imposed  by  the 
authority  of  the  port  in  virtue  of  the  stipulations  of  the  present  convention  is  free  to  pro- 
ceed to  sea. 

It  may  be  authorized  to  disembark  its  cargo  after  the  necessary  precautions  shall  have 
been  taken,  namely,  first,  isolation  of  the  ship,  its  crew  and  passengers;  second,  in  regard  to 
plague,  demand  for  information  relative  to  the  existence  of  an  unusual  mortality  among 
rats;  third,  in  regard  to  cholera,  the  discharge  of  the  bilge  water  after  disinfection  and  the 
substitution  of  a  good  potable  water  for  that  which  is  provided  on  board  the  ship. 
'  Authority  may  also  be  granted  to  disembark  such  passengers  as  may  demand  it,  upon 
condition  that  these  submit  themselves  to  all  measures  prescribed  by  the  local  authorities. 

Ajrt.  XXXII.  Ships  coming  from  a  contaminated  port,  which  have  been  disinfected  and 
which  may  have  have  been  subjected  to  sanitary  measures  applied  in  an  efficient  manner, 
shall  not  undergo  a  second  time  the  same  measures  upon  their  arrival  at  a  new  port,  provided 
that  no  new  case  shall  have  appeared  since  the  disinfection  was  practiced  and  that  the 
ships  have  not  touched  in  the  meantime  at  an  infected  port. 

When  a  ship  only  disembarks  passengers  and  their  baggage,  or  the  mails,  without  having 
been  in  communication  with  terra  firma,  it  is  not  to  be  considered  as  having  touched  at  a 
port,  provided  that  in  the  case  of  yeUow  fever  it  has  not  approached  sufficiently  near  the 
shore  to  permit  the  access  of  mosquitoes. 


SECOND    INTERNATIONAL    SANITAKY    CONVENTION.  109 

Abt.  XXXIIT.  Pa.sHongei'H  arriving;  on  an  inlVictod  siiip  have  t?if!  right  to  demand  of  the 
sanitaiy  authority  of  tlie  port  a  certiiicato  sliowing  tlic  date  of  their  arrival  and  the  meas- 
ures to  which  tiiey  and  their  baggage  liave  l)een  suljjeoted. 

Art.  XXXIV.  Pacitet  boats  shall  be  Hul)je(;ted  to  special  regulations,  to  be  established  by 
mutual  agreement  between  the  countries  in  interest. 

Art.  XXXV.  Without  prejudice  to  the  right  which  governments  possess  to  agree  upon 
the  organization  of  common  sanitary  stations,  each  country  should  provide  at  least  one 
port  upon  cacli  of  its  seaboards,  with  an  organization  and  equipment  suííicient  to  receive  a 
vessel,  whatever  may  be  its  sanitaiy  condition. 

When  an  indemne  vessel,  coming  from  an  infected  port,  arrives  at  a  large;  mercantile  port, 
it  is  recommended  that  she  be  not  sent  to  another  port  for  the  execution  of  the  prescribed 
sanitaiy  measures. 

In  ever  countiy  ports  liable  to  the  arrival  of  vessels  from  ports  infected  with  plague, 
cholera,  or  yellow  fever  should  be  equipped  in  such  a  manner  that  indemne  ve.ssels  may 
there  undergo,  immediately  upon  their  arrival,  the  prescribed  measures,  and  not  be  sent  for 
this  purpose  to  another  port. 

Governments  should  make  declaration  of  the  ports  which  are  open  in  their  territories  to 
arrivals  from  ports  infected  with  plague,  cholera,  or  yellow  fever. 

Art.  XXXVI.  It  is  recommended  that  in  large  seaports  there  be  established: 

(a)  A  regular  medical  sei-vice  and  a  permanent  medical  supervision  of  the  sanitary  condi- 
tions of  crews  and  the  inhabitants  of  the  port. 

(b)  Places  set  apart  for  the  isolation  of  the  sick  and  the  observation  of  suspected  persons. 
In  the  Stegomyia  belt  there  must  be  a  building  or  part  of  a  building  screened  against  mosqui- 
toes, and  a  launch  and  ambulance  similarly  screened. 

(c)  The  necessaiy  installation  for  efficient  disinfection  and  bacteriological  laboratories. 

(d)  A  supply  of  potable  water  above  suspicion,  for  the  use  of  the  port,  and  the  installa- 
tion of  a  system  of  sewerage  and  drainage  adequate  for  the  removal  of  refuse. 

Section  1Y.— -Measures  upon  land  frontiers — Travelers — Railroads — Frontier  zones — River 

routes. 

Art.  XXXVII.  Land  quarantines  should  no  longer  be  established,  but  the  governments 
reserve  the  right  to  establish  camps  of  observation,  if  they  should  be  thought  necessary,  for 
the  temporary  detention  of  suspects. 

This  principle  does  not  exclude  the  right  for  each  country  to  close  a  part  of  its  frontier  in 
case  of  necessity. 

Art.  XXXVIII.  It  is  important  that  travelers  should  be  submitted  to  a  surveillance  on 
the  part  of  the  personnel  of  railroads,  to  determine  their  condition  of  health. 

Art.  XXXIX.  Medical  intervention  is  limited  to  a  visit  (inspection),  with  the  taking  of 
temperature  of  travelers  and  the  succor  to  be  given  to  those  actually  sick.  If  this  visit  is 
made,  it  should  be  combined  as  much  as  possible  with  the  custom-house  inspection,  to 
the  end  that  travelers  may  be  detained  as  short  a  time  as  possible.  Only  persons  evi- 
dently sick  should  be  subjected  to  a  searching  medical  examination. 

Art.  XL.  As  soon  as  travelers  coming  from  an  infected  locality  shall  have  arrived  at 
their  destination,  it  would  be  of  the  greatest  utility  to  submit  them  to  a  surveillance,  which 
should  not  exceed  ten  or  five  days,  counting  from  the  date  of  departure,  the  time  depending 
upon  whether  it  is  a  question  of  plague  or  cholera.  In  case  of  yellow  fever  the  period  should 
be  six  days.  ^ 

Art.  XLI.  Governments  may  reserve  to  themselves  the  right  to  take  particular  measures 
in  regard  to  certain  classes  of  persons,  notably  vagabonds,  emigrants,  and  persons  traveling 
or  passing  the  frontier  in  bands. 

Art.  XLII.  Coaches  intended  for  the  transportation  of  passengers  and  maus  shoiild  not 
be  retained  at  frontiers. 

In  order  to  avoid  this  retention,  a  system  of  relays  ought  to  be  established  at  frontiers, 
with  transfer  of  passengers,  baggage,  and  mails.  If  one  of  these  carriages  be  infected  or 
shall  have  been  occupied  by  a  person  suffering  from  plague,  cholera,  or  yellow  fever,  it  shall 
be  detached  from  the  train  for  disinfection  at  the  earliest  possible  moment. 

Art.  XLIII.  Measures  concerning  the  passing  of  frontiers  by  the  personnel  of  raüroads 
and  of  the  post-office  are  a  matter  for  agreement  of  the  sanitary  authorities  concerned. 
These  measures  should  be  so  arranged  as  not  to  hinder  the  service. 

Art.  XLIV.  The  regulation  of  frontier  traffic,  as  well  as  the  adoption  of  exceptional 
measures  of  surveillance,  should  be  left  to  special  arrangement  between  contiguous  countries. 

Art.  XLV.  The  power  rests  with  governments  of  countries  bordering  upon  rivers  to 
regulate  by  special  arrangement  the  sanitary  regime  of  river  routes. 


lio  SECOND    INTEKNATIONAL    SANITARY    CONVENTION. 

ARTICLES  RELATING  TO  YELLOW  FEVER. 

Art.  XLVI.  Ships  infected  with  yellow  fever  are  to  be  subjected  to  the  following 
regulations: 

1.  ^ledical  visit  (inspection). 

2.  The  sick  are  to  be  immediately  disembarked,  protected  by  netting  against  the  access 
of  mosquitoes,  and  transferred  to  the  place  of  isolation  in  an  ambulance  or  a  litter  similarly 
screened. 

3.  Other  persons  should  also  be  disembarked,  if  possible,  and  subjected  to  an  obserration 
of  six  days,  dating  from  the  day  of  arrival. 

4.  In  the  place  set  apart  for  obsei-vation  there  shall  be  screened  apartments  or  cages 
where  anyone  presenting  an  elevation  of  temperature  above  37.6°  C.  shall  be  screened 
imtil  he  may  be  carried  in  the  manner  indicated  above  to  the  place  of  isolation. 

5.  The  ship  shall  be  moored  at  least  200  meters  from  the  inhabited  shore. 

6.  The  ship  shall  be  fumigated  for  the  desti-uction  of  mosquitoes  before  the  discharge 
of  cargo,  if  possible.  If  a  fumigation  be  not  possible  before  the  discharge  of  the  cargo,  the 
health  authorities  shall  order,  either 

(a)  The  employment  of  immune  persons  for  discharging  the  cargo;  or 

(b)  If  nonimmunes  be  employed  they  shall  be  kept  under  observation  during  the  discharg- 
ing of  cargo  and  for  six  days,  to  date  from  the  last  day  of  exposure  on  board. 

Ajrt.  XLVII.  Ships  suspected  of  yellow  fever  are  to  be  subjected  to  the  measures  which 
are  indicated  in  Nos.  1,3,  and  5  of  the  preceding  article;  and  if  not  fumigated,  the  cargo  shall 
be  discharged  as  directed  under  subparagraph  (a)  or  (&)  of  the  same  article. 

Art.  XLVIII.  Ships  indemne  from  yellow  fever,  coming  from  an  infected  port,  after  the 
medical  visit  (inspection)  shall  be  admitted  to  free  pratique,  provided  the  duration  of  the 
trip  has  exceeded  six  days. 

If  the  trip  be  shorter,  the  ship  shall  be  considered  as  suspected  until  the  completion  of  a 
period  of  six  days,  dating  from  the  day  of  departure. 

If  a  case  of  yellow  fever  develop  during  the  period  of  observation,  the  ship  shall  be  con- 
sidered as  infected. 

Art.  XLES.  All  persons  who  can  prove  their  immunity  to  yellow  fever,  to  the  satisfaction 
of  the  health  authorities,  shall  be  permitted  to  land  at  once. 

Art.  L.  It  is  agreed  that,  in  the  event  of  a  difference  of  interpretation  of  the  English  and 
Spanish  texts,  the  interpretation  of  the  English  text  shall  prevail. 

TRANSITORY  DISPOSITION. 

The  governments  which  may  not  have  signed  the  present  convention  are  to  be  admitted 
to  adherence  thereto  upon  demand,  notice  of  this  adherence  to  be  given  through  diplomatic 
channels  to  the  Government  of  the  United  States  of  America  and  by  the  latter  to  the  other 
signatory  governments. 

Made  and  signed  in  the  city  of  Washington  on  the  14th  day  of  the  month  of  October, 
1905,  in  two  copies,  in  English  and  Spanish  respectively,  which  shall  be  deposited  in  the 
State  Department  of  the  Government  of  the  United  States  of  America,  in  order  that  certi- 
fied copies  thereof,  in  both  English  and  Spanish,  may  be  made  to  transmit  them  thrgugh 
diplomatic  channels  to  each  one  of  the  signatory  countries.  j 

Dr.  Eduardo  Moore.  -^ 

Juan  J.  Ulloa. 
•  Juan  Guiteras. 

E.  B.  Barnet. 

Emilio  C.  Joubert. 

M.  H.  Alcivar. 

Walter  Wyman. 

H.  D.  Geddings. 

John  S.  Fulton. 

Walter  D.  McCaw. 

J.  D.  Gatewood. 

H.  L.  E.  Johnson,  M.  D. 

Joaquin  Yela.  " 

E.  LiCÉAGA.  " 

J.  L.  Medina,  M.  D. 
Daniel  Edo.  Lavorería. 
N.  Veloz-Goiticoa. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  Ill 

PAPER   READ  BY  DR.  E.  LICÉAGA  IN  ACCORDANCE  WITH  THE 
SCIENTIFIC  PROGRAMME. 

[From  tmnslation  fumishod  by  Doctor  Licéaga.] 

Gentlemen:  Allow  me  that,  before  our  attention  is  occupied  with  the  subjects  which 
form  the  subject-matter  of  the  sciontiiic  progi-anmio,  I  direct  same  for  a  few  moments 
toward  another  particular  which  interests  us  as  a  preliminaiy  question  now,  as  it  will  be 
afterwards  the  capital  question. 

This  question,  gentlemen,  is  the  one  which  refers  to  the  primordial  object  of  our  reunion; 
and  so  as  to  establish  same  conveniently,  I  trust  that  you  will  gi'ant  me  the  peimiasion  to 
remind  you  of  its  antecedents. 

During  the  last  months  of  the  year  1901  and  first  month  of  1902  the  vSccond  International 
American  Conference  met  in  Mexico,  to  which  assisted  representatives  of  seventeen  of  the 
Kepublics  of  the  occidental  hemisphere  so  as  to  promote  all  that  which  could  increase  the 
moral  and  material  well-being  of  the  respective  countries. 

By  virtue  of  their  full  powers  those  delegates  accepted  and  signed,  on  the  29th  of  January, 
1902,  some  resolutions  upon  "international  sanitary  police,"  which  contents  I  ask  you 
permission  to  extract: 

The  first  one  of  those  resolutions  proposes:  That  all  the  measures  upon  international 
sanitary  police  remain  under  the  dependency  of  the  national  government. 

The  second  asks:  That  the  detention  which  is  to  be  exacted  from  the  vessels  in  the  ports 
be  of  two  kinds,  one  of  observation  and  inspection  and  the  other  of  disinfection. 

The  third  clause  has  for  object:  To  suppress  the  quarantine  upon  the  merchandises  and 
manufactured  articles  which  have  not  had  occasion  of  getting  contaminated  upon  their 
passing  through  an  infected  country. 

The  fourth  clause  proposes:  That  the  Govermnents  lend  their  cooperation  to  the  pro- 
vincial and  municipal  authorities,  with  the  object  that  they  better  the  sanitary  conditions 
of  the  places  which  need  it.  That  clause  asks  in  addition:  That  the  declaration  of  the 
infectious  sicknesses  should  be  made  obligatory  from  one  country  to  the  other. 

The  fifth  clause  I  permit  myself  to  transcribe  integrally,  because  it  is  the  one  which  refers 
directly  to  the  object  of  our  convention.     It  reads: 

5.  The  second  international  conference  of  the  American  States  further  recommends,  in 
the  interest  of  the  mutual  benefit  that  would  be  derived  therefrom  by  each  of  the  American 
Republics,  and  that  they  may  more  readily  and  effectively  cooperate  one  with  the  other  in 
all  matters  appertaining  to  the  subjects  mentioned  in  the  above  resolutions,  that  a  general 
convention  of  representatives  of  the  health  organizations  of  the  difl'erent  American  Repub- 
lics shall  be  called  by  the  governing  board  of  the  International  Union  of  American  Republics 
to  meet  at  Washington,  D.  C,  within  one  year  from  the  date  of  the  adoption  of  these  resolu- 
tions by  this  conference;  that  each  Government  represented  in  this  conference  shall  des- 
ignate one  or  more  delegates  to  attend  such  convention;  that  authority  shall  be  conferred 
by  each  Government  upon  its  delegates  to  enable  them  to  join  delegates  from  the  other 
Republics  in  the  conclusion  of  such  sanitary  agreements  and  regulations  as  in  the  judg- 
ment of  said  convention  may  be  in  the  best  interests  of  all  the  Republics  represented  therein; 
that  voting  in  said  convention  shall  be  by  Republics,  each  Republic  represented  therein  to 
have  one  vote;  that  said  convention  shall  provide  for  the  holding  of  subsequent  sanitary 
conventions  at  such  regular  times  and  at  such  places  as  may  be  deemed  best  by  the  con- 
vention, and  that  it  shall  designate  a  permanent  executive  board  of  not  less  than  five 
members,  who  shall  hold  ofíice  until  the  next  subsequent  convention,  at  which  time  the 
board  shall  be  appointed  with  a  chairman  to  be  elected  by  ballot  by  the  convention,  the 
said  executive  board  to  be  known  as  the  "International  Sanitary  Bureau,"  with  perma- 
nent headquarters  at  Washington,  D.  C. 

Gentlemen,  allow  me  to  call  your  attention  upon  these  facts: 

First.  In  conformity  with  the  clause  which  I  have  just  read,  the  Fii'st  International 
Sanitary  Convention  met  from  the  2d  to  the  5th  of  December,  1902. 

Second.  In  conformity  vsdth  same  a  new  reunion  was  fixed  to  take  place  at  Santiago,  in 
Chile,  in  April  of  1904. 

Third.  In  obedience  vrith  the  same  an  executive  commission  was  named,  which  should 
act  permanently  between  one  convention  and  the  following. 

Fourth.  This  executive  commission  or  board,  which  was  denominated  "International 
Sanitary  Office,"  resolved:  That  the  convention  which  could  not  meet  in  Santiago,  Chile, 
in  April  of  1904,  should  meet  on  the  9th  of  October,  1905,  in  Washington,  D.  C. 

Fifth  and  last.  This  same  International  Sanitary  OflBce  has  convoked  us  in  this  capital 
and  by  virtue  of  this  convocation  we  are  here  congregated. 

Gentlemen,  all  the  facts  which  I  have  just  mentioned  and  our  presence  here  prove  to  the 
certainty  that  the  resolutions  which  were  signed  on  the  29th  of  January,  1902,  by  the 
representatives  of  the  Republics  here  represented  are  in  full  force. 


112  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

The  facts  demonstrate  equally,  geutlenien  delegates,  that  the  most  part  of  the  preventions 
contained  in  clause  fifth  have  been  faiUilled,  but  the  nonsigning  a  convention  in  1902 
shows  also  that  the  principal  has  not  been  fulfilled.  And  I  say  the  principal  because  this 
is  the  final  object,  the  conclusive,  and  for  the  same  reason  the  more  important  of  the 
dispositions,  which  literallj'  says: 

That  each  one  of  the  Governments  represented  in  this  conference  appoint  one  or  more 
delegates,  so  that  they  assist  to  the  mentioned  convention,  giving  them  the  necessary 
authoritj-,  so  that  they  may,  together  with  the  other  delegates  of  the  other  Republics, 
celebrate  the  sanitary  conventions  and  enact  the  regulations  which  in  their  judgment  may 
prove  more  beneficial  to  the  interests  of  all  the  countries  which  may  be  represented  in  the 
same,  and  with  this  prevention  we  have  not  fulfilled. 

Gentlemen  delegates,  allow  me  to  ask  you:  Is  there  in  all  the  resolutions  which  I  have 
transcribed  an}'  precept  more  concrete,  better  defined,  more  clearly  expressed  Í 

Is  there  any  possible  doubt  that  it  contains  the  final  object  of  the  convention?  The 
answer  is  not  doubtful.  This  precept  is  the  capital  one:  The  convention  has  for  object  to 
take  to  the  practice  all  the  resolutions  of  the  conference  which  met  in  Mexico,  relating  to 
the  international  sanitary  police,  but  veiy  specifically  that  of  "celebrating  sanitaiy  agree- 
ments and  to  enact  regulations  which  in  the  judgment  of  the  same  convention  should  be 
more  beneficial  to  the  interests  of  all  the  countries  which  would  be  represented  in  the  same." 

Gentlemen,  have  we  fulfilled  this  capital  precept  in  the  convention  of  1902?  Evidently 
not.  But  this  is  explainable.  That  convention,  being  the  first,  was  the  explorating  one 
of  the  intentions  of  the  Governments  whom  accepted  to  concur  to  the  same.  It  was  des- 
tined to  fix  the  extent  of  the  scientific  problems,  to  formulate  them,  to  approve  them,  if 
this  was  possible.  All  this  was  done  in  that  convention;  the  problems  were  presented;  ' 
they  were  concretely  formulated:  thej^  were  definitely  resolved,  those  which  were  the  more 
important.  This  means  that  the  preparatory  meeting,  the  preliminary,  the  one  of  scientific 
order,  is  already  ended;  that  of  those  subjects  the  first  convention  occupied  itself.  That 
one  fulfilled  its  duties.     It  has  passed. 

Gentlemen,  let  us  possess  ourselves  of  the  part  which  we  are  to  perform  in  the  actual 
convention.  We  do  not  come  only  with  the  character  which  is  given  to  us  by  our  oflacial 
position  of  technical  advisers  in  subjects  of  hj^giene;  as  representatives  of  the  advisory 
boards;  we  come  now  in  the  name  of  our  Governments,  provided  with  the  data  which  the 
sanitary  science  has  reached  up  to  the  actual  moment ;  bearing  on  the  experience  that  each 
one  of  us  has  been  able  to  acquire  in  his  respective  country,  and  sufficiently  authorized  to 
sign  a  sanitary  convention  between  the  Republics  which  are  represented  here. 

This  is  our  mission;  for  this  we  have  come.  Let  us  make,  gentlemen,  from  this  first 
moment  the  agreement  and  a  solemn  one  of  not  separating  ourselves  before  signing  those 
agreements;  to  enact  those  regulations,  mentioned  by  the  fifth  clause,  and  only  then  we 
will  have  fulfilled  with  our  duties. 

Think,  gentlemen,  in  the  responsibility  which  we  will  incur  with  our  Governments  if  we 
return  to  our  homes  without  having  fulfilled  the  commission  which  has  been  confided  to  us ! 

I  ask  you  again,  gentlemen  delegates,  that  we  should  not  separate  without  having  signed 
a  sanitary  convention. 

Gentlemen,  I  have  occupied  myself  exclusively  of  the  legal  question  because  it  is  the  one 
which  obligates  us.  With  intention  I  did  not  want  to  treat  the  questions  of  conveniences 
and  utility  because  these  are  indubitable. 

That  the  quarantines  subsisted  in  past  times,  one  can  conceive  and  explain,  because  it 
rested  only  on  a  practical  knowledge.  This  practical  knowledge  is  that  the  epidemical 
sicknesses  are  transmitted  by  the  men,  by  their  means  of  transportation,  by  their  clothes, 
and  by  the  merchandises.  This  is  the  brutal  fact,  but  it  was  the  one  which  was  used  to 
dictate  the  precautionary  measures.  The  men  bring  us  the  sickness;  well,  let  us  detain  the 
men.  The  vessels  transported  the  sicknesses;  let  us  detain  the  vessels.  The  goods  some 
time  conduct  the  sickness;  let  us  stop  the  entrance  of  the  merchandise.  All  this  are  facts 
of  observation,  but  badly  observed.  During  how  much  time  will  we  detain  the  men  and 
the  vessels?  Upon  resolving  this  question  conunenced  the  difference  of  opinions.  Differ- 
ence of  opinion  that  had  for  base  the  observation  also,  but  incomplete  of  the  facts  observed. 

The  vessels  used  to  be  detained  seven  days,  ten  days,  twenty  days,  forty  days,  two  months 
as  was  done  at  Panama  in  the  year  1892,  when  the  cholera  which  had  invaded  Spain 
threatened. 

But  to  the  fear  as  adviser  in  hygiene,  we  commence  to  substitute  the  reason: 

Already  England  observes  that  in  the  disinfected  and  cleaned  cities  the  transmissible 
sicknesses  do  not  become  epidemic,  and  they  clean  the  ports,  investing  in  same  enormous 
sums,  and  since  then  they  separate  the  sick  men,  clean  the  vessels,  and  let  them  in. 

After  comes  the  admirable,  transcendental  discoveries  of  Pasteur;  and  at  once,  as  if  a 
veil  had  been  rent,  it  is  discovered  that  the  sicknesses  which  form  the  group  of  the  trans- 
missibles  depended  of  difl'erent  causes  of  live  germs.  And  after  Pasteur  come  the  Kochs, 
the  Pfeiffers,  the  Rouxs,  the  Yersins,  the  Kitassatos,  and  show  us  that  one  is  the  germ  of  the 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  113 

cholera,  and  another  that  of  tlio  turberculosis,  and  another  that  of  the  diphtheria,  and 
another  different  the  one  of  tiio  bubonic  phi^e. 

And  in  possosnion  of  thi.s  knowlodi^o,  tliis  m  to  say,  that  the  germs  of  those  sicknesses  are 
live  beings,  it  is  founfl  out  the  phwc  they  occupy  in  tlie  series;  natural  history  is  studied, 
where  are  found  tlieir  conditions  to  live,  how  tlicy  live,  iiow  they  develo}),  what  means  favor 
their  multiplication  and  which  are  unfavorable  and  in  which  other  their  lives  arc  annihilated ; 
and  of  this  detailed  and  individual  knowledge  for  each  germ,  of  each  sickness,  logically, 
necessarily  are  taken  the  means  to  combat  them. 

But  there  are  transmissible  sicknesses,  death-dealing  ones,  which  cause  the  ruin  of  terri- 
tories and  whole  populations  and  which  germ  is  not  yet  known.  It  is  true,  Imt  then  appear 
the  fine,  delicate,  memorable  experiments  of  Kced,  of  Carroll,  of  Agi'amonte,  giving  form, 
color,  and  life  to  the  discovery  made  by  the  genius  of  Finlay,  and  they  discover,  what? 
The  germ; of  the  yellow  fever?  No.  Well,  what  do  they  discover?  They  discover  the  way 
that  the  sickness  transmits  itself. 

There  was  a  scientific  curiosity  only  known  of  the  naturalists,  and  it  was  this,  that  there 
are  live  beings,  that  there  are  organisms,  that  to  complete  their  evolutions,  to  reach  the 
objects  of  their  life,  need  to  pass  through  two  organisms,  and  here  come  the  Italian  and 
English  doctors  to  demonstrate  that  the  plasmodia  discovered  by  Laveran  in  the  blood  of 
the  paludals  is  one  of  those  organisms  that  need  to  pass  through  two  other  live  beings,  one 
the  man  and  the  other  the  body  of  a  mosquito  Anopheles;  and  for  once  is  confirmed  the 
admirable  discovery  of  Laveran,  the  etiology  of  the  malaria  is  completed  and  its  way  of 
transmission  is  known. 

Here  are,  gentlemen,  the  data  that  the  science  has  put  to  our  disposal  to  transform  in 
scientific,  the  measures,  up  to  now  empirical,  employed  to  defend  us  from  the  sicknesses 
which  are  transmissible. 

After  knowing  that  each  of  the  sickness  of  those  which  the  man  can  take  with  him  from 
a  port  to  another  is  originated  by  a  different  germ  and  that  this  germ  has  diverse  conditions 
of  existence,  and  when  we  know  the  transmissive  agent  of  the  plague,  that  of  the  malaria, 
that  of  the  yellow  fever,  can  we  detain  m  front  of  a  port  the  vessel  with  the  man  which  he 
brings  on  board  and  the  animals  which  perhaps  continue  to  produce  the  sickness  in  the 
very  vessel? 

But  let  us  analyze  the  fact  after  the  light  of  the  actual  knowledge.  Is  the  vessel  all  a 
danger?  Ai-e  all  the  men  that  are  on  the  vessel  dangerous?  Are  all  the  animals  which 
accidentally  are  in  the  same  offensive,  from  the  point  of  view  of  the  transmission  of  the 
sicknesses  ? 

Of  the  vessel  there  is  only  dangerous  the  part  which  has  been  soiled  by  the  dejections  of 
a  choleric,  by  the  sputum  of  a  tuberculous  and  those  of  a  pestered.  There  is  not  a  more 
dangerous  place  than  the  one  where  there  are  rats  infected  of  plague,  or  mosquitoes  anapheles 
which  carry  the  germ  of  the  malaria,  or  Stegomyias,  infected  of  the  yellow  fever.  Therefore 
if  it  is  in  our  power  to  disinfect  the  place  of  the  vessel  which  has  been  soiled  with  the  dejec- 
tions of  the  choleric,  with  the  sputum  of  the  tuberculous  or  of  the  pestered ;  if  it  is  possible 
for  us  to  destroy  the  rats  and  mice  sick  with  plague  and  the  mosquitoes  infected  with  the 
yellow  fever  or  which  cany  the  germ  of  the  malaria,  let  us  direct  our  doings  upon  those  places 
or  against  those  animals ;  let  us  change  the  water  from  the  bilge  which  might  contain  larvae 
of  the  insects;  let  us  cover  the  drinking-water  tanks  so  that  the  mosquitoes  may  not  lay 
their  eggs  in  the  same;  and  as  soon  as  these  operations  are  done,  let  us  free  the  vessel.  It 
is  not  dangerous  any  more ;  let  us  free  it,  and  not  impose  on  same  a  quarantine  of  detention, 
for  it  is  useless;  and  if  it  is  useless  for  our  defense  it  is  prejudicial  to  the  interests  of  the 
commerce. 

Let  us  study  the  question  of  the  man,  the  awe-inspiring  man,  to  whom  quarantine  was 
imposed. 

Thereupon  not  all  the  men  that  come  in  a  vessel  are  sick.  Let  us  inspect  them,  to  dis- 
cover those  which  are  so.  There  are  sick  ones;  let  us  separate  them  from  the  others, 
because  they  are  dangerous  for  their  innocent  companions  on  board;  but  there  are  others 
which,  without  being  surely  attacked  of  such  sickness,  are  suspected  of  having  same.  Let 
us  separate  them  likewise  and  let  us  have  them  in  observation,  but  out  of  the  vessel.  There 
they  would  be  dangerous  if  they  have  already  the  sickness,  and  they  would  be  victims  if 
they  did  not  have  it.  Let  us  separate  them,  then.  The  inspection  has  allowed  us  to  dis- 
cover that  the  other  passengers  are  healthy.  Then  let  us  free  them;  but  we  might  be  told 
some  of  these  passengers  who  seem  to  be  healthy  may  take  with  them  or  have  incubated 
the  sickness.  Yes;  it  is  true.  But  would  it  be  convenient  to  leave  them  in  a  narrow  place, 
little  ventilated,  in  the  staterooms,  and  where  there  is  accumulation?  Would  it  not  be 
better  to  take  them  away  and  watch  them  outside  of  the  vessel,  and  only  for  the  number  of 
days  that  the  incubation  lasts,  and  in  a  special  place  and  spacious,  where  there  is  a  personnel 
intelligent  who  watches  them?  Well,  let  us  do  it  so;  but  by  all  means  let  us  empty  the  ves- 
sel, so  as  to  disinfect  the  same  of  the  germs  which  may  be  on  its  floor  and  of  the  infected 
mosquitoes  which  may  be  on  its  ceilings. 

5610—06 S 


114  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Therefore  it  is  in  our  possibility  to  separate  and  isolate  separately  the  sick  and  suspected 
ones  and  watch  those  which  might  take  in  germ  the  sickness ;  let  us  free  all  the  others  who 
will  not  fear  the  rigor  of  the  quarantine,  and  will  not  deceive  us  upon  the  state  of  their 
health,  because  it  is  of  no  utility  to  them  to  deceive  us.  The  vessel  empty,  then  we  can 
disinfect  the  same  and  in  turn  let  him  free. 

How  are  the  inspections  to  be  made  for  the  crew  and  passengers :  how  is  the  disinfection 
of  the  vessels  to  be  made  as  to  each  one  of  the  sicknesses  which  germ  is  different  and  which 
means  of  transmission  is  also  different?  This  I  explained  carefullj'  in  the  discourse  which 
I  made  in  the  previous  convention,  and  I  proposed  a  series  of  resolutions  on  the  subject  of 
yellow  fever,  the  cholera,  and  the  plague,  and  another  general  resolution  which  contained 
all  of  them — resolutions  which,  in  my  opinion,  can  serv^e  as  a  base  for  discussion. 

If  the  gentlemen  delegates  wish  it  so,  the  secretary  of  the  convention  can  read  the 
resolutions  and  the  considerations  which  caused  the  same. 

Gentlemen,  after  the  exposition  which  I  have  just  made,  can  there  be  any  doubt  of  the 
convenience  and  of  the  utility  to  suppress  the  cjuarantincs  as  they  were  made  a  century 
ago,  and  to  make  them  as  it  is  claimed  by  our  state  of  civilization,  as  it  is  exacted  by  the 
precise  knowledge  upon  each  sickness,  as  we  are  obliged  to  do  it  by  jointly  the  interests 
of  the  conuiierce  and  the  free  communication  of  men? 

But  there  are  ideas,  gentlemen,  which,  united  to  an  expression,  to  a  word,  is  so  identified 
with  it,  that  as  long  as  that  expression  exists,  also  that  word,  there  is  no  way  to  separate 
them  from  the  idea  to  which  it  was  associated  centuries  ago.  Gentlemen,  let  us  make  the 
sacrifice  of  the  word  quarantine,  let  us  strike  it  out  of  our  actual  vocabulaiy ,  and  then  it  will 
not  be  hard  work  for  us  to  accept  the  measures  which  I  am  proposing:  but,  what  will  be  more, 
we  shall  not  fear  then  to  accept,  in  the  name  of  our  govcnmients,  the  resolutions  adopted 
in  the  previous  convention,  which  was  only  the  scientific  preamble  of  the  one  which  has 
made  us  meet  in  this  hospitable  country,  the  cradle  of  so  many  innovations;  in  the  midst 
of  this  nation  which  has  broken  all  the  conventional  ties  which  still  binds  many  nations 
with  the  preoccupations  of  tlie  past,  with  the  traditions  of  such  a  thiiig  vvhich  is  not  useful 
nor  practical;  a  nation  which  has  declared  the  same  its  political  independence  as  its  indus- 
trial; the  same  the  scientific  as  the  artistic;  that  has  separated  itself  from  the  trivial 
paths  in  war  and  in  the  diplomacy. 

To  you,  gentlemen  delegates,  who  represent  here  in  your  respective  nations  the  future 
of  the  Latin  race  in  the  world  of  Colon;  to  you  w^ho  are  the  banner  bearers  of  the  advanced 
ideas  of  the  Republics  who  have  sent  you,  I  address  myself,  asking  that  these  young  nations, 
fill]  of  life  and  of  noble  aspirations,  go  into  the  new  ways  with  frank  and  resolved  steps. 

Let  us  leave,  gentlemen,  the  ancient  preoccupations;  let  us  forget  what  the  word  quar- 
antine signified;  let  us  substitute  that  antiquated  phrase  by  another  which  represents  the 
actual  aspirations  about  public  hygiene.  Let  us  adopt  a  new  flag  for  the  battle  against 
the  transmissible  sicknesses;  let  us  inscribe  on  same  the  motto,  "To  safeguard  the  interests 
of  the  public  health  without  impairing,  or  impairing  the  least  possible,  the  interests  of  the 
commerce  and  of  the  free  communication  of  men,"  and,  affiliated  to  the  scientific  doctrine 
and  basing  our  sanitaiy  laws  upon  that  sublime  maxim,  "Do  not  do  to  others  what  you 
do  not  like  to  have  done  to  yourself,"  let  us  reduce  the  exigency  against  our  neighbors  to 
those  which  we  would  wish  them  to  impose  on  us.  If  we  sign  a  convention  which  on  one 
side  is  founded  on  science  and  on  another  on  justice,  we  wiff  have  celebrated  a  compact 
which  will  prove  that  the  nations  of  the  Latin  America  are  meritorious  to  inherit  the  civili- 
zation of  those  who  in  the  Old  World  gave  them  life,  and  that  the  tree  which  was  rooted 
two  thousand  years  ago  in  the  place  of  birth  of  Lacio  comes  now  to  deposit  its  products, 
but  already  ripe,  on  the  other  side  of  the  Atlantic,  effacing  the  inscription  which  was 
engraved  at  the  outlet  of  the  Mediterranean,  "Non  plus  ultra."  Let  us  prove,  gentlemen, 
that  we  have  science  and  justice  on  our  side  to  wrest  from  its  place  that  old  inscription, 
remembering  that  actually  the  science  and  justice  ignore  the  frontier  of  the  nations,  the 
nationality  of  the  different  languages,  and  that  if  we  have  to  invoke  the  past  it  will  be 
only  to  bring  to  your  memory  its  glory  to  which  we  should  aspire. 

When  the  North  American  nation  calls  us  unto  its  own  house,  places  at  our  disposition 
the  conquests  of  its  sons  made  by  them  in  the  sanitary  sciences;  when  it  has  assembled 
us  here,  with  sufficient  authorization  from  our  respective  governments  to  make  and  sign 
agreements  and  regulations,  to  give  unity  to  the  measures  which  may  secure  at  the  same 
time  the  interests  of  the  public  health,  without  impairing,  or  impairing  the  least  possible, 
the  interests  of  the  commerce,  can  we  be  satisfied,  as  the  past  time,  with  making  studies  of 
scientific  character,  as  if  we  assisted  to  an  academy,  without  fulfilling  the  obligations  which 
are  imposed  on  us  by  the  fifth  clause  of  the  international  Pan-American  conference,  this 
is  to  say,  without  applying  to  the  practice  what  science  has  taught  us?  No;  it  is  not 
possible.  This  is  not  in  accord  with  the  legitimate  aspirations  of  the  governments  who  have 
sent  us  here  to  give  a  solution,  the  best  solution,  to  a  problem  which,  if  we  do  not  resolve 
at  once,  wül  defer  the  urgent  realization  of  a  great  progress  in  benefit  of  the  hygiene  and 
of  the  commerce,  and  the  occasion  to  bind  with  a  new  tie  of  reciprocal  interests  the  friend- 
ship of  the  nations  of  the  occidental  hemisphere. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  115 

Gentlemen  delegates,  in  the  name  of  the  progresses  of  the  sanitary  science,  in  name  of 
the  civilization,  in  name  of  the  interests  well  understood  of  humanity,  I  pray  you  to 
adjust  an  International  Sanitary  (Jonvontion  of  the  Kopubliiis  roproHisntod  \)cs<i,  and  that 
you  obtain  from  your  respective  governments  the  legal  ratification  of  this  convention, 
so  that  this  congress  may  reach  the  object  for  which  it  was  summoned, 

Washington,  D.  C,  October  9,  1906. 


REPORT  FROM  THE  DELEGATE  FROM  CHILE,  DR.  EDUARDO 

MOORE. 

During  the  last  two  years  the  territory  of  the  Chilean  Republic  has  been  invaded  by  two 
diseases  which  were  imported  from  abroad,  namely,  bubonic  plague  and  smallpox. 

The  bubonic  plague  prevailed  for  a  considerable  period  along  the  Pacific  coast  of  North 
America,  invaded  the  littoral  regions  of  some  departments  in  Peru  and,  a  short  while  after, 
the  Chilean  territory  (Iquique,  Piagua,  Antofogasta,  and  other  places  of  minor  importance 
in  the  Atacama  Desert).  This  epidemic  was  strongly  fought,  and  at  present  only  one  or 
two  cases  occur  once  in  a  while;  the  disease  is  dying  out  very  rapidly. 

Smallpox  existed  in  Chile  in  a  sporadic  foi-m,  but  one  and  a  half  years  ago  it  was  imported 
from  Bolivia  by  means  of  the  Ajitofogasta  Railroad.  This  epidemic  has  shown  the  fact 
that  the  exotic  virus  has  considerable  strength,  because  in  spite  of  the  great  number  of 
people  that  had  been  vaccinated  it  broke  out  among  them  without  distinction  of  ages  and 
sexes.  The  work  of  revaccination  is  being  carried  out  to  such  an  extent  that  the  domestic 
production  of  vaccine  is  not  sufficient,  and  therefore  it  is  necessary  to  import  it  from  the 
neighboring  Republics. 

Up  to  the  present  time  we  have  not  as  yet  any  law  in  the  country  making  vaccination 
compulsory. 

The  work  of  vaccination  and  revaccination  has  almost  destroyed  the  epidemic. 

The  invasion  of  smallpox  in  Chile  has  established  two  points,  viz:  First,  that  the  vari- 
olous vims  that  existed  in  the  country  was  very  mild,  because  the  few  cases  that 
occurred  before  the  introduction  of  the  exotic  virus  were  of  a  mild  nature,  affecting  in 
very  rare  instances  people  that  had  been  vaccinated,  people  who  were  immune  with  the 
old  human  vaccine,  which  was  the  only  one  in  existence  twenty  years  ago;  second,  that 
every  severe  and  death-dealing  epidemic  comes  from  abroad,  because  the  present  virus 
is  from  Bolivia,  and  a  large  epidemic  that  prevailed  before  in  the  austral  provinces  was 
introduced  from  the  Atlantic  coast. 

It  may  be  added  that  some  scientists  claim  that  the  vaccination  in  both  arms  makes 
a  person  immune  for  his  lifetime;  however,  the  epidemics  of  an  exotic  origin  which  were 
introduced  in  Chile,  broke  out  without  distinctions,  affecting  a  large  number  of  persons 
vaccinated  previously  and  in  both  arms,  which  was  the  only  system  known  then. 

These  epidemics  have  also  demonstrated  that  the  immunity  which  the  animal  vaccine 
furnishes  lasts  from  six  to  seven  years. 

SANITARY   MEASURES. 

Since  the  First  International  Sanitary  Convention  of  the  American  Republics  Chile  has 
improved  its  public  health  service. 

First.  The  paving  of  the  whole  city  of  Santiago  has  been  approved  and  the  works  therefor 
have  already  been  provided  for  in  contracts. 

Second.  The  construction  of  the  sewer  system  of  the  city  of  Santiago  was  commenced 
in  the  beginning  of  this  year. 

Third.  The  surveys  for  the  improvement  of  the  sanitary  works  in  Valparaiso,  the  sewer 
system  specially,  are  about  to  be  completed,  as  well  as  the  works  for  the  completion  of  the 
water  and  sewer  system  in  the  cities  of  Talca  and  Concepción. 

Fourth.  Nearly  all  the  towns  that  have  no  water  system  are  furnished  with  drinkable 
water,  and  in  others  the  service  is  being  improved. 

OTHER   WORKS. 

A  contract  has  been  made  for  the  great  work  of  the  construction  of  the  Valparaiso  port, 
which  contract  has  been  approved  by  the  Government.  This  important  work  will  cost 
the  national  treasury  over  50,000,000  pesos. 

The  survey  of  the  improvement  of  the  port  of  Constitución,  on  the  Maule  River,  has  been 
completed. 

SANITARY   LAWS. 

The  sanitary  laws  of  the  Republic  were  fuUy  described  in  the  report  which  I  submitted 
to  the  last  convention,  in  1902. 


116  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

HEPORT  FROM  THE  DELEGATE  FROM  COSTA  RICA,  DR.  JUAN 

J.  ULLOA. 

Since  the  last  meeting  held  by  this  convention  at  this  same  city  of  Washington  in  1902, 
some  new  work  has  been  carried  through  in  Costa  Rica  in  the  sanitary  line,  and  its  Govern- 
ment has  continued  pa3'ing  to  all  matters  dealing  with  public  hygiene  a  good  deal  of  attention. 

As  I  had  the  pleasure  to  inform  you  at  the  last  convention,  the  National  Government 
exerts  full  power  on  all  dispositions  of  a  legal  natm'e  tending  to  the  enforcement  of  all  the 
sanitary  measures  that  the  proper  authorities  consider  of  importance  to  recomiliend,  and 
which  are  made  obligatory,  after  having  been  consulted  with  the  medical  faculty  of  Costa 
Rica,  which  is  the  highest  consulting  board  on  sanitation. 

There  are  proper  sanitary  police  authorities  in  the  diñ'erent  sections  of  the  country,  and 
more  especially  at  the  seaports,  where  a  regular  physician  is  the  head  of  the  department  and 
who  is  invested  with  full  executive  powers  to  carry  through  all  sanitary  dispositions  and 
regulations. 

Since  the  theory  of  the  modest  Cuban  sage,  Dr.  Carlos  Finlay,  became  a  doctrine,  princi- 
pally after  the  fiill  demonstration  of  its  merits  thi-ough  the  verji^  able  ^ork  done  by  the 
United  States  army  board,  it  has  been  adopted  by  the  great  majority  of  the  leaders  in 
sanitary  science  of  the  world,  obliging  all  the  governments,  as  the  public  guardians  of  the 
welfare  of  their  subjects,  to  base  their  protective  measures  against  yellow  fever  on  the 
established  fact  of  the  pi'opagation  of  this  disease  through  the  bite  of  the  infected  mosquito 
of  the  Stegotnya  fasciata  species. 

Costa  Rica  has  based  aU  its  prophylactic  measures  against  so  justly  dreaded  an  enemy  as 
yellow  fever,  on  the  doctrine  of  Firday,  copying  on  a  small  scale  the  ver^'  efficient  installment 
of  the  city  of  Habana  which  I  had  the  pleasure  to  inspect  personally.  We  have  not  had  any 
cases  of  j-ellow  fever  in  Port  Limon  for  more  than  eighteen  months,  and  I  feel  confident  that 
by  continuing  with  the  policy  in  force  to-day  we  shall  in  the  future  be  free  from  an  epidemic 
of  this  disease.  No  cases  of  j'^ellow  fever  have  been  reported  from  Puntarenas,  our  port  on 
the  Pacific,  where  similar  measures  are  adopted  to  those  in  Port  Limon. 

I  am  very  happy  to  be  able  to  add  our  expei'ience  in  Costa  Rica,  as  strengthening  evi- 
dence to  the  demonstrations  given  in  Plabana,  and  corroborated  lately  by  the  efficient  work 
carried  through  in  the  Republic  of  Mexico  under  the  direction  of  Doctor  Licéaga,  proving 
without  reasonable  doubt  the  sole  transmission  of  yellow  fever  through  the  intermediary 
Stegoraya  fasciata. 

It  gives  me  great  pleasure  to  state  that  the  measures  adopted  in  Costa  Rica  against  yellow 
fever  are  based  on  the  teachings  of  Finlay,  Guiteras,  Carroll,  Read,  Agramonte,  and  part  of 
whose  writings  were  translated  by  Mr.  Cleto  Gonzales  Viquez,  and  which  were  also  the 
fountains  which  instructed  me  to  be  able  to  prepare  my  reports  to  my  Government  on  this 
very  important  matter  after  the  interesting  meeting  of  the  Pan-American  Sanitary  Con- 
gress which  held  its  sessions  in  Habana  in  February  of  1901. 

The  adoption  of  the  sanitary  measures  based  on  the  teachings  of  the  above-named  able 
men,  fully  and  efficiently  demonstrated,  have  placed  our  ports  in  a  very  good  sanitary  stand- 
ing and  have  enabled  us  to  give  ample  guarantees  to  all  the  countries  we  have  commercial 
relations  with,  and  to  authorize  us  to  protest  against  undue  restrictive  quarantine 
regulations. 

Quarantine  laws  are  at  present  in  force  in  Costa  Rica  against  the  ports  of  Colon,  Panama, 
and  New  Orleans  on  account  of  the  prevalence  there  of  yellow  fever. 

Very  strict  quarantine  measures  were  decreed  against  the  ports  of  Colon  and  Panama,  on 
account  of  the  two  cases  of  bubonic  plague  which  were  reported  from  Ancon. 

There  is  no  epidemic  of  any  kind,  at  present,  in  any  part  of  Costa  Rica;  as  in  the  majority 
of  the  cities  of  the  world,  we  have  cases  of  typhoid  fever  and  of  tuberculosis,  but  the  action 
■of  the  health  authorities  is  directed  against  them,  and  we  hope  to  decrease  their  number 
soon,  thanks  to  the  diflFusion  of  knowledge  to  the  people,  and  to  the  betterment  of  our  defec- 
tive sewers  and  waterworks,  which  are  under  consideration  at  the  present  time  and  which 
wall  be  carried  through  before  long. 

In  a  very  short  time  work  will  be  started  toward  the  completion  of  the  contracts  for  the 
system  of  sewerage,  and  for  the  extension  and  reform  of  the  waterworks  of  San  José,  the 
capital  of  the  Republic. 

The  Government  has  paid  considerable  attention  to  the  city  of  Limon,  our  port  on  the 
Atlantic,  which  is  the  principal  avenue  of  our  communications  with  the  external  world,  and 
which  is  our  principal  entrance  to  commerce.  There  is  a  well-constructed  sea  wall  around 
the  port  which  has  enabled  the  city  to  fill  and  cover  a  gi-eat  extension  of  the  low  coral  for- 
mation, which  was  before  a  source  of  infection  due  to  the  death  and  decomposition  of 
large  amounts  of  all  kinds  of  shellfish  principally.  The  streets  of  the  city  are  macadamized. 
There  is  a  good  waterworks  system  and  a  pretty  good  sewerage,  which  is  being  reformed 
at  present.     I  fully  believe  that  Port  Limon  is  the  most  hygienic  port  to  the  south  of  the 


SECOISTD    INTERNATIONAL    BANITARY    CONVENTION.  117 

United  States  on  the  Atlantic,  and  its  conditions  are  continually  being  improved  \>y  our 
Government,  which  realizes  the  importance  of  its  betterment. 

Not  wishing  to  occupy  your  attention  with  other  matters  that  are  really  foreign  to  the 
object  of  this  convention  I  end  ray  report  heic. 


REPORT  FROM  THE  DELEGATE  FROM  CUBA,  DR.  E.  B.  BARNET. 

Mr.  President  and  gentlemen  of  the  convention:  As  the  delegate  from  the  liepublic 
of  Cuba  I  have  the  honor  to  submit  before  this  convention  tiio  sanitary  ordinances  agreed 
upon  by  the  superior  board  of  health  of  the  island  of  Cuba  for  the  sanitary  management  of 
the  municipalities  of  the  Republic,  in  accordance  with  the  provisions  of  military  order  No. 
159,  series  of  1902,  of  the  former  government  of  intervention  of  the  United  States. 

The  organic  sanitary  law  which  is  in  force  at  present  is  said  order  No.  1 59,  which  pre- 
scribes that  there  shall  be  enacted  by  the  superior  board  of  health  general  rules  for  the  sani- 
tary service  of  all  towns  of  the  Eepublic,  and  said  rules  are  the  ordinances  which  I  now 
deliver,  and  which  as  soon  as  they  are  enacted  by  the  Cuban  Government  will  immediately 
be  put  in  force  for  the  purposes  to  which  they  are  designated. 

As  prescribed  by  order  No.  159  these  ordinances  will  only  be  of  a  general  character.  After 
their  enactment  each  municipahty,  within  the  period  to  be  designated  by  the  Executive, 
shall  modify  them  to  adapt  the  local  conditions,  subject  to  the  approval  of  the  superior 
board  of  health.  There  are  at  present  in  the  Republic  of  Cuba  82  municipalities;  but  when 
these  ordinances  were  drafted  the  importance  of  a  city  such  as  Havana  was  taken  into 
consideration,  leaving  to  the  discretion  of  each  municipality  the  power  to  propose  the  amend- 
ments which  I  have  mentioned. 

These  ordinances  are  a  work  of  selection  and  adaptation.  Sanitary  regulations,  ordi- 
nances, provisions,  codes,  etc.,  of  other  countries  were  had  in  view  when  it  was  being  carried 
out,  because  in  sanitary  matters,  particularly  in  sanitary  legislation,  it  is  impossible  to  try  to 
make  original  or  new  provisions,  but  one  must  be  guided  by  what  practice  and  experience 
have  demonstrated  in  other  countries. 

These  ordinances  are  divided  into  three  parts.  The  first  part  consists  of  four  chapters, 
and  is  a  sort  of  a  regulation  derived  from  order  No.  159,  above  mentioned.  This  part  con- 
tains general  provisions  and  refers  to  local  sanitary  boards,  local  sanitary  chiefs,  and 
inspectors.     It  contains  instructions  rather  than  provisions. 

The  second  part  is  the  one  which  really  contains  provisions,  and  has  27  chapters,  all  of 
them  regarding  the  sanitary  matters  of  a  community. 

The  third  part  concerns  violations  and  penalities.  The  former  are  classified  in  minor 
and  grave  offenses  according  to  the  sanitary  importance,  and  gives  the  correctional  court 
jurisdiction  over  them  for  the  imposition  of  the  proper  penalty.  Courts  of  justice  are  given 
jurisdiction  over  violations  which  constitute  crimes  against  public  health. 

As  a  whole  these  ordinances  have  635  sections. 

As  every  human  work,  and  having  been  carried  out  in  a  new  country,  which  has  just  been 
born  to  the  life  of  freedom,  and  where  matters  of  public  health  were  formerly  unknown  in 
practice,  perhaps  these  ordinances  contain  many  errors  and  deficiencies.  Time  and  expe- 
rience will  amend  and  improve  them.  And,  undoubtedly,  these  ordinances  will  help  Cuba 
in  maintaining  the  high  sanitary  reputation  which  she  has  among  her  sister  Republics  of 
America. 


Ordinances  of  the  Superior  Board  of  Health  of  the  Island  of  Cuba,  for  the 
Sanitary  Administration  of  the  Ayuntamientos  of  the  Republic. 

Chapter  I. 

In  accordance  with  the  provisions  of  paragraphs  7  (k)  and  (b)  of  sections  1,  2,  and  4, 
respectively,  of  order  No.  159,  series  of  1902,  the  Superior  Sanitary  Board  has  passed  the 
following  ordinances,  which,  upon  approval  by  the  Executive,  shall  regulate  the  sanitary 
service  of  the  ayuntamientos  of  the  Republic. 

In  compliance  with  paragraph  (b),  section  4,  of  said  order,  these  regulations  may  be 
modified  to  conform  to  the  local  conditions  of  each  ayuntamiento  upon  a  request  from  the 
local  sanitary  board,  approved  by  the  alcalde  and  forwarded  to  the  Superior  Sanitary 
Board,  whose  action  thereon  shall  be  final. 

In  accordance  with  the  provisions  of  the  Presidential  decree  No.  11,  of  May  20,  1902, 
the  chief  sanitary  officer  shall  himself  or  through  the  secretary  of  the  board  dispose  of  the 
business  of  the  board  together  with  the  secretary  of  the  interior  or  the  Department  of 
Havana,  when  it  is  so  required  by  reason  of  the  importance  of  a  particular  case. 


118  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

SANITARY  ADMNISTRATION. 
Chapter  II. 

LOCAL  SANITARY  BOARDS. 

Section  1.  The  sanitary  administration  in  each  ayuntamiento  shall  be  controlled  by  a 
local  sanitary  board,  which  shall  be  constituted  and  empowered  in  accordance  with  para- 
graphs (a)  and  (c)  of  section  4  of  order  No.  159.  In  municipalities  where  there  is  no  quar- 
antine oflicer  of"  the  port  or  chief  of  the  section  of  special  hygiene  one  of  the  members  shall 
be  a  pharmacist,  a  veterinarian,  an  engineer,  an  architect,  or  some  other  professional  man, 
if  practicable.  The  members  shall  qualify  as  soon  as  their  appointment  has  been  approved 
by  the  Superior  Board. 

Sec.  2.  The  local  sanitary  board  shall  prepare  the  rules  and  regulations  for  its  interior 
management,  to  be  submitted  to  the  approval  of  the  Superior  Board. 

Sec.  3.  The  local  sanitary  board,  by  virtue  of  the  powers  with  which  it  is  vested,  shall 
take  special  care  of  all  matters  relating  to  the  sanitation  of  its  respective  municipal  district 
and  shall  see  that  all  sanitary  laws  and  regulations  in  force  and  the  orders  or  instructions 
of  the  Superior  Sanitar^^  Board  in  each  special  case  are  strictly  complied  with,  subject  to 
the  provisions  of  these  ordinances. 

Sec.  4.  The  local  sanitary  boards  shall  be  considered  as  deputies  of  the  Superior  Sanitary 
Board  for  the  faitliful  execution,  under  a  uniform  system,  of  the  functions  with  which  they 
are  intrusted  in  regard  to  the  maintenance  of  public  health. 

Sec.  5.  The  local  sanitary  board  shall  have  charge,  under  the  supervision  of  the  Superior 
Board,  notwithstanding  the  provisions  of  paragraph  (e)  of  section  2  of  order  No.  159,  of 
the  services  of  sanitation  and  hygiene  within  its  mifnicipal  district;  of  the  prophylactic 
vaccination  and  inoculation;  of  cemeteries,  interments,  disintennents,  embalming,  and  of 
the  removal  of  cadavers;  of  the  inspection  of  the  medical  attendance  in  private  houses, 
sanitariums,  asylums,  barracks,  fortresses,  etc.,  and  of  the  sanitation  of  all  such  institutions. 

Sec.  6.  The  local  sanitary  board  shall  publish  such  instructions  as  it  may  deem  proper 
to  prevent  the  spread  of  diseases,  submitting  said  instructions  previously  to  the  approval 
of  the  Superior  Board. 

Sec.  7.  The  local  sanitary  board  shall  make  frequent  inspection  of  the  schools  and  shall 
order  the  removal  of  teachers  and  pupils  which  it  may  find  suffering  from  any  infectious 
disease,  prohibiting  their  return  to  the  school  until  aU  danger  of  infection  shall  have 
disappeared. 

Ssc.  8.  It  shall  see  that  proper  hygienic  methods  are  followed  in  hospitals,  particularly 
in  all  that  concerns  the  isolation  of  persons  having  contagious  diseases. 

Sec.  9.  It  shall  see  that  all  tenement  houses,  hotels,  boarding  houses,  cafés,  etc.,  comply 
with  the  sanitary  provisions  in  force,  holding  the  manager,  owner,  or  tenant,  as  the  case 
may  be,  responsible  for  the  violation. 

Sec.  10.  it  shall  instruct  the  head  of  the  family  in  which  there  is  a  case  of  infectious 
disease  concerning  the  precautions  which  he  must  take,  and  shall  notify  the  principal  of 
the  school  v,  ho  are  the  pupils  living  in  the  infected  house  and  who  must  not  be  admitted 
to  the  school  until  said  house  be  disinfected  after  the  termination  of  the  case  or  any  other 
which  might  follow  it. 

Sec.  11.  If  the  local  sanitary  board  should  not  have  the  proper  means  with  which  to 
perfonn  a  bacteriological  analysis,  it  shall  send  to  the  Superior  Sanitarj'  Board  samples  of 
the  sputimi,  blood,  defecation,  or  other  pathological  matter  which  the  physicians  may 
furnish  for  the  purpose  of  diagnosis.  As  soon  as  the  board  shall  receive  the  result  of  the 
analysis  it  shall  notify  the  interested  parties  thereof. 

Sec.  12.  The  local  sanitarj'  board  shall  send  three  samples  of  each  beverage  or  food  prod- 
uct suspected  of  falsification  or  adulteration,  the  receptacles  of  which  shall  be  strapped, 
sealed,  and  signed  in  the  presence  of  the  interested  party,  in  order  that  it  shall  not  be  possi- 
ble to  substitute  the  contents  thereof  without  leaving  traces  of  such  substitution,  and  it 
shall  deliver  to  the  seller  a  sample  similarly 'strapped,  sealed,  and  signed,  retaining  one  and 
sending  the  remaining  sample  to  the  Superior  Board,  with  the  minutes  and  the  respective 
report,  for  the  necessary  analysis. 

Sec.  13.  Whenever  necessary  it  shall  make  domiciliary  inspections,  house  by  house, 
making  report  upon  each  one  of  them  in  the  form  prescribed  for  the  purpose,  which  report 
shall  state  chiefly:  The  number  of  persons  hving  in  the  house;  whether  there  is  in  it  a  case 
of  a  contagious  disease  or  if  any  has  occurred  therein  within  a  year  prior  to  the  date  of  the 
report;  sanitary  conditions  of  the  house,  water-closets,  drains,  etc. 

Sec.  14.  It  shall  order  owners  of  houses,  in  writing,  what  alterations  they  must  carry  out 
in  their  respective  houses  within  a  definite  period,  which  may  be  extended  for  justifiable 
reasons,  provided  that  it  shall  not  unreasonably  delay  the  execution  of  the  work. 


SECOND    INTERNATIONAL    8ANITARY    CONVKNTION.  iV,) 

Sec.  15.  It  shall  give  the  respective  court  infonnation  of  all  violations  which  should  be 
punished,  sending  in  the  record  of  each  case  and  authorizing  one  of  its  members  or  employ- 
ees to  prosecute  the  oiTonder. 

Sec.  16.  It  shall  servo  notice  to  all  those  who  refii-se  to  obey  the  order  or  who  delay  the 
execution  of  the  work  that  they  shall  be  brought  before  the  couit  if  they  do  not  comply 
therewith  within  the  designated  period. 

Sec.  17.  Houses,  buildings,  etc.,  which  constitute  a  menace  to  public  health  or  safety 
shall  bo  declared  uninhabitable  and  ordered  closed  by  tlio  local  sanitary  board,  and  if  nec- 
essary it  shall  request  the  ayuntamiento  to  have  the  same  demolish(!d.  The  inspection  of 
the  municipal  architect  shall  be  necessary  previous  to  tlie  demolition.  ' 

Sec.  18.  it  shall  recommend  to  the  ayuntamiento  the  vvoiks  which  it  deems  necessary 
for  the  sanitation  of  its  municipal  district  and  which  the  i(!sid('./il,s  are  not  compelled  by 
law  to  carry  out,  such  as  the  sanitation  of  swamps  in  public  lands,  drainage  of  jjool.s, 
cleaning  of  streets,  etc.,  sanitation  of  slaughterhouses  and  cemeteries,  and  all  other 
necessary  works  in  public  places. 

Sec.  19.  When  the  sanitation  recommended  constitutes  an  urgent  necessity  and  the 
ayuntamiento  refuses  to  perform  the  work  in  due  time,  the  local  sanitary  board  shall  notify 
tiae  fact  to  the  Superior  Board  of  Health  for  the  pui-poses  stated  in  paragraph  (e)  of  section 
3  of  order  No.  159. 

Sec.  20.  It  shall  inform  the  Superior  Board  what  works  of  sanitation  must  be  carried 
out  by  the  province  or  the  government  within  its  respective  municipality. 

Sec.  21.  The  local  sanitary  board  shall  submit  to  the  Superior  Board  of  Health  an 
annual  estimate  of  the  expenses  required  for  the  maintenance  of  the  sanitation  of  the 
ayuntamiento,  and  which  must  be  stated  in  the  municipal  appropriations. 

Sec.  22.  It  shall  keep,  besides  the  minutes  of  proceedings,  a  record  of  all  its  transactions, 
as  well  as  a  register  of  the  physicians,  phannacists,  dentists,  midv^-ives,  and  veterinarians 
within  its  municipal  jurisdiction,  in  the  fonn  prescribed  and  furnished  by  the  Superior 
Board. 

Sec.  23.  It  shall  make  an  annual  report  to  the  Superior  Board  of  Health,  within  the 
month  of  January,  on  forms  furnished  by  said  Superior  Board,  upon  the  sanitary  conditions 
and  necessities  of  the  municipality;  the  method  of  transacting  its  business;  infectious 
diseases  and  epidemics  and  their  interesting  characteristics;. other  events,  and  all  data 
which  the  Superior  Board  may  require.  • 

Sec.  24.  When  requested  by  the  Superior  Board,  it  shall  furnish  the  same  with  sanitary 
and  demographic  statistics  made  on  forms  prescribed  for  the  purpose. 

Sec.  25.  It  shall  report  to  the  Superior  Board  the  permanent  causes  of  the  diseases 
which  may  prevail  iu  its  jurisdiction,  stating  what  measures  it  deems  advisable  for  the 
suppression  thereof. 

Sec.  26.  It  shall  see  that  no  disinfecting  materials  are  lacking  in  its  district,  and  that 
drug  stores  are  always  provided  with  antiseptic  substances  and  have  the  same  for  sale 
at  reasonable  prices ;  anything  to  the  contrary  shall  be  notified  to  the  Superior  Board. 

Sec.  27.  It  shall  prepai-e  or  be  provided  with  exact  and  detailed  maps  of  its  municipahty 
in  order  to  make  upon  them  graphic  representation  of  the  diseases  and  other  subjects 
worthy  of  note. 

Sec.  28.  It  shall  send  to  the  Superior  Sanitary  Board  a  monthly  extract  of  aU  resolutions 
passed  during  the  previous  month. 

Sec.  29.  It  shall  furnish  the  inspectors  of  the  Superior  Board  of  Health  with  aU  infor- 
mation and  data  which  they  may  require  for  the  accurate  performance  of  their  duties. 

Sec.  30.  The  oiHce  of  member  of  the  local  sanitary  board  is  incompatible  with  that  of 
councilor  or  employee  of  the  ayuntamiento. 

Sec.  31.  The  secretary  shall  be  selected  by  the  board  from  among  its  members;  he  may 
employ  a  clerk  under  his  supervision  for  the  dispatch  of  business. 

Chapter  III. 

THE   LOCAL   SANITARY    CHEEP. 

Sec.  32.  The  local  sanitary  chief  shall  be  an  experienced  and  competent  physician, 
appointed  and  paid  by  the  ayuntamiento,  subject  to  the  approval  of  the  Superior  Sanitary 
Board.  In  case  the  first  and  second  nominations  of  the  ayuntamiento  be  rejected  by  the 
Superior  Sanitary  Board,  the  latter  shall  appoint  the  person  which  it  deems  capable  for  the 
position. 

Sec.  33.  The  local  sanitary  chief  shall  be  the  president  of  the  board  and  its  executive 
officer. 

Sec.  34.  He  shall  submit  to  the  approval  of  the  Superior  Board  the  appointment  and 
removal  of  the  employees  of  the  local  board. 


120  SECOND    INTEENATIONAL    SAT^ITARY    CONVENTION. 

Sec.  35.  He  shall  make  the  reports,  statistical  data,  documents,  etc.,  that  the  superior 
sanitar}^  chief  may  require  in  regard  to  the  sanitation  of  his  respective  municipal  district. 

Sec.  36.  In  the  performance  of  his  duties  as  local  sanitaiy  chief,  he  shall  comply  with  the 
instructions  which  the  superior  sanitaiy  chief  may  give  him. 

Sec.  37.  He  shall  issue  orders  for  the  detention  and  isolation  of  any  person  suflering 
from  an  infectious  disease  until  the  period  of  his  liabihty  to  spread  the  disease  is  passed,  in 
accordance  with  the  provisions  of  paragraph  (f)  of  section  3  of  order  No.  159. 

Sec.  3S.  He  shall  make  monthly  and  annual  reports  of  his  trar sections  to  the  local  sani- 
tary board.         ,  . 

Chapter  IV. 

INSPECTORS. 

Sec.  39.  Sanitary  inspectors  shall  be  considered  as  the  deputies  of  the  chief  sanitary 
officer;  they  shall  devote  the  service  hours  exclusively  to  the  performance  of  their  duties, 
and  shall  always  be  ready  to  execute  the  orders  which  are  given  them. 

Sec  40.  The  inspector  shall  be  provided  with  credentials  and  a  badge  of  oflBce,  and  shall 
wear  a  uniform  if  the  Superior  Sanitary  Board  so  orders  it.  By  virtue  of  his  office,  he  shall 
be  respectful  and  polite  to  all  persons  with  whom  he  may  come  in  contact  in  the  perform- 
ance of  his  duties;  he  must  always  avoid  discussion,  and  shall  submit  his  reports  in  writing. 

Sec  41.  He  shall  make  in  his  reports,  which  must  be  specific,  accurate  and  reliable,  the 
reconmaendations  which  he  may  deem  necessary  to  prevent  the  violations  which  may  come 
under  his  observation;  he  shall  not  give  any  direct  information  or  order,  verbally,  or  in 
writing,  to  the  interested  parties. 

Sec.  42.  He  shall  endeavor  to  be  well  informed  in  all  that  concerns  the  sanitary  condi- 
tions of  his  district,  so  that  he  may  at  any  time  furnish  any  information  which  the  board  or 
the  local  sanitary  chief  may  request  of  him. 

Sec  43.  He  shall  be  correctly  dressed,  and  avoid  all  places  of  disrepute  during  the  sers^ice 
hours. 

Sec.  44.  He  shall  remain  in  his  district  during  the  service  hours,  unless  he  receives 
express  orders  to  the  contrary,  and  he  shaU  not  engage  in  any  private  business  during  said 
houre.    « 

Sec  45.  Before  entering  a  house  he  shall  announce  his  office  and  the  object  of  his  visit, 
and  he  shall  make  the  inspection  with  careful  attention  and  minuteness  of  detail,  so  that 
the  orders  which  may  result  therefrom  shall  not  have  to  be  modified  because  of  deficiencies, 
errors,  or  inaccuracies  therein. 

Sec.  46.  If  he  should  meet  with  unreasonable  resistance  on  the  part  of  the  owner  or  ten- 
ant of  a  house  to  allow  him  to  make  the  inspection,  he  shall  notify  the  fact  to  the  sanitary 
chief,  in  order  that  through  him  the  aid  of  the  police  it  may  be  secured,  after  all  persuasive 
means  have  been  exhausted. 

Sec  47.  He  shall  exercise  the  greatest  prudence  and  reserve  in  regard  to  anything  that 
he  may  obser^^e  in  the  houses  by  him  inspected:  he  shall  not  exercise  the  powers  of  his 
office  with  malicious  intention  to  injure  or  benefit  a  third  person,  or  on  behalf  of  his  own 
private  interests  or  his  relatives. 

Sec.  48.  He  shall  request  the  leave  of  the  local  sanitary  board  when  it  be  necessary  for 
him  to  absent  himself  temporarily  on  account  of  illness  or  other  private  cause. 

SANITARY  ORDINANCES. 
Chapter  I. 

WATER    SUPPLY. 

Sec.  49.  The  local  sanitary  board  shall  take  particular  care  of  the  supply  of  water  in  its 
locality,  respecting  the  quantity  and  the  biochemical  qualities  as  well,  obtained  either 
from  aqueducts,  springs,  streams,  wells,  cisterns,  or  any  other  natural  or  artificial  source; 
and  it  shall  prescribe  the  measures  necessary  for  the  preservation  of  the  purity  and  salu- 
brity of  the  water  intended  for  drinking  and  other  domestic  purposes. 

Sec.  50.  In  towns  where  there  are  acqueducts  that  furnish  drinkable  water  in  sufficient 
quantities,  and  where  the  service  is  well  regulated  and  reasonable  in  price,  the  installation 
of  independent  pipes  in  all  houses,  buildings,  and  upon  all  floors  in  the  same  that  are  to  be 
rented  separately,  and  the  suppression  of  all  wells,  cisterns,  and  other  receptacles  shall  be 
ordered  unless  they  are  used  for  industrial  purposes,  in  which  case  the  interested  party 
shall  be  required  to  apply  for  the  written  consent  of  the  board,  which  may  grant  the  request 
or  not,  in  its  discretion. 

Sec  51.  It  shall  be  compulsory  for  the  managers  of  aqueducts  to  make  the  water  reach 
the  highest  places  of  the  town  during  the  daytime. 


SECOND    INTERNATIONAL    HANITARY    CONVENTION.  121 

Sec.  52.  When  the  requirements  of  the  case  shall  demand  it,  the  use  of  filters  or  other 
means  oí  puriíication  shall  be  ordered  for  the  amelioration  of  water  used  in  schools,  asylums, 
cafés,  and  other  public  places. 

Sec.  53.  In  towns  where,  on  account  of  the  lack  of  aqueducts,  the  use  of  wells  and  cis- 
terns is  permitted,  said  wells  and  cisterns  must  be  provided  with  lids  and  impermeable 
walls,  and  their  openings  must  be  protected  by  wiie  gauze  against  the  access  of  mosquitoes; 
the  water  conduits  must  also  be  impermeable  and  the  entrance  of  the  first  rain  water  must 
be  prevented.  The  well  and  cistern  walls  mu.st  be  at  a  distance  of  at  least  10  meters  from 
any  cesspool,  sewer,  etc.  No  cultivation  of  any  sort  shall  be  permitted  upon  cisterns  and 
wells. 

Sec.  54.  The  extraction  of  water  from  wells  and  cisterns,  although  they  be  covered, 
shall  be  made  only  by  means  of  pumps,  in  order  to  prevent  effectively  the  access  of  mos- 
quitoes. 

Sec.  55.  In  towns  where  it  is  absolutely  necessary,  to  avail  of  river  water  for  domestic 
consumption,  a  place  in  the  I'iver  where  the  water  can  not  be  easily  infected,  shall  be  selected, 
and  bathing,  washing,  and  the  drainage  of  latrines,  sewers,  distilleries,  sugar  mills,  slaughter- 
houses, cemeteries,  etc.,  shall  be  prohibited  in  any  part  from  the  head  of  the  river  to  the 
place  selected  for  the  extraction  of  water. 

Sec.  56.  Any  public  sale  of  water  for  domestic  consumption  must  be  authorized  by  the 
local  sanitary  board,  which  shall  regulate  and  inspect  the  service  assiduously,  and  shall 
require  that  the  receptacles  be  well  covered  and  composed  of  materials  proper  for  the  clean- 
ing, such  as  glass,  iron,  or  clay  coated  with  porcelain  or  glass. 

Sec.  57.  Only  drinkable  water  shall  be  permitted  for  public  consumption  for  drinking 
purposes. 

Sec.  58.  Only  water  pei-fectly  purified  shall  be  used  in  the  manufacture  of  ice  and  aer- 
ated waters,  and  all  operations  of  the  factory  shall  be  perfoimed  with  strict  cleanliness. 

Ice  intended  for  domestic  consumption  must  be  pure,  without  any  taste,  and  free  from 
all  danger  of  transmitting  infection. 

Sec.  59.  Soiling  or  in  any  way  injm-ing  a  river  or  stream,  thus  making  its  water  unhealth- 
ful  or  improper  for  consumption,  is  prohibited. 

Sec.  60.  He  who,  directly  or  indirectly,  makes  water  intended  for  consumption  danger- 
ous to  health,  shall  be  held  criminally  responsible. 

Sec.  61.  When,  on  account  of  the  appearance  of  a  disease,  the  local  sanitary  board,  sus- 
pects that  an  aqueduct,  or  a  well,  cistern,  stream,  etc.,  is  infected,  it  shall  cause  an  analy- 
sis of  the  water  to  be  made  immediately,  and  pi^escribe  the  measures  showing  the  manner 
in  which  to  continue  its  use  without  danger,  or  prohibit  the  use  of  such  water,  as  the  case 
may  be. 

Chapter  II. 

FOOD  products  AND  BEVERAGES. 

Sec.  62.  Food  products  or  beverages  imported  or  intended  for  sale  in  a  town  must  be 
pure  or  fresh,  ripe  or  preserved,  and  their  component  materials  and  character  must  always 
correspond  with  the  name  under  which  they  are  sold,  clearly  stated  on  the  labels  of  their 
receptacles  or  packages. 

Sec.  63.  When  a  food  substance,  or  a  beverage,  contains  one  or  more  materials  foreign 
to  its  known  and  accepted  natural  composition,  it  shall  be  considered  as  adulterated;  it 
shall  also  be  so  considered  when  any  or  several  of  its  component  materials  have  been 
extracted  from  it,  or  do  not  correspond  in  nature,  quality,  or  composition  to  the  name  under 
which  the  product  or  beverage  is  sold. 

Sec.  64.  Ajiy  substance  shall  be  considered  as  noxious  or  detrimental  to  health,  and  its 
mixture  with  any  food  or  beverage  being  therefore  illegal,  when  it  has  been  shown  that  it 
is  hurtful  to  the  human  body,  and  when  there  is  any  doubt  as  to  its  innocuousness,  either 
in  its  immediate  or  subsequent  effects. 

Sec.  65.  Any  food  or  beverage  shall  be  considered  adulterated  when — 

(1)  It  is  in  a  state  of  decomposition. 

(2)  It  has  become  acid,  decayed,  or  rancid,  or  has  undergone  any  alteration  which  might 
change  its  taste  or  its  nutritive  qualities,  or  which  would  render  it  detrimental  to  health. 

Sec.  66.  Adulterated  or  falsified  food  products  or  beverages,  as  well  as  those  that  have 
substituted  for  others,  or  may  prove  to  be  difi'erent  from  what  is  stated  on  the  label,  must 
be  seized  and  deposited,  or  disposed  of  in  such  a  manner  as  the  nature  of  the  ordinance 
requires  it;  the  manufacturer  or  seller  shall  be  held  personally  responsible. 

Sec.  67.  The  sale  of  any  food  product  or  beverage,  from  which  the  constituent  of  nutri- 
tive value  shall  have  been  extracted  in  part  or  in  whole,  or  that  shall  have  been  mixed  with 
other  substances,  if  its  composition  be  not  stated  on  the  label  and  be  made  known  to  the 
purchaser,  is  prohibited. 


122  SECOND    INTERNATIONAL    SANITAEY    CONVENTION. 

Sec.  6S.  The  sale,  importation,  or  storage  of  meat,  fish,  pouUry,  game,  fruits,  vegetables, 
milk,  beverages,  wines,  liquors,  etc.,  which  are  not  found  in  perfect  condition  for  consump- 
tion, and  also  of  canned  goods  the  receptacles  of  which  are  damaged  or  opened,  is 
prohibited. 

Sec.  69.  The  sale  in  public  streets  of  meat,  fish,  pies,  candies,  etc.,  unless  they  be  prop- 
erly covered  and  protected  against  dust,  insects,  and  hands,  is  prohibited;  and  likewise 
the  sale  of  pies,  candies,  viands,  etc.,  in  establishments,  unless  they  be  kept  in  closed  show 
cases ;  the  use  of  proper  instruments  for  handling  said  articles  is  recommended  instead  of 
the  use  of  hands. 

Sec.  70.  The  lisc  of  mineral  colors  in  which  composition  lead,  antimony,  copper,  chro- 
mium, arsenic,  or  mercury,  form  a  part;  of  organic  colore,  such  as  gum  gutta  and  aconite; 
of  coloring  materials  derived  from  bitumen,  and,  in  general,  of  all  materials, which  might  be 
injurious  to  health,  is  proliil)ited  in  the  coloration  of  an)^  food  product. 

As  an  exception,  the  use  of  colors  derived  from  bitumen  for  the  coloration  of  food  prod- 
ucts is  permitted,  provided  said  colors  do  not  contain  antimon}^,  arsenic,  barium,  lead,  cad- 
mium, chromium,  copper,  mercury,  uranium,  zinc,  tin,  gum  gutta,  coralline,  or  picric  acid. 

Sec.  71.  The  use  of  leaden  tin  foil  for  wrapping  fruits,  candies,  chocolate,  cheese,  and 
any  other  food  products,  is  prohibited. 

Tin  foil  intended  for  such  purpose  must  be  composed  of  an  alloy  containing  at  least  97 
per  cent  of  tin  immersed  in  metastannic  acid. 

This  alloy  must  not  contain  more  than  a  half  of  1  per  cent  of  lead  and  to  o  o  o  of  arsenic. 

Sec.  72.  Likewise,  timiing  of  vases  and  kitchen  utensils  is  prohibited  unless  the  solution 
contains  a  similar  alloy  to  that  prescribed  in  the  preceding  section. 

The  use  of  tin  vases  and  utensils  intended  for  containing  or  preparing  food  products  is 
prohibited  if  said  vases  and  utensils  be  manufactured  ^vith  an  alloy  containing  more  than 
10  per  cent  of  lead  or  other  metals  which  are  ordinarily  found  alloyed  with  tin;  such  alloys 
should  not  contain  more  than  x^oo o  of  arsenic. 

Sec.  73.  Objects  of  metal  or  alloys,  the  nature  of  which  niight.be  injurious  to  health, 
must  not  be  mixed  with  bonbons,  candies,  and,  in  general,  any  food  product.  Metallic  foil 
used  in  gilding  or  silver-plating  bonbons  and  pastilles  must  be  of  fine  gold  or  silver. 

Sec.  74.  It  shall  be  the  duty  of  any  peison  having  information  of  the  existence  of  un- 
wholesome or  decaj^ed  food  products  for  sale  to  notify  the  fact  to  the  local  sanitary  chief. 

Sec.  75.  It  is  prohibited  to  manufacture,  sell,  or  give  away,  or  to  authorize  the  manu- 
facture, sale,  or  giving  away  of  food  products  or  beverages  injurious  to  health,  whether 
their  toxic  or  noxious  efl'ect  be  immediate  or  tardy. 

Sec.  76.  All  establishments  engaged  in  the  sale  or  deposit  of  food  products  or  beverages 
must  be  kept  perfectly  ventilated  and  clean — floors,  walls,  counters,  kitchens,  water-closets, 
seweis,  etc.,  particularly. 

Sec.  77.  The  use  of  poisonous  substances,  or  substances  prejudicial  to  health,  for  dyeing, 
painting,  or  coloring  food  products  or  beverages,  or  paper  for  wrapping  the  same,  is  prohib- 
ited; and  also  the  use  of  said  poisonous  or  noxious  substances  for  painting,  varnishing, 
tinning,  or  coating  receptacles  of  any  kind  which  might  infect  the  food  products  or  bever- 
ages; toys  and  other  articles  for  children  are  included  in  this  prohibition. 

The  use  of  colore  in  the  composition  of  which  lead,  antimony,  copper,  chromium,  areenic, 
mercury,  gum-gutta,  or  aconite  form  part,  is  prohibited  in  the  preparation  of  paper,  paste- 
board, or  other  materials  for  packing  food  products. 

Sec.  78.  Wine  is  defined  to  be  the  liquid  resulting  from  the  femientation  of  grape  juice, 
without  addition  of  substances  foreign  to  the  composition  of  said  juice. 

Sec.  79.  Artificial  mne  is  that  which  is  not  derived  from  the  fennentation  of  grape  juice. 

Sec.  80.  The  use  of  the  following  substances  in  the  manufacture  of  all  kinds  of  alcoholic 
liquors,  and  the  addition  of  the  same  to  wines,  is  prohibited: 

(1)  Metallic  salts,  mineral  or  organic  acids,  pernirnes,  ethere,  and  essences. 

(2)  AH  antiseptic  substances. 

(3)  Aiiy  other  substances  foreign  to  the  natural  composition  by  fermentation  of  wines 
and  alcoholic  liquors. 

Sec.  81.  Wines  and  alcoholic  liquore  containing  any  of  the  following  substances  shall  be 
considered  as  adulterated,  and  noxious  or  not,  as  the  case  may  be: 

(1)  More  than  two  grams  of  sulphate  of  potash  per  liter. 

(2)  More  than  one  gram  of  sodium  chloride  per  liter. 

(3)  Excess  of  water  or  alcohol. 

(4)  Coloring  substances  foreign  to  the  composition,  whatever  their  origin  may  be. 

Sec.  82.  Alcoholic  liquors  obtained  by  fermentation  must  not  contain  foreign  coloring 
matter. 

Sec.  83.  Persons  selling  adulterated  or  artificial  wines  not  detrimental  to  health  shall 
incur  the  penalty  of  seizure  and  payment  of  the  cost  of  analysis  and  the  fine.  Those  selling 
adulterated  or  artificial  wines  detrimental  to  health  shall  be  brought  before  the  courts  of 
justice. 


SECOND    INTERNATIONAL    H ANITA  K Y    (JONVKNTION.  123 

Sec.  84.  The  sale  of  wine  vinegars  containing  less  than  5  per  pent  of  acctio  acid  is  pro- 
hibited. 

Seo.  85.  Vinegars  derived  from  alcohol,  beer,  cider,  etc.,  may  be 'sold,  provided  the  label 
on  their  receptacles  show  the  product  from  whi(;h  they  are  derived.  None  of  tluae  vinegars 
shall  contain  less  than  3  per  cent  of  acetic  acid. 

Seo.  86.  Vinegars  containing  sulwtances  foreign  to  their  natural  composition  shall  be 
considered  as  adulterated. 

Sec.  87.  The  addition  of  any  substance  to  wheat  flour  for  tlie  purpo.se  of  increasing  its 
natural  weight  or  volume  is  prohibited. 

Sec.  88.  Ordinary  bread,  intended  for  sale,  must  bo  manufactured  with  wheat  flour  with- 
out any  mixture  whatsoever,  and  well  kneaded  and  baked  The  use  of  any  substance 
foreign  to^the  natural  and  known  composition  of  bread  is  proliibited.      ' 

Sec.  89.  Any  other  kind  of  biead  which  is  not  exclusively  made  of  wheat  flour,  leaven, 
salt,  and  water  may  be  sold  provided  its  composition  is  made  known  to  the  purchaser. 

Sec.  90.  Bakeries  must  be  established  in  places  with  good  light  and  the  ventilation 
necessary  for  their  perfect  cleanliness.  Flooi's,  walls,  kneading  troughs,  etc.,  must  be  kept 
absolutely  clean.  No  bedrooms,  water-closets,  stables,  animals,  etc.,  shall  be  permitted 
in  the  premises  of  any  bakery  or  in  direct  communication  with  the  same. 

Persons  suffering  from  cutaneous  or  infectious  diseases  are  prohibited  from  intervening 
personally  in  the  confection,  sale,  etc.,  of  bread. 

The  transportation  of  bread  shall  be  made  with  absolute  cleanliness  and  protection 
against  dust,  insects,  and  hands. 

Sec.  91.  The  use  of  wood  and  other  fuel  that  has  been  painted,  undergone  any  chemical 
process  or  been  saturated  with  substances  noxious  to  health,  for  the  heating  of  furnaces  in 
bakeries,  confectioneries,  etc.,  is  prohibited. 

Sec.  92.  The  kind  of  flour  used  in  the  confection  of  soup  pastes  shall  be  stated  on  the 
label  of  the  package. 

Sec.  93.  Only  pure  saffron  and  annatto  may  be  used  in  coloring  soup  pastes. 

Sec.  94.  The  sale  of  spices  intended  for  food  or  condiments,  such  as  cinnamon,  saffron, 
clove,  etc.,  that  have  been  adulterated  or  the  natural  weight,  volume,  or  composition  of 
which  has  been  increased,  is  prohibited,  unless  it  be  done  in  accordance  with  the  provisions 
of  section  67  of  these  ordinances. 

Sec.  95.  Products  exclusively  manufactured  with  milk,  or  cream  derived  from  milk,  or 
with  both,  with  or  without  salt  and  coloring  substances,  and  in  the  composition  of  which 
there  is  more  than  15  per  cent  of  water,  is  prohibited  from  being  sold  as  or  termed  "  butter." 

Sec.  96.  Any  food  product  which,  on  account  of  its  appearance  or  flavor  might  be  taken 
for  butter,  or  which  is  prepared  for  the  same  use,  shall  not  be  sold  except  under  the  name  of 
"oleomargarine,"  if  such  be  the  case;  in  other  cases  the  provisions  of  section  67  of  these 
ordinances  shall  be  complied  with  in  the  sale,  under  penalty  of  seizure  and  fine  if  the  viola- 
tion does  not  constitute  crime. 

Sec.  97.  Packages,  boxes,  cans,  paper,  and  packing  of  any  kind,  containing  oleomarga- 
rine for  sale  or  deposit  in  large  or  small  quantities,  must  have  printed  thereon  in  Spanish 
and  in  conspicuous  roman  letters,  of  a  half  a  square  inch  at  least,  the  word  "  Oleomargarine." 

The  sale  of  such  product  without  the  above  or  other  specification  shall  be  understood 
to  be  of  butter,  for  the  purposes  of  sanitary  inspection. 

Sec.  98.  Merchants  or  dealers  selling  products,  which,  not  being  pure  pork  lard,  are 
similar  thereto,  or  which  might  be  taken  for  it  on  account  of  their  flavor  or  appearance, 
under  the  name  of  "lard"  or  "compound  lard,"  are  hereby  compelled  to  inform  the  pur- 
chaser or  consumer,  at  the  time  of  the  sale,  that  said  substances  are  not  "pork  lard,"  and 
to  put  on  the  receptacles  thereof  labels  with  the  words  "Artificial  lard"  printed  in  Spanish, 
with  intelligible  letters  a  half  a  square  inch  long;  these  labels- shall  be  placed  on  the  most 
conspicuous  part  of  the  receptacles. 

Sec.  99.  The  only  oil  that  shall  be  sold  under  the  name  of  "olive  oil"  is  that  extracted 
from  olives,  free  from  any  mixture. 

Other  oils  intended  for  table  use  and  which  are  not  noxious  may  be  sold,  provided  that 
the  labels  on  their  receptacles  state  in  roman  letters,  in  Spanish,  and  in  an  intelligible 
and  durable  way,  their  nature  or  origin.  The  sale  of  adulterated  or  rancid  oils  of  any 
kind  for  table  use  is  prohibited. 

Sec.  100.  The  manufacture  of  all  kinds  of  beverages  must  be  made  with  ingredients  of 
good  quality,  using  for  the  purpose  clean  vessels  which  are  not  made  of  copper  or  other 
material  that  might  make  them  prejudicial  to  health. 

Sec.  101.  The  use  of  saccharine  in  beverages  and  food  products  is  prohibited. 

Sec.  102.  The  sale  of  watered,  skimmed,  or  otherwise  adulterated  milk,  and  that  derived 
from  sick  animals,  or  animals  that  have  been  fed  with  industrial  refuse  in  fermentation, 
is  prohibited. 

Sec.  103.  For  the  purpose  of  these  ordinances,  the  following  shall  be  considered  as 
adulterated  milk: 


124  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

(1)  Milk  containing  more  than  18.5  per  cent  of  water,  less  than  11.5  per  cent  of  solid 
materials,  and  less  than  2.7  per  cent  of  grease,  or  containing  any  substance  foreign  to  its 
natural  composition.  ; 

(2)  Milk  obtained  fifteen  days  before  or  eight  days  after  the  parturition  of  the  animals. 

(3)  Milk  derived  from  sick  animals,  or  animals  that  have  been  fed  with  waste  materials 
and  products  in  a  state  of  fermentation. 

(4)  Milk  from  which  the  cream  has  been  totally  or  partially  skimmed. 

(5)  Milk  obtained  from  animals  kept  in  narrow  or  unhealtliful  places. 

(6)  Milk  to  which  water,  other  liquid,  condensed  milk,  or  any  other  foreign  substance  has 
been  added,  or  curdled  or  otherwise  spoiled  milk. 

^  (7)  Milk  coming  from  places  where  scarlet  fever,  cholera,  typhus,  typhoid  fever,  diph- 
theria, or  other  contagious  diseases  prevail. 

(8)  Milk  extracted  from  animals  tliat  have  been  fed  with  poisonous  plants  or  that  have 
taken  toxic  substances. 

Sec.  104.  For  purposes  of  inspection,  milk  the  density  of  which  is  less  than  25°  (1025), 
ascertained  by  the  Qucvenne  lactometer  at  a  temperature  of  15°  centigrade  approximately 
shall  be  considered  as  suspicious. 

Sec.  105.  Milk  intended  for  sale  shall  not  be  kept  on  places  used  as  bedrooms  or  for  any 
other  purposes. 

Milk  shall  not  be  drawn  off  in  the  public  streets,  trains,  or  railway  stations  except  when 
it  is  to  be  delivered  to  the  purchaser. 

Sec.  106.  The  sale  of  milk  intended  for  public  consumption  shall  be  permitted  only 
when  the  bottles,  flasks,  or  other  vessels  which  contain  it  have  undergone  the  following 
treatment: 

(1)  Bottles,  flasks,  and  vessels,  before  being  filled  with  milk,  shall  be  washed  first  with 
a  hot  solution  of  soap,  lye,  or  other  alkaline  substance,  and  afterwards  with  hot  water. 

(2)  Milk  must  be  bottled  in  places  which  are  not  used  for  habitations,  bedrooms,  or  other 
domestic  purposes,  and  which  are  not  near  any  stables. 

(3)  Vessels  containing  mük  intended  for  sale  must  be  provided  with  an  adequate. cover 
to  protect  it  against  dust  and  other  impurities. 

Sec.  107.  Vessels  used  as  receptacles  for  milk  must  be  very  clean,  and  their  joints  must 
be  smooth  and  not  rusty.  Vessels  made  of  untinned  copper,  brass,  lead-coated  metal,  or 
unevenly  varnished  porcelain,  are  prohibited. 

Sec.  108.  If  it  be  not  desirable  to  cover  the  milk  while  it  is  in  the  stable  or  dairy,  a  fine 
cloth  shall  be  placed  upon  the  mouth  of  the  vessel  containing  it. 

Cleaning  of  vessels  shall  be  done  immediately  after  they  shall  have  been  emptied,  with 
boiling  water,  soap,  and  brush;  they  shall  be  rewashed  with  boUed  water  only  and  put  to 
dry  in  the  sun,  mouth  downward,  but  not  upon  the  ground. 

Sec.  109.  Milk  stored  for  sale  must  always  be  deposited  in  a  refrigerator  or  ice  box. 

Sec.  110.  Ice  boxes  must  be  washed  twice  a  week,  at  least,  with  hot  lye  water. 

Sec.  111.  The  drain  pipe  of  an  ice  box  must  not  be  directly  connected  with  sewers  or 
gutters. 

Sec.  112.  Measures  and  other  utensils  used  for  measuring  milk  in  dairies  and  other 
places  where  milk  is  sold,  must  be  carefully  washed  after  the  sale  with  boiling  water  to 
which  lye  shall  have  been  added  in  a  proportion  of  one  tablespoonful  per  liter. 

Sec.  113.  Milk  must  be  properly  stirred  in  the  vessel  before  sale,  in  order  that  the  last 
portions  extracted  shall  contain  as  much  cream  as  the  first. 

Sec.  114.  Ice  must  not  be  put  into  the  milk,  as  a  means  of  preserving  it;  milk  must 
be  kept  in  the  ice  box. 

Sec.  115.  Wagons  assigned  to  the  transportation  of  milk  must  be  made  of  waterproof 
materials  or  oil-painted  wood,  and  always  kept  perfectly  clean. 

The  use  to  which  it  is  assigned  shall  be  stated  in  the  exterior  of  each  wagon  in  permanent 
and  intelligible  letters,  as  well  as  its  number  and  the  place  from  which  it  comes. 

Milk  dealers  on  horseback,  or  availing  themselves  of  other  means  of  transportation,  must 
keep  the  panniers,  saddlebags,  etc.,  perfectly  clean. 

The  transpoitation  in  wagons,  panniers,  saddlebags,  etc.,  assigned  to  the  delivery  of 
milk,  of  other  products  or  substances  except  fresh  cheese,  butter,  and  similar  dairy  products, 
is  prohibited. 

Milk  dealers  must  carry  with  them  during  the  ■  sale  hours  their  respective  licenses, 
which  they  must  exhibit  to  the  sanitary  inspectors  whenever  requested  to  do  so. 

Sec.  116.  Vehicles  and  horses  assigned  to  the  transportation  of  milk  shall  be  registered 
in  the  records  kept  for  this  purpose  by  the  local  sanitary  board. 

Sec.  117.  Persons  engaged  in  the  traflic,  transportation,  and  handling  of  mük  intended 
for  sale  shall  provide  themselves  with  a  certificate  from  the  local  sanitary  officer  guaran- 
teeing the  hygienic  condition  of  the  milk.  These  certificates  shall  be  renewed  from  year 
to  year. 


SECOND    INTERNATIONAL    HANITAKY    CONVENTION.  125 

Sec.  118.  Milk  dealers  shall  be  provided,  besides  tlie  industrial  HccriHO  that  inay  be 
required  by  the  municipal  laws,  with  a  copy  of  tiio  rcf^ulationsof  these  Ordinances  regarding 
the  sale  of  milk,  whicli  copy  shall  be  furnished  by  tlie  local  sanitary  board. 

Sec.  119.  Buildings  intended  for  milch-cow  stables  must  have  30  cubic  meters  at  least 
of  space  for  each  animal;  good  light  and  ventilation;  properly  canalized  pavements;  and 
must  be  well  roofed  and  provided  with  pure  and  fresh  water  and  all  that  is  nojcessary  for 
the  maintenance  of  cows  and  other  milch  animals  in  good  condition  of  liealth  and  hygiene, 
in  accordance  with  the  special  regulations  in  icgard  to  dairies.  Such  stables  must  be 
located  outside  of  the  city  limits,  and  no  other  industry  or  business  shall  be  conducted 
therein. 

Seo.  120.  Owners  or  managers  of  stables  for  cows  or  other  milch  animals  must  keep  the 

f)remises,of  their  establishments  perfectly  clean,  and  take  the  cows  to  the  pasture  grounds 
rom  4  p'.  m.  to  8  p.  m.,  and  shall  not  put  them  in  the  stables  but  from  4  to  0  of  ¿lie  next 
morning. 

Sec.  121.  Persons  suffering  from  cutaneous  or  contagious  diseases,  or  those  that. have 
come  in  contact  with  them,  are  prohibited  from  milking  cows  or  other  animals,  selling  milk, 
handling  vessels,  measures,  and  other  milk  receptacles,  or  helping  in  any  such  operations, 
until  their  liability  to  spread  the  disease  has  disappeared.  Persons  engaged  in  dairy  opera- 
tions must  be  clean  and  free  from  filth  of  any  kind. 

Seo.  122.  Milk  derived  from  sick  cows  must  not  be  sold,  used  in  the  confection  of  food 
products,  or  mixed  with  other  milk.  Likewise,  its  use  for  any  other  purpo.se,  even  if  it 
were  for  feeding  other  animals,  is  prohibited. 

Sec.  123.  The  importation,  sale,  or  storage  of  adulterated  condensed  milk  is  prohibited. 
For  the  purposes  of  these  ordinances  "condensed  milk"  is  understood  to  be  pure  milk  from 
which  a  part  of  its  water  has  been  extracted,  or  from  which  a  part  of  water  has  been  extracted 
and  sugar  added.  The  term  "adulterated,"  in  the  last  case  cited,  refers  to  condensed  milk 
in  which  the  quantity  of  grease  is  less  than  25  per  cent  of  the  solid  substances  contained 
in  it,  and  to  which  any  foreign  substance,  except  sugar,  has  been  added  as  a  means  of 
preserving  it. 

Seo.  124.  Milk  intended  for  sale  shall  be  subject,  at  any  time  and  place,  and  under  all 
circumstances,  to  the  vigilance  of  sanitary  inspectors,  who  are  hereby  authorized  to  take 
samples  in  quantities  not  exceeding  a  half  a  liter  per  vessel,  in  order  to  submit  them  to 
analysis.  Before  taking  samples  the  milk  must  be  sufficiently  shaken,  in  order  that  the 
small  particles  of  grease  be  equally  distributed  in  the  liquid. 

Sec.  125.  Inspectors  shall  use  the  Quevenne  lactometer  in  order  to  ascertain  the  specific 
weight  of  milk,  and  shall  keep  a  record  of  all  samples  tested. 

Sec.  126.  As  soon  as  there  are  suspicions  that  a  certain  milk  is  adulterated,  an  inspection 
of  the  dairy,  stable,  or  place  from  whence  it  came,  shall  be  ordered,  and  it  is  left  to  the  discre- 
tion of  the  inspector  to  require  or  not  the  exhibition  of  the  cows  from  which  the  milk  in 
question  was  extracted. 

Sec.  127.  Milk  dealers  who  do  not  comply  strictly  with  the  regulations  prescribed  for  the 
sale  of  this  article  shall  be  subject  to  fine  and  subsequent  seizure ;  if  the  violation  constitute 
a  crime  the  inspector  shall  notify  the  fact  to  the  local  sanitary  chief  for  proper  action. 

Sec.  128.  Dairies  and  cow  stables  must  be  well  ventilated  and  kept  in  perfect  cleanliness, 
and  their  pavements  shall  be  scrubbed  daily. 

In  the  stable  each  animal  shall  have  a  manger  and  a  trough,  general  mangers  and  troughs 
being  prohibited. 

Sec.  129.  No  sick  cows  shall  be  allowed  in  the  stables,  and  the  sound  ones  should  be 
separated  from  each  other,  well  fed,  given  fresh  and  pure  water,  and  bathed  daily. 

Sec.  130.  The  premises  of  stables  should  be  well  ventilated  and  the  pavement  sprinkled 
before  milking  the  cows  in  order  to  avoid  the  falling  of  dust  into  the  milk. 

Sec.  131.  Milking  must  be  done  with  perfect  cleanliness;  before  the  operation  the  milker 
should  wash  his  hands  and  also  the  udder  of  the  animal  that  is  to  be  milked,  drying  them 
with  a  clean  piece  of  cloth;  he  shall  avoid  the  falling  into  the  milk  of  hair  or  any  other 
substance  that  might  soil  it. 

Sec.  132.  It  is  prohibited  to  milk  cows  or  other  animals  the  udders  of  which  have  any 
«ruptibn,  inflammation,  or  other  disease. 

Sec.  133.  If,  during  the  operation  of  milking,  the  milk  turns  out  to  be  bloody,  yellowish, 
or,  in  general,  of  a  color  and  a  flavor  different  from  the  natural  ones,  it  shall  be  thrown 
away,  carefully  cleaning  the  vessel  that  contained  it,  suspending  the  operation  of  milking, 
and  placing  the  cow  under  observation  until  the  condition  of  its  health  has  been  ascertained 
and  the  sanitary  inspector  authorized  the  milking  anew. 

Sec.  134.  If,  for  any  cause,  should  the  milk  be  soiled,  it  shall  not  be  collated,  but  thrown 
away,  washing  the  vessel  that  contained  it  immediate^  after. 

Sec.  135.  Farm  dairies  engaged  in  the  extraction  of  milk  for  sale,  manufacture  of  cheese, 
etc.,  must  compty  with  the  preceding  provisions  as  much  as  possible,  and  shall  be  subject 
to  frequent  inspection  by  the  local  sanitary  board. 


126  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sec.  136.  OwTiers  of  stables  and  dairies  are  compelled  to  have  posted  in  a  conspicuous 
place  thereof  a  printed  copj'^  of  the  special  regulations  regarding  the  trade,  to  be  furnished 
by  the  local  sanitary  board. 

Sec.  137.  The  use  of  "  presers'ing "  substances  in  milk,  as  well  as  in  other  food  products, 
is  prohibited. 

Sec.  138.  The  manufacture  of  pot  cheese  should  be  made  with  cream  or  milk  of  good 
quality  and  derived  from  sound  animals,  and  the  manufacturer  shall  take  proper  hygienic 
precautions  approved  by  the  local  sanitary  chief. 

The  sale  of  cteam  or  pot  cheese  by  peddlers,  or  others  who  do  not  keep  the  article  in  a 
refrigerator  and  protected  against  dust  in  order  to  avoid  its  decomposition  and  the  produc- 
tion of  poisonous  substances,  is  prohibited. 

Sec.  139.  Organic  substances  susceptible  of  easy  decomposition,  intended  for  food 
products,  shall  be  preserved  in  a  refrigerator. 

Sec.  140.  Grains  or  powders  sold.under  the  name  of  "coffee"  must  be  exclusively  com- 
posed of  this  substance.  The  sale  of  coffee  mixed  with  foreign  substances,  as  well  as  the 
sale  of  "powder  coffee,"  deprived,  by  the  infusion  thereof  into  water,  of  the  constituents 
which  give  it  its  perfume,  flavor,  and  peculiar  qualities,  is  prohibited. 

Sec.  141.  Products  prepared  and  sold  under  the  name  of  "chocolate"  shall  be  obtained 
only  from  cacao  seeds,  pulverized  and  mixed  with  sugar,  aromatized  or  not.  The  maximum 
proportion  of  sugar  shall  be  of  60  per  cent;  proportions  exceeding  this  number  shall  be 
expressly  and  clearly  stated  on  the  label  of  the  package  containing  the  article. 

Sec.  142.  Owners  or  managers  of  grocery  stores  must  permit  the  visits  of  the  sanitary 
inspector;  failure  to  complj^  with  this  provision  shall  be  punished  by  fine  for  the  first  offense, 
and  with  the  penalties  that  the  court  might  deem  proper  in  case  of  a  repetition  of  the  offense. 

Chapter  III. 

construction  of  buildings  within  city  limits — ventilation— drainage  and  sanitary 

plumbing. 

Sec.  143.  Lands  on  which  houses  or  buildings  are  to  be  constructed  should  be  previously 
drained ;  if  it  be  necessary  to  fill  the  land  before  the  construction,  the  filling  shall  be  done 
with  materials  which  are  not  noxious.  Before  commencing  an  excavation  or  removal  of 
earth  or  materials,  the  local  sanitary  chief  shall  be  notified  in  order  that  he  may  issue  the 
necessary  orders  for  the  disinfection  of  the  land. 

Sec.  144.  The  building  should  be  based  on  a  firm  ground,  upon  a  bed  of  cement  or  other 
proper  material.  Ground-floor  rooms  should  be  isolated  from  the  earth  by  a  bed  of  asphalt 
or  cement  of  a  minimum  depth  of  15  centimeters. 

In  order  to  prevent  the  ascension  of  humidity  through  the  walls  the  same  should  be 
isolated  with  coating  of  cement,  asphalt,  slate,  or  other  impermeable  material.  This  insulat- 
ing coat  shall  be  placed  at  about  15  centimeters  under  the  level  of  the  floor. 

Sec.  145.  If  stables  or  storerooms  for  salt  or  other  corrosive  substances  are  to  be  built 
against  a  wall,  a  distance  of  15  centimeters  at  least  should  be  left  between  the  wall  and  the 
intended  construction. 

Sec.  146.  Glass  or  other  material  roofs  are  prohibited  upon  interior  courts  or  yards  above 
the  stanchion  of  the  ground  floor,  unless  said  roof  be  removable  or  be  provided  with  venti- 
lators of  vertical  faces,  which  openings  should  not  be  smaller  than  one-third  of  the  surface 
of  the  yard  or  court,  and  have  a  height  of  50  centimeters. 

Sec.  1 17.  Each  house  or  building  in  streets  where  there  are  no  sewers,  and  while  these 
are  being  constructed  shall  have  a  cesspool  for  the  deposit  of  fecal  matter  exclusively;  but 
as  soon  as  the  construction  of  the  general  sewers  in  the  streets  be  completed  the  property 
owners  shall  be  compelled  to  construct  the  outlets  to  the  general  sewers  and  to  fill  the  cess- 
pools. ■  Owners  of  houses  or  buildings  in  streets  where  there  are  sewers  shall  proceed  to 
construct  the  outlets  to  the  same  within  the  six  months  following  the  pubMcation  of  these 
rules. 

Sec.  148.  The  construction,  reconstruction,  or  alteration,  partially  or  totally,  for  any 
purpose,  of  a  house  or  building,  which  construction,  reconstruction,  or  alteration  might 
constitute  a  danger  to  public  health  and  safety,  on  account  of  lack  of  substantiability 
ventilation,  light,  drainage,  sanitary  plumbing,  or  other  similar  requisites,  shall  be  pro- 
hibited. 

Sec.  149.  The  permission  from  the  ayuntamiento  must  be  previously  secured  for  the 
construction,  reconstruction,  or  alteration,  partial  or  total,  of  a  house  or  building,  and  to 
make  or  change  the  sanitary  plumbing  in  the  same,  and  the  works  shall  be  carried  out 
subject  to  the  restrictions  prescribed  by  the  ordinances  regulating  constructions  and  to  the 
specifications  of  the  department  of  engineering,  or  of  the  municipal  architect  in  places 
where  there  be  no  such  department  of  engineering.  Before  granting  the  Ucense  the  ayunta- 
miento shall  submit  the  apphcation  to  the  local  sanitary  board  for  its  opinion,  which  shall 
be  based  on  these  ordinances,  and  if  such  opinion  be  unfavorable  it  shall  point  out,  within 


SECOND  intí:rnational  sanitary  convention.         127 

twenly  days,  the  defects  and  the  proper  way  to  corrcet  them.  An  appeal  against  the 
decision  of  the  local  sanitary  board  may  be  taken  before  the  Superior  Board  for  final  action. 
If  the  decision  of  the  local  sanitary  Ijo'ard  be  favorable,  the  license  sball  be  irrariled  at  the 
earliest  possible  convenience,  unless  other  lepal  ie(|uisites  have  not  Ijr'cn  iullilled. 

Sec.  150.  Before  a  nevi^or  partially  or  tolaliy  rebuilt  or  altered  housfi,  or  Ijuildinjí,  is  occu- 
pied, rented,  or  in  any  other  way  availed  of,  it  shall  he  inspected,  a  favorable  certificate  of 
the  inspection  from  the  local  sanitary  board  bcinfi  necessary.  Tlie  inspection  shall  t>e  limited 
to  verifying  the  fulfillment  of  the  prescriptions  required  by  the  approved  plan  and  specifi- 
cations. An  appeal  against  the  decision  of  the  local  sanitary  board  may  be  taken  to  the 
Superior  Board,  whose  action  shall  be  final. 

Sec.  151.  No  house,  building,  or  part  thereof,  shall  be  used  for  living  purposes  unless  it 
has  all  proper  conditions  of  capacity,  water  service,  ventilation,  light,  drainage,  and  other 
indispensable  requisites  of  cleanliness  and  sanitation. 

Sec.  152.  New  houses  or  buildings  shall  be  constructed  leaving  15  per  cent  at  least  of  the 
built  area  for  uncovered  surface  or  interior  courts  or  yards,  in  order  that  all  rooms  shall 
have  good  hght  and  ventilation. 

Sec.  153.  Existing  houses  or  buildings  used  as  residences,  which  have  not  the  conditions 
prescribed  in  the  preceding  section,  shall  be  provided  with  air  shafts,  or,  if  these  be 
impracticable,  supplemental  ventilation. 

Sec.  154.  All  rooms  shall  have  doors  and  windows  overlooking  directly  the  street,  garden, 
court,  or  open  passage.     Doors  shall  have  transoms,  protected  or  not  by  glass  frames. 

Sec.  155.  All  rooms  should  have  a  capacity  of  at  least  36  cubic  meters,  and  a  surface  in 
doors  and  windows  of  not  less  than  3  square  meters,  increasing  this  space  in  a  proportion 
of  1^  square  meters  for  every  30  meters  of  cubic  contents. 

Sec.  156.  The  pavement  of  ground-floor  rooms  shall  be  higher  than  that  of  courts,  and 
the  latter  higher  than  the  street  level.  No  other  exceptions  shall  be  made  outside  of  those 
expressly  authorized  in  wi-iting  by  the  local  sanitary  board,  when  the  requisites  prescribed 
by  the  same  shall  have  been  complied  with  in  each  case,  subject  to  these  ordinances. 

Sec.  157.  The  pavement  of  ground-floor  rooms,  as  well  as  that  of  courts,  shall  be  made  of 
cement,  compressed  cement  tiles,  or  other  impermeable  materials. 

Sec.  158.  Walls  of  houses  or  buildings  shall  be  so  constructed  as  to  prevent  the  impreg- 
nation of  the  humidity  from  the  ground,  employing  for  the  purpose  impermeable  materials. 

Sec.  159.  In  houses  or  buildings,  in  places  where  the  use  of  wooden  pavements  for  gi-ound 
floors  is  permitted,  the  space  between  the  ground  and  the  floor  shall  have  ventOation. 

Sec.  160.  No  cesspools  shah  be  constructed  under  the  floor  of  any  room.  Such  deposits 
shall  be  located  in  the  most  central  part  of  courts  or  gardens,  ventilated  and  exposed  to 
the  sun. 

Sec.  161.  Water-closets  shall  be  located  in  courts,  passages,  corridors,  or  other  places 
with  good  light  and  ventilation,  but  never  in  bedrooms,  and  should  be  isolated  from  living 
rooms,  kitchens,  pantries,  etc.,  by  solid  walls. 

Sec.  162.  Drainpipes  from  roofs,  water-closets,  etc.,  should  be  made  of  cast  iron  and 
must  not  be  set  into  the  walls,  but  placed  outside  of  them. 

Sec.  163.  Each  house  or  building  shaU  have  one  water-closet  for  every  twenty  persons, 
with  all  necessary  requisites  to  prevent  emanations  and  infiltrations. 

Sec.  164.  The  owner,  agent,  manager,  or  representative  of  a  house,  building,  or  residence 
shall  always  be  primarily  held  responsible  for  the  maintenance  in  good  condition  of  the  sani- 
tary plumbing  of  the  property,  irrespective  of  the  action  which  might  be  properly  taken 
against  the  tenants,  as  the  case  may  be. 

Sec.  165.  Outbuildings  should  have  the  required  conditions  of  ventilation,  light,  and 
water,  and  their  own  water-closets  and  sewers;  if  not,  the  o-Roier  shall  be  compelled  to 
allow  the  tenants  the  use  of  the  water-closets  and  sewers  of  the  main  building,  in  the  pre- 
scribed proportion  to  the  number  of  persons. 

Sec.  166.  Outbuildings  used  for  the  sale  of  meat,  milk,  candies,  etc.,  shall  have  the  sani- 
tary service  completely  separated  fi'om  the  store;  they  shall  not  be  in  direct  communication 
with  the  main  building;  they  shall  have  in  the  upper  part  of  the  door  a  transom  40  to  50 
centimeters  high  by  whatever  the  width  of  the  door  may  be.  Only  the  pei'sons  in  charge 
of  their  custody,  and  in  no  case  any  family,  shall  be  permitted  to  sleep  therein,  but  in 
adjoining  rooms. 

Sec.  167.  Owners  of  houses  in  towns  where  there  are  aqueducts  and  water  pipes  from 
the  same  in  the  streets  are  obliged  to  place  in  the  houses  faucets  in  proportion  to  the  num- 
ber of  tenants,  and  an  independent  water  service  for  each  floor  that  is  to  be  rented  sepa- 
rately. 

Sec.  168.  The  construction  of  wells,  cisterns,  or  other  deposits  for  water  in  new  houses 
which  streets  have  water  pipes  from  the  aqueduct  shall  not  be  permitted,  except  when  they 
are  to  be  assigned  to  industrial  pm'poses,  in  which  case  the  permission  ft-om  the  local  sanitary 
board  shall  be  necessary,  and  the  use  of  such  weUs  and  cisterns  shaU  be  subject  to  the 
requisites  that  said  board  may  prescribe.  Pools  for  domestic  purposes  are  excepted  from 
this  prohibition  if  they  have  the  conditions  prescribed  by  the  local  sanitary  board. 


128  SECONU    INTERNATIONAL    SANITARY    CONVENTION, 

Sec.  169.  Cesspools,  in  towns  where  they  are  permitted,  shall  be  located  at  a  distance  of 
not  less  than  10  meters  from  wells,  cisterns,  springs,  or  other  water  sources.  This  provi- 
sion shall  apply  to  deposits  for  refuse,  garbage,  etc. 

Sec.  170.  The  installation  of  water  pipes  through  sewers,  drains,  etc.,  is  prohibited. 

Sec.  171.  The  construction  or  opening  of  churches,  theaters,  circusis,  foundling  asylimis, 
hotels,  hospitals,  asylums,  and  other  public  places  shall  not  h^  permitted  except  upon  favor- 
able report  of  the  local  sanitary  board  after  the  examination  of  the  plans,  specifications,  etc. 

Sec.  .172.  Theaters,  circuses,  churches,  hotels,  lodging  hous:^s,  asylums,  etc.,  shall  have, 
besides  the  general  requisites,  the  following  special  ones:  (a)  SufBcient  ventilation;  (b)  fire 
extinguishers  "and  escapes;  (c)  abundant  suppty  of  water,  and  proportionate  number  of 
water-closots  and  urinals;  and  (d)  perfect  cleanliness  in  all  outbuildings. 

Sec.  173.  No  barracks  and  jails  shall  be  constructed  except  upon  favorable  report  of  the 
Superior  Sanitary  Board. 

Sec.  174.  Persons  having  knowledge  of  the  commission  of  an  act  or  the  carrying  out  of  a 
work  in  a  building  dangerous  or  detrimental  to  public  health  shall  report  the  fact  to  the 
local  sanitary  chief. 

Chapter  IV. 

HOTELS,  LODGING   HOUSES,  BOARDING   HOUSES,  CAFÉS,  RESTAURANTS,  AND  INNS. 

Sec.  175.  No  hotel,  lodging  house,  boarding  house,  café,  restaurant,  inn,  or  bar  shall  be 
established  unless  the  owner  subjects  the  establishment  to  the  conditions  prescribed  by  the 
sanitary  chief  in  a  written  license.  Owners  of  hotels,  lodging  houses,  etc.,  which  are  in 
operation  at  pres'^nt  are  hereby  granted  a  maximum  period  of  six  months  from  the  publica- 
tion of  these  ordinances,  within  which  time  they  shall  make  the  required  improvements, 
under  penalty  of  fine  and  closing  of  the  establishinent. 

Sec.  176.  Hotels,  lodging  houses,  and  boarding  houses  shall  keep  a  book  where  the  name, 
place  of  origin,  date  of  arrival  and  departure,  and  number  of  the  room,  of  each  guest  shall 
be  recorded,  and  also  the  names  of  persons  employed  in  the  establishment. 

Sec.  177.  It  is  hereby  prohibited  to  lodge  in  hotels,  boarding  houses,  lodging  houses,  and 
inns  a  larger  number  of  persons  than  that  corresponding  to  the  capacity  of  the  rooms,  in  a 
proportion  of  20  cubic  meters  of  space  for  each  person. 

Sec.  178.  Every  room  or  chamber  shall  be  numbered  with  permanent  figures. 

Sec.  179.  A  larger  number  of  beds  than  that  corresponding  to  the  above-mentioned  pro- 
portion shall  not  be  permitted  in  rooms  or  chambers  uidess  there  be  other  proper  means 
for  more  ventilation,  approved  by  the  local  sanitary  board  and  by  license  in  writing,  in 
which  the  number  of  beds  permitted  shall  be  stated. 

Sec.  180.  Every  bedroom  shall  have  40  cubic  meters  capacity  at  least,  and  the  neces- 
sary doors  and  windows,  the  latter  being  not  less  than  1  square  meter,  so  that  it  shaU  have 
communication  with  the  exterior  air,  unless  other  adequate  means  to  furnish  good  ventila- 
tion be  employed. 

Sec.  181.  Every  room  shall  always  be  kept  perfectly  clean,  as  well  as  the  furniture,  uten- 
sils, bed  clothing,  etc.     The  walls  shall  be  whitewashed  once  a  year  at  least. 

Sec.  182.  Garbage  and  refuse  shall  be  deposited  in  receptacles  of  zinc  or  other  imperme- 
able material  in  accordance  with  the  model  prescribed  by  the  local  sanitary  board,  and  shall 
be  collected  daily. 

Sec.  183.  Hotels,  lodging  houses,  boarding  houses,  and  inns  should  have  the  urinals, 
water-closets,  sculleries,  sewers,  pipes,  etc.,  kept  perfectly  clean  and  in  good  serviceable 
condition.  There  shall  be  one  bathroom  and  one  water-closet  for  every  twenty  persons. 
Water-closets  shall  be  located  in  places  of  sufficient  capacity,  well  ventilated,  and  with 
enough  light,  natural  or  artificial,  during  day  and  night.  The  walls  must  be  impermeable 
to  a  height  of  at  least  1  meter.  The  pavement  of  bathrooms,  water-closets,  urinals,  sewers, 
etc.,  must  be  impermeable,  and  shall  always  be  kept  perfectly  clean. 

Sec.  184.  The  above-mentioned  establishments  shall  be  provided  with  water  supply 
sufficient  to  furnish  at  least  100  liters  daily  for  each  person. 

Sec.  185.  Cafés,  restaurants,  bars,  etc.,  shall  be  provided  with  sanitary  water-closets, 
urinals,  and  washstands  for  the  pubhc  service,  all  of  them  in  good  serviceable  and  clean 
condition,  in  number  proportionate  to  the  importance  of  the  establishment;  said  water- 
closets,  etc.,  shall  be  subject  to  the  approval  of  the  local  sanitary  board,  and  installed  in 
accordance  with  the  plan  and  system  prescribed  by  the  board. 

Sec.  186.  The  establishments  referred  to  in  the  three  preceding  sections  shall  be  provided 
with  cuspidors,  in  the  proportion  of  one  for  every  twenty  persons,  in  corridore,  passages,  etc., 
of  the  model  and  with  the  disinfecting  solution  to  be  prescribed  by  the  local  sanitary  board. 
In  cafés  the  number  of  cuspidors  shall  be  equal  to  that  of  tables  in  use. 

Sec.  187.  It  is  the  duty  of  the  keeper  or  owner  of  an  hotel,  lodging  house,  or  boarding 
house  to  report  to  the  sanitary  chief  any  case  of  disease  on  the  premises  which  may  be  found 
to  be  without  medical  attendance;  cases  of  infectious  diseases  shall  be  reported  as  well. 


SECOND    TNTERNATTOKAL    SANITARY    CONVENTION.  129 

Seo.  188.  Any  person  suffering  from  a  contagious  disease  who  is  lodged  in  a  iiotel,  lodging 
house,  or  boarding  house,  etc.,  shall  be  removed  to  an  isolated  hospital  when  the  sanitary 
chief  shall  deem  it  nccessaiy. 

Seo.  189.  The  owner  or  keciper  of  a  hotel,  lodging  house,  inn,  n^staurant,  or  bar  who  shall 
fail  to  comply  with  the  provisions  of  this  chaptisr  shall  be  held  responsible  for  the  offense. 
Should  he  find  resistance  on  the  part  of  any  of  the  lodgers  to  comply  with  said  provisions,  or 
should  any  of  such  lodgers  have  violated  the  same,  lie  shall  notify  the  fact  at  once  to  the 
sanitary  chief. 

Chapter  V. 

TENEMENT  HOUSES. 

Seo.  IQO.  For  the  purposes  of  these  ordinances  it  shall  be  understood  by  the  term  "tene- 
ment house  "  any  building  or  part  thereof  assigned  as  residence  of  three  or  more  families 
who  live  independently  from  one  another,  with  general  right  to  use  the  passages,  courts, 
bathrooms,  or  water-closets,  and  with  separate  kitchens. 

Seo.  191.  Every  tenement  house  shall  have  a  person  in  charge  of  it,  who  shall  be  held 
primarily  responsible  for  the  fulfillment  of  the  following  duties,  irrespective  of  the  action 
that  may  be  brought  against  the  owner. 

Sec.  192.  He  shall  keep  a  register,  where  the  name,  place  of  birth,  age,  place  of  origin, 
date  of  arrival,  and  number  of  rooms  of  each  tenant  shall  be  stated,  as  well  as  the  changes 
of  rooms  which  might  take  place  within  the  building,  or  the  date  on  which  any  of  such  rooms 
may  be  left  vacant. 

Seo.  193.  He  shall  notify  the  sanitary  chief  whenever  there  is  a  sick  person  in  the  building 
without  medical  attendance. 

Seo.  194.  He  shall  ask  the  physician  attending  a  sick  person  in  the  building  whether  the 
disease  is  contagious  or  not;  if  the  answer  be  affirmative,  he  shall  immediately  notify  the 
fact  to  the  sanitary  chief. 

Seo.  195.  He  shall  compel  the  tenants  to  deposit  the  garbage  and  refuse  in  galvanized- 
iron  receptacles,  to  be  furnished  by  the  owner  of  the  building  and  made  in  accordance  with 
the  model  and  number  prescribed  by  the  sanitary  board. 

Seo.  196.  He  shall  see  that  all  courts,  yards,  and  corridors  are  always  kept  perfectly 
clean,  and  for  this  purpose  he  shall  not  allow  garbage  or  dirty  water  to  be  thrown  in  said 
courts,  yards,  or  corridors. 

Seo.  197.  He  shall  not  permit  the  deposit  in  the  building  of  furniture  or  articles  not  in  use. 

Seo.  198.  He  shall  see  that  the  inlets  to  sinks  are  supplied  with  water  and  properly 
covered.  He  shall  inspect  the  same  frequently  to  see  that  they  are  in  good  condition,  as 
well  as  the  faucets,  traps,  sinks,  washstands,  and  other  sanitary  plumbing. 

Sec.  199.  He  shall  see  that  water-closets  and  urinals  are  always  kept  clean  and  in  good 
serviceable  condition,  and  that  no  urine  or  other  filthy  substances  are  deposited  on  the 
floors  thereof. 

Seo.  200.  He  shall  inspect  all  rooms  in  the  building  in  order  to  see  that  they  are  kept 
clean.  Should  he  find  any  room  in  an  unsanitary  condition  he  shall  admonish  the  tenant, 
and  if  such  tenant  refuses  to  comply  vñth  the  notice  he  shall  report  the  fact  to  the  sanitary 
chief. 

Sec.  201.  He  shall  keep  the  courts  or  yards  in  such  a  condition  that  no  puddles  can  be 
formed,  and  he  shall  see  that  the  wells,  cisterns,  tanks,  and  other  receptacles  for  water  are 
properly  protected  v/ith  covers  of  wire  gauze  against  the  access  of  mosquitoes. 

Sec.  202.  He  shall  not  allow  in  any  room  overnight  a  greater  number  of  persons  than  that 
corresponding  to  its  capacity  as  prescribed  by  the  sanitary  board,  which  number  shall  be 
posted  in  every  room. 

Sec.  203.  Inxmediately  after  a  room  is  left  vacant  he  shall  clean  it  thoroughly  before  it  is 
rented  again,  keeping  it  closed  in  the  meanwhile.  If  a  case  of  any  disease  the  report  of 
which  is  compulsory  should  have  occurred  in  the  room,  he  shall  notify  the  fact  to  the  local 
sanitary  chief  for  the  necessary  disinfection. 

Seo.  204.  Every  tenement  house  shall  be  provided  with  cuspidors  in  the  proportion  of  one 
to  every  20  persons,  which  cuspidors  shall  be  placed  upon  stands  1  meter  high,  in  courts, 
passages,  and  corridors,  and  it  shall  be  the  duty  of  the  person  in  charge  of  the  building  to 
keep  them  clean  and  supplied  with  the  antiseptic  solution  prescribed  by  the  board. 

Sec.  205.  Every  tenement  house  shall  be  provided  with  one  water-closet,  one  bathroom, 
and  one  sink  for  every  20  persons;  the  floors  and  walls  of  such  water-closets  and  bathrooms 
shall  be  impermeable,  and  also  the  walls  to  a  height  of  IJ  meters,  at  least. 

Sec.  206.  All  tenement  houses  shall  be  provided  with  water  supply  sufficient  to  furnish 
at  least  100  liters  daily  for  each  person. 

Sec.  207.  Roofs,  walls,  doors,  and  windows  of  tenement  houses  shall  be  kept  clean,  white- 
washed and  painted,  and  without  clefts.  The  walls  shall  be  whitewashed  at  least  once  a 
year. 

5610—06 9 


18U  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sec.  20S.  The  placing  of  cloth  or  paper  over  holes  or  small  windows  of  rooms  in  such 
manner  as  to  obstruct  the  access  of  light  or  air,  is  prohibited. 

Sec.  203.  Wash  tubs,  or  other  receptables  for  washing  purposes,  should  have  metal  hoops, 
and  props  for  stands,  and  not  barrels,  cases,  or  other  such  devices.  Walls,  in  places  assigned 
to  washing  purposes,  should  be  covered  with  impermeable  material  to  a  height  of  at  least 
li  meters. 

Sec.  210.  Washing  or  coolting  in  dwelling  rooms  is  prohibited.  All  newly  constructed 
tenement  houses  shall  be  provided  with  special  compartments,  uninliabited  and  for  general 
use,  one  for  the  washing  place  and  the  other  for  the  kitchen. 

Sec.  211.  Dividing  of  rooms  by  means  of  thin  walls,  whatever  be  the  material  employed 
for  the  purpose,  is  hereby  prohibited. 

Sec.  212.  The  smallest  room  in  a  tenement  house  should  not  be  less  than  9  square 
meters  in  area  and  4  meters  high. 

Sec.  213.  Industrial  or  commercial  establishments  in  tenement  houses  arc  prohibited; 
therefore,  no  shops  of  any  kind  can  be  conducted  wñthin  the  piemises  of  said  buildings, 
except  in  those  higher  than  one  story,  the  entrance  and  sanitary  service  being  independent 
from  the  part  assigned  to  living  purposes,  all  with  the  consent  of  the  sanitary  board. 

Sec.  214.  No  stables  shall  be  permitted  in  tenement  houses,  nor  can  animals  of  enxy  kind 
be  kept  therein,  except  birds  in  cages. 

Sec.  215.  Any  person  sud'ering  from  a  contagious  disease  in  a  tenement  house  shall  be 
removed  to  an  isolation  hospital  whenever  the  sanitary  chief  shall  deem  it  nccessan,'. 

Sec.  216-  Should  the  person  in  charge  of  a  tenement  house  encounter  resistance  on  the 
part  of  tenant  to  comply  with  the  provisions  of  these  ordinances,  or  should  any  tenant  violate 
any  of  said  provisions,  it  shall  be  his  duty  to  report  the  fact  immediately  to  the  sanitary 
chief. 

Sec.  217.  Newly  constructed  buildings  shall  not  be  used  as  tenement  houses  imtil  the 
plans  thereof  shall  have  been  approved  by  the  sanitary  board;  nor  shall  buildings  already 
existing  be  used  for  like  purposes  without  the  previous  consent  of  the  sanitary  board. 

Sec.  218.  It  shall  be  the  duty  of  persons  in  charge  of  tenement  houses  to  furnish  the 
sanitary  inspector  anji^  information  in  regard  to  said  buildings,  and  also  to  accompany 
them  upon  their  inspection  visits. 

Sec.  219.  Printed  copies  of  the  rules  contained  in  this  chapter  shall  be  posted  at  the 
entrance  of  every  tenement  house,  said  copies  to  be  furnished  by  the  local  sanitary  board. 

Chapter  VI. 

PRIVATE   HOUSES   AND   BUILDINGS   JN    GENERAL. 

Sec.  220.  All  houses,  buildings,  constructions,  etc.,  are  hereby  made  subject  to  sanitary 
inspection  by  the  local  sanitary  board,  and  their  owners,  keepers,  agents,  lessees,  tenants, 
inhabitants, "etc.,  shall  allow  and  facilitate  any  inspection  by  the  officers  or  agents  duly 
authorized  by  the  local  sanitary  board,  and  also  carry  out,  or  permit  the  carrying  lOut  of, 
the  sanitary  works  in  the  house  which  might  have  been  ordered  as  a  consequence  of  the 
inspection. 

Sec.  221.  Every  house  or  dwelling  shall  be  provided  with  all  the  necessary  hygienic  con- 
ditions, so  that  it  shall  not  constitute  a  danger  or  menace  to  the  health  or  life  of  its  inhab- 
itants and  neighbors. 

Sec.  222.  Every  house,  or  floor  thereof  rented  separately,  shall  be  provided  with  water 
supply  sufficient  for  the  domestic  necessities  of  its  inhabitants,  at  the  rate  of  100  liters,  at 
least,  per  day  for  each  person. 

Sec.  223.  Owners  or  tenants,  as  the  case  may  be,  shall  take  the  necessary  precautions  to 
prevent  the  sewers,  sinks,  water-closets,  etc.,  from  exhaling  emanations  or  other  annoying 
odors. 

Sec.  '224.  Drainpipes  should  be  sufBciently  ventilated  and  have  all  the  necessary'  require- 
ments to  facilitate  the  discharge  of  refuse  matter,  prevent  nitrations  through  walls  and  pave- 
ments, and  permit  the  escape  of  gases  in  such-  a  manner  that  they  shall  not  be  detrimental 
to  the  health  of  tenants  end  neighbors;  to  this  end  the  construction,  installation,  or  altera- 
tion of  the  same  shall  conform  with  the  engineering  specifications  prescribed  in  the  respec- 
tive permit.  Similar  specifications  are  required  in  the  case  of  water-closets,  cesspools,  scul- 
leries, sinks,  and  other  sanitary  plumbing. 

Sec.  225.  The  consti-uction  of  drainpipes,  ventilating  tubes,  or  smokestacks  which  may 
annoy  or  damage  the  neighboring  houses,  or  that  in  which  the  same  are  intended  to  be  con- 
structed, is  prohibited.  The  provisions  of  this  section  shall  be  applied  to  such  drainpipes, 
etc.,  that  are  already  constructed. 

Sec.  226.  Houses  in  towns  where  there  are  aqueducts  and  sewers  shall  be  provided  with 
water-closets  of  the  system  adopted  by  the  Superior  Sanitary  Board,  exclusive  of  any  other 
system.     Houses  in  towns  where  there  are  no  aqueducts  or  sewers  shall  be  provided  with 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  131 

cesspools,  constructed  in  accordiance  with  the  proper  engineering  specifications  and  at  a 

distance  of  not  Joss  than  10  meters  from  wells,  cisterns,  rooms,  anrl  kitchens,  nnless  the 
sanitary  l)oar(i  should  adopt  otiiei'  system  for  tl](!  collfiction  and  (ixtniction  of  feed  matter. 

Sko.  227.  Cesspools  and  dumps  sliall  he  constructed  in  such  a  manner  aa  to  prevent  the 
overflow  on  account  of  rains. 

Seo.  22S.  The  construction  or  existence  of  cesspools  and  sinks  in  houses  shall  only  be  per- 
mitted in  streets  whore  there  are  no  sewers. 

Sec.  229.  The  owner  or  tenant  of  every  house  shaJl  pour  into  cesspools  and  sinks  unslaked 
lime,  sulphate  of  iron,  creohne,  or  other  disinfecting  substancies,  when  so  ordered  by  the  sani- 
tary boai'd  for  special  reasons. 

Sec.  230.  Pavements  of  water-closets,  bathrooms,  washing  places,  sculleries,  etc.,  shall  be 
made  of  inj^permeable  material,  and  the  walls  shall  be  covered  with  the  same  material,  if  they 
are  made  of  sto.?e,  to  a  height  of  1^  meters,  at  least,  and  oil  painted  if  they  are  wooden. 

Sec.  231.  Owners  of  houses  shall  sec  that  cesspools  and  sinks  are  never  filled  up  nor 
allowed  to  overflow,  ordering  the  cleaning  of  the  same  whenever  necessary.  In  ca.se  they 
shall  fail  to  do  so,  the  sanitary  board  shall  cause  such  cleaning  to  be  made  by  the  public 
service  of  cleaning  at  the  expense  of  the  owner  of  the  house,  irrespective  of  the  fine  wliich  may 
be  imposed  on  him  for  the  oil'ense. 

Sec.  232.  Wells,  cisterns,  tanks,  or  other  receptacles  for  water  shall  be  so  arranged  that 
no  dampness  from  the  same  can  be  communicated  to  rooms,  and  that  no  iiltrations  be 
received  by  the  same  from  cesspools  and  sinks,  and  they  shall  always  be  protected  with 
wire-gauze  covers  against  the  access  of  mosquitos. 

Only  fountains  constantly  operating  with  running  water  shall  be  permitted. 

Sec.  233.  No  deposit  of  refuse,  garbage,  or  offal,  stanched  water,  or  any  other  matter  dele- 
terious to  health  shall  be  permitted  within  the  premises  of  any  house. 

Sec.  234.  Receptacles  used  for  containing  garbage  and  refuse  shall  be  placed  as  distantly 
as  possible  from  the  rooms  of  the  house  and  must  not  have  holes. 

Sec.  235.  Breeding  or  fattening  of  pigs  within  city  limits  is  prohibited;  and  it  shall  only 
be  permitted  at  a  distance  of  200  meters  from  said  boundaries. 

Sec.  236.  Rooms  used  as  kitchens,  or  permanent  stoves  or  furnaces,  should  be  provided 
with  mantles  or  chimneys  to  facilitate  the  escape  of  gases  and  smoke  generated  by  com- 
bustion, so  built  that  they  shall  not  injure  the  health  of  tenants  and  neighbors.  Portable 
furnaces  shall  be  placed,  when  in  use,  in  places  where  they  shall  not  be  annoying  to  tenants 
or  dwellers. 

Sec.  237.  All  rooms,  outbuildings,  courts,  roofs,  and  sanitary  plmnbing  of  a  house  shall 
always  be  kept  perfectly  clean.  Walls  must  be  kept  in  good  condition  and  properly  painted, 
as  well  as  doors  and  windows ;  pavements  and  roofs  must  be  kept  in  good  condition  in  order 
to  prevent  humidity  in  rooms,  and  for  this  purpose,  wherever  necessary,  the  construction 
of  drainpipes  and  conduits  shall  be  required. 

Sec.  238.  Stables  shall  only  be  permitted  in  perfectly  ventilated  places,  with  impermeable 
pavements  and  walls,  and  all  the  requirements  prescribed  by  the  special  regulations  for 
stables. 

Sec.  239.  The  use  of  cellars  and  semisubterraneous  places  for  sleeping  or  dwelling  piir- 
poses  is  hereby  prohibited,  and  no  door  or  opening  communicating  a  cellar  with  a  bedroom 
shall  be  permitted.  This  prohibition  shall  be  applicable  to  ground  floors  if  the  height  of 
the  same  be  less  than  2J  meters  and  if  they  are  not  provided  with  windows  to  furnish  suffi- 
cient ventilation. 

Sec.  240.  The  accumulation  of  domestic  animals,  such  as  dogs,  cats,  rabbits,  poultry, 
pigeons,  birds,  etc.,  in  rooms  shall  not  be  permitted. 

Sec.  241.  If  a  house  or  a  part  thereof  be  declared  unhealthy,  as  a  result  of  the  inspection, 
the  sanitary  chief  shall  notify  the  fact  to  the  owner  or  tenant,  as  the  case  may  be,  giving 
him  sufficient  time  within  which  he  may  make  the  works,  repairs,  or  improvements  that  he 
might  have  been  ordered  to  carry  out.  At  the  expiration  of  the  time  allowed  a  reinspection 
of  the  building  shall  be  made  for  the  purpose  of  ascertaining  whether  the  order  has  been 
complied  with  or  not.  If  not,  and  if  the  justifiable  and  unavoidable  causes  that  prevented 
the  carrying  out  the  works  ordered  have  not  been  stated  in  writing,  a  complaint  shall  be  filed 
before  the  proper  court  for  the  imposition  of  the  penalty  fixed  by  law,  and  further  period  of 
time  shall  again  be  granted  for  like  purpose.  If  after  the  third  time  the  works  have  not  been 
carried  out  the  house  or  part  thereof,  as  the  case  may  be,  shall  be  declared  uninliabitable 
and  the  police  shall  proceed  to  dislodge  it  and  close  it  within  thirty  days.  It  shall  remain 
closed  until  the  worl¿  ordered  shaU  have  been  carried  out. 

Sec.  242.  A  house  or  building,  or  part  thereof,  used  for  dwelling,  sleeping,  manufacturing, 
or  other  purposes,  which  constitutes  a  permanent  danger  to  health  or  Hfe,  and  which  can 
not  be  placed  in  proper  hygienic  conditions,  shall  be  declared  uninhabitable  or  dangerous 
after  proper  investigation  and  shall  be  dislodged  and  closed  upon  order  of  the  sanitary 
chief  by  the  police  within  thirty  days. 


132  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Chapter  VII. 
schools  and  colleges. 

Sec.  243.  No  school  or  college  shall  be  established  without  the  favorable  report  of  the 
local  sanitary  board  in  regard  to  location,  hygienic  conditions,  sanitary  plumbing,  and 
capacity  of  the  building  in  proportion  to  the  number  of  pupils  and  school  furniture. 

Sec.  244.  Lecture  halls  must  be  dry,  with  good  sufficient  ventilation,  and  an  area  in 
proportion  to  the  nmuber  of  pupils  at  the  rate  of  1^  meters  per  person. 

Sec.  245.  School  and  college  buildings  shall  be  pro^•ided  with  one  water-closet  for  every 
30  pupils  at  least  and  as  many  urinals  as  it  is  deemed  necessary. 

Sec.  246.  Sanitary  plumbing  of  schools  and  colleges  shall  always  be  kept  perfectly  clean, 
■as  well  as  the  outbuildings,  courts,  floors,  walls,  etc. 

Sec.  247.  Schools  and  colleges  are  subject  to  inspection  by  the  local  sanitary  board 
regarding  the  buildings  as  well  as  the  condition  of  the  health  of  professors  and  pupils. 

Sec.  248.  Every  pupil  in  a  school  or  college  shall  be  vaccinated  and  the  parents,  guardians, 
■etc.,  shall  be  responsible  for  violation  of  this  provision,  as  well  as  tlie  director  and  professor, 
as  the  case  may  be.  The  same  provision  is  applicable  to  the  director,  teachers,  and  other 
^subordinate  employees. 

Sec.  249.  When  the  director  of  a  school  or  college  finds  that  a  pupil,  teacher,  servant,  etc., 
lives  in  a  place  where  a  contagious  disease  prevails,  he  shall  dismiss  such  person  ft-om  the 
school  temporarily  and  give  notice  of  the  fact  to  the  sanitary  chief  within  twenty-four  hours. 

Sec.  250.  No  pupil,  teacher,  servant,  etc.,  so  dismissed  shall  be  readmitted  to  the  school 
or  college  without  the  proper  authorization  from  the  sanitary  chief. 

The  provisions  of  this  and  the  preceding  section  shall  also  be  applicable  to  night  and 
Sunday  schools. 

Sec.  251.  The  permanent  or  temporary  closing  of  a  school  or  college  on  account  of  the 
-prevalence  therein  of  a  contagious  disease  or  of  the  unhealthy  condition  of  the  building 
shall  be  ordered  by  the  local  sanitary  board. 

Sec.  252.  Persons  suffering  from  chronic  contagious  diseases  shall  not  be  permitted  to 
discharge  any  office  or  position  in  a  school  or  college. 

Chapter  VIII. 

FACTORIES   AND  WORKSHOPS. 

Sec.  253.  Before  a  permit  for  the  installation  of  a  factory  or  workshop  is  issued,  the 
favorable  report  of  the  sanitary  board  is  necessary.  Said  report  shall  be  prepared  upon  the 
statement  submitted  to  the  board  expressing  the  nature  of  the  establishment,  its  location, 
technical  conditions,  proper  for  its  industrial  purposes,  safety,  stability,  light,  ventilation, 
capacity,  kind  and  maximum  munber  of  machines  and  apparatus  to  be  operated,  and 
number  of  laborers  and  other  employees. 

Sec.  254.  Every  factory  or  workshop  shall  have  an  area  of  2  square  meters  per  person  and 
a  cubic  volume  of  at  least  12  meters. 

Sec.  255.  Workshops  shall  be  located  in  dry  places,  with  good  light  and  ventilation  and 
■other  hygienic  requirements  necessary  for  the  health  and  life  of  laborers  and  employees. 

Sec.  256.  Factories  or  workshops  in  which,  due  to  the  nature  of  the  works,  gases,  dust,  or 
liquid  refuse,  annoying  or  noxious  to  laborers,  employees  or  neighbors,  are  indispensably 
produced,  shall  be  provided  with  the  proper  means  of  gathering  and  distributing  said  gases, 
-dust,  or  liquid  refuse,  without  constituting  any  danger,  by  the  process  deemed  necessary 
and  approved  by  the  local  sanitary  board. 

Sec.  257.  Owners  of  factories,  workshops,  establishments,  houses,  etc.,  where  smoke- 
stacks are  to  be  or  have  been  already  placed,  shall  construct  or  modify  them,  as  the  case 
may  be,  in  such  a  manner  that  the  smoke  can  not  have  access  into  neighboring  houses  or 
rooms. 

Sec.  258.  The  discharge  of  refuse  matter  from  workshops,  factories,  or  industrial  estab- 
lishments into  streams,  canals,  rivers,  etc.,  the  waters  of  which  ai'e  used  for  fishing,  drinking, 
qr  other  purposes  is  prohibited,  unless  such  refuse  matter  be  previously  purified  by  means 
of  proper  process  approved  by  the  Superior  Board. 

Sec.  259.  No  child  under  the  age  of  14  years  shall  be  employed  in  any  factory  or  work- 
shop. Minors  under  18  years  of  age  shall  not  be  employed  for  the  handling  of  dangerous 
machines  or  apparatus. 

Sec.  260.  Factories  or  workshops  where  there  are  machines,  or  where  dangerous  sub- 
stances are  manufactured,  and  the  number  of  laborers  exceeds  200,  shall  have  a  permanent 
physician  during  the  labor  hours  ready  to  render  his  assistance  in  case  of  accident. 

Sec.  261.  Every  factory  or  workshop  shall  be  provided  with  cuspidors  in  proportion  to 
the  nmnber  of  laborers.  Said  cuspidors  shall  be  kept  perfectly  clean  and  washed  daily 
with  boiling  water  or  some  disinfecting  solution.     The  sanitary  board  shall  prescribe  the 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  133 

model  and  number  of  said  cuspidors,  and  tlio  disinfecting  solution  wJiich  tlie  same  shall 
contain  and  that  with  which  they  shall  be  washed. 

Seo.  262.  Factories  and  workshops  shall  bo  provided  with  sufficient  number  of  water- 
closets  in  a  proportion  of  at  least  5  per  cent  of  persons,  and  urinals  and  washstands,  all  of 
which  shall  be  kept  perfectly  clean  and  in  good  serviceable  condition. 

Seo.  263.  Owners  or  managers  of  factories  or  workshops  shall  not  permit  therein  any 
laborer  or  employee  suffering  from  a  contagious  disease. 

Seo.  264.  (Jigar  factories  shall  be  subject  to  the  following  provisions: 

(a)  Working  tables  shall  be  so  arranged  that  the  laborers  shall  not  sit  facing  each  other. 

(b)  Each  table  shall  be  provided  with  a  small  receptacle  made  of  enameled  iron,  for 
the  water  and  paste  to  be  used  in  the  confection  of  cigars.  The  use  of  saliva  and  the  teeth 
in  such  coijfection  shall  not  be  permitted. 

(c)  Every  table  shall  be  provided  with  a  receptacle  for  the  waste  of  materials  employed 
in  manufacturing  cigars. 

(d)  Walls  and  tables  shall  be  cleansed  once  a  week,  at  least. 

(e)  Cloth  used  in  tables  for  gathering  waste  matter  shall  be  kept  clean. 

(f)  Spitting  on  floors  shall  be  prohibited. 

(g)  There  shall  be  a  cuspidor  for  every  laborer, 
(h)  Pavements  shall  be  washed  daily. 

(i)  They  shall  be  so  kept  that  no  cracks  may  be  found  thereon. 

(j)  Windows  of  workrooms  shall  be  so  airanged  that  the  upper  part  thereof  shall  remain 
open. 

(k)  There  shall  be  in  workrooms  a  space  of  20  cubic  meters  for  every  laborer. 

(1)  The  manufacture  of  cigars,  etc.,  in  bedrooms  is  prohibited. 

(m)  The  sale  of  tobacco  refuse  which  shall  have  fallen  upon  floors  shall  not  be  permitted. 

(n)  Water  which  shall  have  been  used  in  the  confection  of  cigars  must  be  thrown  away 
before  it  decomposes. 

Seo.  265.  Factories,  workshops,  and  industrial  establishments  in  general,  where  machin- 
ery, apparatus,  etc.,  are  employed,  shall  have  the  same  mounted  in  such  manner  that  the 
parts  thereon  which  by  their  movement  or  other  cause  constitute  a  danger,  shall  be  covered 
or  protected  with  wire  gauze  or  other  material.  Steam  boilers  or  other  means  of  generat- 
ing motive  power  shall  be  kept  in  the  best  condition  of  safety  and  must  be  explosion  proof ; 
all  buildings  pertaining  to  an  industrial  establishment  shall  be  so  constructed  as  to  prevent 
danger  of  lives. 

Wells,  traps,  holes,  etc. ,  shall  be  kept  closed. 

The  foregoing  provisions  are  also  applicable  to  theaters,  circuses,  stores,  and  other  estab- 
lishments where  mechanical  apparatus  are  emplo3'^ed. 

Chapter  LX. 

dangerous,  unhealthful  or  annoying  factories,  industries  and  establishments. 

Sec.  266.  Dangerous,  unhealthful  or  annoying  factories,  industries,  and  establishments 
shall  not  be  permitted  hereafter  except  in  accordance  with  the  following  requirements  as  to 
their  location  the  respective  classiñcation  and  the  prescriptions  of  the  regulations  con- 
cerning the  same : 

(a)  They  shall  be  located  far  from  dwellings,  streets,  and  roads. 

(b)  They  may  be  located  in  the  suburbs  of  towns. 

(c)  They  may  be  located  in  any  part  of  the  city,  but  subject  to  frequent  inspection  and 
governmental  prescriptions. 

Sec.  267.  Besides  the  requirements  of -construction,  engineering,  etc. ,  prescribed  by  the 
ayuntamiento,  no  permit  shall  be  granted  for  the  installation  of  any  of  such  factories  or  estab- 
lishments, without  the  favorable  report  of  the  local  sanitary  board;  and  it  shall  not  be 
operated  until  after  it  has  been  demonstrated  to  the  board  that  all  sanitary  requirements 
prescribed  in  the  permit  have  been  complied  with.  An  appeal  from  the  decision  of  the 
local  board  may  be  taken  to  the  Superior  Board. 

Sec.  268.  The  kind  of  products  sought  to  be  manufactured  in  the  factory  or  establish- 
ment shall  be  stated  in  the  permit  or  license  for  the  installation  and  operation  thereof,  as 
well  as  the  process  of  manufacture  to  be  followed  and  the  maximum  amount  of  goods  that 
the  warehouses  or  storerooms  can  contain. 

Sec.  269.  When  a  factory  or  industrial  establishment  shall  have  suspended  its  operations 
for  more  than  a  year,  or  has  to  be  removed  to  another  location,  it  shall  have  to  fill  the  same 
requirements  as  if  it  were  a  new  one. 

Sec.  270.  When  the  interest  of  public  health  shall  so  demand  it,  the  removal  of  any 
establishment  may  be  compelled  through  due  process  of  law. 

Sec.  271.  Departments  in  factories  or  industrial  establishments,  where  organic  sub- 
stances susceptible  of  easy  decomposition  are  manufactured,  shall  be  provided  with  per- 
fectly impermeable  pavements,  and  sufficient  supply  of  water  for  frequent  washing. 


13-4  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sec.  272.  No  organic  substances  shall  be  stored  in  a  factory  or  industrial  establishment 
over  twenty-four  hours,  unless  they  be  protected  against  decompositioa.  Waste  matter 
and  reñise  shall  be  collected  eveiy  day  from  such  establishments. 

Sec.  273.  The  preparation  or  cooking  of  animal  refuse,  for  industrial  or  commercial  pur- 
poses, within  city  limits,  is  prohibited  as  well  as  the  grinding  or  trituration  of  bones  or  shells, 
and  other  industrial  operations  producing  fetid  odors,  or  which  might  endanger  public 
health. 

Sec.  274.  Renting  or  ceding  rooms  for  dwelling  or  sleeping  purposes  in  houses  or  buildings 
where  there  are  dangerous  or  unliealthful  establishments  or  factories,  is  prohibited.  The 
connection  of  such  establishments  or  factories  with  tenement  houses  is  likewise  prohibited. 

Sec.  275.  No  laundiy  shall  be  established  in  a  house,  unless  said  house  b^  previously 
inspected  by  the  sanitary  board  and  a  favorable  report  from  tlie  same  be  secured  for  the 
purpose. 

Sec.  276.  In  laundries  where  steam  is  not  used,  the  clothes  shall  be  immersed  in  boiling 
water  for  at  least  an  hour. 

Sec.  277.  The  local  sanitary  board  shall  prescribe  in  each  case  the  requirements  which 
the  sanitaiy  .service  in  laundries  must  have  (cemented  tanks,  drainage,  etc.). 

Sec.  278.  Stables  for  all  kinds  of  animals  shall  be  considered  as  unhealthful  establish- 
ments, subject  to  special  regulations,  and  shall  be  located  in  the  suburbs. 

Sec.  279.  No  license  shall  be  granted  for  the  installation  and  operation  of  stables  without 
the  favorable  report  of  the  local  sanitary  board. 

Sec.  280.  The  sanitary  conditions  required  for  the  granting  of  such  licenses,  and  to 
which  all  existing  stables  shall  be  subject,  are  as  follows: 

(a)  Stables  shall  be  located  outside  of  the  city  limits. 

(b)  Buildings  for  stables  shall  be  made  of  stone,  brick  or  iron,  5  or  6  meters  high,  and 
shall  be  provided  with  ventilating  holes,  one  for  every  4  animals. 

(c)  The  stables  shall  be  in  galleries  4  meters  high  at  least. 

(d)  Galleries  having  only  one  manger  adhered  to  the  wall  shall  not  be  less  than  4 
meters  wide  in  all  its  longitude. 

(e)  The  walls  shall  be  covered  with  cement  or  other  impermeable  material. 

(f1  The  racks  for  forage  shall  be  made  of  iron ;  the  mangers  may  be  made  of  wood. 

(g)  The  pavements  shall  be  made  of  cement,  with  an  inclination  of  at  least  200  per   cent. 

(h)  The  sewers  shall  be  constructed  with  a  bottom  of  an  elhptical  shape,  and  shall  be 
perfectly  polished. 

(i)  In  order  to  prevent  the  animals  from  slipping,  or  catching  cold  when  lying  down  on 
the  pavement,  the  same  shall  be  covered  with  wooden  boards  about  2  inches  thick,  said 
boards  to  be  removable  and  placed  in  such  a  manner  that  sufficient  space  be  left  between 
the  boards  and  the  pavement. 

(j)  Each  animal  shall  be  separated  one  from  the  other  by  a  proper  distance.  The 
stables  shall  be  provided  with  proper  divisions  of  a  space  1^  meters  wide. 

(k)  Racks  for  forage  of  all  kinds  shall  be  made  of  stone,  brick,  or  iron. 

(1)  Stables  shall  have  an  infirmary,  which  shall  be  independent  from  the  rest  of  the 
premises,  and  where  only  the  sick  animals  affected  with  diseases  not  transmissible  to  man- 
kind, shall  be  lodged. 

(m)  In  case  there  be  no  general  sewer  system  in  the  place  where  a  stable  is  located,  the 
excreta  shall  be  deposited  in  a  dumping  place  of  the  capacity  prescribed  in  each  case;  such 
dumping  place  shall  be  made  of  impermeable  materials,  and  must  be  emptied  whenever 
necessary,  the  contents  being  removed  to  the  general  dumping  places  of  the  city. 

(n)  Stable  buildings  shall  be  provided  with  the  necessary  number  of  ventilators  or  win- 
dows. 

(o)  The  drinking  troughs  shall  be  made  of  impermeable  materials  and  so  arranged  that 
they  may  be  easily  cleaned.     There  shall  be  one  drinking  trough  for  each  animal. 

Sec.  281.  Dwellings  in  stables  are  prohibited,  except  those  exclusively  assigned  to 
employees  thereof;  establishments  having  no  connection  whatever  with  stables  are  like- 
wise prohibited  therein. 

Sec.  282.  Stables  shall  be  provided  with  water  supply  sufficient  to  furnish  the  necessary 
amount  of  water  for  the  general  cleaning,  which  shall  be  made  twice  a  day  at  least. 

Sec.  283.  Garbage  and  excrement  shall  be  removed  from  stables  eveiy  day  and  taken 
to  the  general  dumping  places  in  the  manner  prescribed  for  the  public  collection  and  disposal 
of  garbage. 

Sec.  284.  The  excreta  shall  be  deposited  in  metal  receptacles  which  shall  be  cleansed 
and  disinfected  daily. 

Sec.  285.  Pavements  of  yards,  workshops,  and  other  compartments  for  the  storage  of 
outfits,  etc. ,  shall  be  perfectly  filled  \vith  stone  or  macadam. 

Sec.  286.  Sick  animals  shall  not  be  employed  in  any  kind  of  work. 

Sec.  287.  It  shall  be  the  duty  of  owners  of  stables  to  engage  the  services  of  a  veterinarian 
who  shall  inspect  the  cattle  once  a  week  at  least. 


dECOND    INTERNATIONAL    SANITARY    CONVKNTION.  1Í55 

Sec.  288.  Whenever  the  municipal  veterinarian,  or  sanitary  inspectors,  make  an  inspection 
of  stables  they  shall  record  the  inspection  in  a  book  kept  for  the  purpose  in  every  stable. 

Sioc.  2S9.  Whenever  tluu'c  is  an  animal  suircsring  from  a  disease  transmi.ssible  to  mankind, 
the  veterinary  attending  such  animal,  or,  in  his  st(!ad,  the  owner  thereof  or  other  interested 
person,  shall  report  the  casci  to  the  local  sanitary  chief. 

Sec.  290.  When  an  animal  suffering  fi-om  an  infectious  disease  is  removed  from  the  stables 
the  municipal  veterinarian  shall  see  that  a  thorough  disinfection  is  made  in  the  place  con- 
sidered infected,  and,  in  cases  of  glanders,  that  the  harness  used  on  such  animal  has  been 
also  disinfected. 

Sec.  291.  Stables  in  houses  and  private  establishments  .shall  l)e  sul^ject  to  the  provisions 
herein  contained  as  regards  the  construction  and  sanitation  thereof. 

Sec.  29^.  Stables  in  towns  where  there  is  no  sewer  system  sliall  be  provided  with  outlets 
to  dumping  places  of  sufficient  capacity.  , 

Sec.  293.  Stables  which  are  not  provided  with  open  sheds  must  have  ventilating  tubes 
projecting  2  meters  out  of  the  ceiling.  Said  tubes  may  be  provided  with  registers  to  regulate 
the  current  of  air. 

Sec.  294.  Stable  utensils,  such  as  pails,  or  water  receptacles,  sponges,  forage  racks,  etc., 
shall  always  be  kept  clean. 

Sec.  295.  Stables  shall  be  washed  twice  a  day. 

Sec.  296.  Animals  in  stables  shall  be  subjected  to  the  test  of  "maleina." 

Sec.  297.  Dangerous  or  annoying  estabhshments,  deposits,  or  factories  must  always  be 
kept  perfectly  clean,  so  that  the  operations  therein  shall  not  be  detrimental  to  public  health. 

Chapter  X. 

SLAUGHTERHOUSES   AND    SLAUGHTERING. 

Sec.  298.  No  slaughterhouse  shall  be  constructed  without  the  favorable  report  of  the 
local  sanitary  board,  approved  by  the  Superior  Sanitary  Board,  after  consideration  of  the 
plans,  specifications,  and  other  documents. 

Sec.  299.  Rooms  for  dwelling  purposes  in  slaughterhouses  are  prohibited  except  when 
specially  permitted  in  writing  by  the  Superior  Board. 

Sec.  300.  Every  ayuntamiento  shall  have  a  public  slaughterhouse  with  the  necessary 
departments,  personnel,  sanitary  service,  etc. 

Sec.  301.  Private  slaughtering  for  the  consumption  of  meat  in  farms  or  factories  is  pro- 
hibited, unless  it  shall  be  duly  authorized  and  made  in  accordance  with  provisions  prescribed 
by  the  local  sanitary  board. 

Sec.  302.  Slaughterhouses  shall  be  managed  by  special  regulations,  to  be  approved  by 
the  Superior  Sanitary  Board,  as  regards  the  sanitary  service  therein. 

Sec.  303.  Slaughtering  of  animals  for  public  consumption  shall  be  made  in  the  official 
slaughterhouses  of  municipalities  only. 

Sec.  304.  Slaughtering  in  courts  or  yards  of  houses  within  city  limits  is  prohibited. 
Slaughtering  in  country  houses  or  houses  in  towns  of  lesser  importance  is  prohibited  unless 
it  be  intended  for  private  consumption:  a  favorable  certificate  of  the  examination  of  the 
animal  by  a  competent  official  shall  be  necessary  therefor. 

Sec.  305.  Animals  intended  for  public  consumption  shall  be  examined  before  and  after 
the  slaughter  by  the  veterinarian  or  by  a  physician  if  there  be  no  veterinarian.  If  the  exami- 
nation shows  that  the  animal  is  not  completely  healthy  it  shall  be  condemned. 

Sec.  306.  Animals  that  are  to  be  slaughtered  must  be  perfectly  clean  and  kept  in  the 
slaughterhouse  corral  during  six  hours  before  they  are  slaughtered.  The  corrals  shall  be 
thoroughly  cleaned  every  twenty-four  hours ;  their  capacity  shall  be  in  proportion  with  the 
number  of  animals ;  said  corrals  must  be  well  ventilated  and  provided  with  sufficient  water 
and  drinking  troughs  and  other  requirements  which  may  be  deemed  necassary. 

Sec.  307.  Persons  in  charge  of  corrals  shall  notify  to  the  respective  veterinarian  the  exist- 
ence therein  of  any  animal  suspected  of  being  sick. 

Sec.  308.  Slaughtering  of  thin,  pregnant,  beaten,  suffocated,  or  wounded  animals  or  of 
animals  sufl'ering  from  ulcers,  fever,  or  other  disease  which  in  the  discretion  of  the  veteri- 
narian may  render  them  unfit  for  consumption,  shall  not  be  permitted. 

Sec.  309.  Animals  that  are  to  be  slaughtered  must  be  able  to  go  to  the  slaughterhouse  on 
their  own  feet,  except  those  which  on  account  of  their  excessive  fatness  can  not  walk. 

Sec.  310.  Slaughterhouses  shall  be  kept  thoroughly  clean  and  ventilated,  and  all  offal, 
blood,  refuse,  and  other  filthy  matter  shall  be  removed  after  the  slaughtering.  All  refuse 
matter  shall  be  destroyed  or  removed  to  places  where  it  can  not  be  detrimental  to  pubhc 
health. 

Sec.  311.  The  transportation  of  meat  to  the  places  where  it  shall  be  sold  must  be  made  in 
the  best  condition  of  cleanliness  and  in  oil-painted  wagons,  the  inside  of  which  shaU  be  cov- 
ered with  tin  or  galvanized  iron ;  they  shall  be  provided  with  hooks  where  the  meat  shall  be 
hanged.     The  transportation  in  any  other  way  whatever  shall  not  be  permitted. 


136  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sec.  312.  Persons  employed  in  the  transportation  of  meat  must  be  cleanly  dressed  and 
shall  not  be  permitted  to  work  unless  they  wear  impermeable  overcoats. 

Sec.  313.  The  transportation  or  conveyance  of  refuse  matter  from  slaughterhouses 
thi-ough  the  streets  shall  not  be  permitted  unless  it  be  done  in  the  manner  prescribed  by  the 
sanitary  board. 

Sec.  314.  The  insufflation  of  the  skin  of  dead  animals  in  order  to  facilitate  the  operation 
of  flaying  shall  be  made  by  means  of  apparatus  fit  for  the  purpose;  such  insuflflation  by 
means  of  the  mouth  is  prohibited. 

Sec.  315.  The'  use,  even  though  temporary,  of  the  premises  of  a  slaughterhouse  for  any 
other  purposes  than  that  to  which  it  is  assigned  is  prohibited. 

Chapter  XI. 


Sec.  316.  No  market  shall  be  built  or  altered  without  the  favorable  report  of  the  local 
sanitary  board  after  consideration  of  the  plans  and  other  documents. 

Sec.  317.  The  capacity  of  a  market  shaU  be  in  proportion  with  the  commercial  necessi- 
ties of  the  locality;  every  market  shall  be  supplied  with  abundant  quantity  of  water;  the 
pavements  thereof  shall  be  made  of  impermeable  material  and  with  the  necessary  declivity  in 
order  to  prevent  stagnation;  the  pillars  shall  be  sufficiently  high  and  distant  from  each 
other  to  furnish  good  ventilation;  the  roofs  shall  be  provided  with  ventilating  holes,  and  if 
they  be  made  of  metal  sheets  they  shall  be  sufficiently  separated  from  the  waUs  in  order  to 
prevent  excesfeive  heat. 

Sec.  318.  Premises  of  markets  which  may  be  constructed  hereafter  shall  not  be  used  for 
dwelling  or  sleeping  purposes,  and  the  construction  of  dwellings  therein  shall  not  be  permit- 
ted. In  markets  already  in  existence  wherein  dwellings  are  permitted  and  to  which  the 
provisions  of  this  article  can  not  be  applied  on  account  of  special  circumstances,  such  dwell- 
ings shall  be  subject  to  the  necessary  conditions  required  by  public  health  and  sanitation. 

Sec.  319.  The  rules  which  the  local  sanitary  board  may  prescribe  for  the  sanitary  man- 
agement of  markets  shall  be  included  in  the  special  regulations  for  the  administration  of  the 
same. 

Sellers  shall  comply  with  all  provisions  in  regard  to  the  keeping  of  their  stands  in  the  best 
of  hygienic  conditions. 

Sec.  320.  The  sale  in  markets  of  cooked  food  products  of  any  kind  is  prohibited  except 
feet  and  intestines,  boiled  only  and  without  any  other  preparation  whatever;  the  use  of 
braziers,  furnaces,  stoves,  etc.,  within  markets  shall  not  be  permitted. 

Sec.  321.  Meat  or  fish  remaining  from  the  daily  sale  can  be  sold  only  when  preserved  on 
ice  or  salted. 

Sec.  322.  Stands  where  meat  is  sold  shaU  have  the  following  requirements: 

(1)  They  shall  be  provided  with  an  iron  or  steel  bar,  perfectly  polished  and  clean,  for 
hanging  the  meat. 

(2)  In  towns  where  it  be  practicable  to  do  so  a  water  cock  of  suflScient  gauge  shall  be 
placed  upon  the  sink,  which  wiU  be  connected  by  means  of  a  pipe  with  the  market  sewerage 
system. 

(3)  A  sink  inlet  with  hydraulic  plug. 

(4)  The  stands  must  be  oil  painted  and  kept  perfectly  clean. 

(5)  They  shall  be  provided  with  wire  gauze  doors  and  covers  to  prevent  the  access  of 
mosquitoes. 

(6)  There  shall  be  in  every  stand  a  marble  counter  and  a  table  of  the  same  material. 

(7)  The  meats  shall  be  so  placed  that  the  customers  and  other  persons  can  not  touch  them. 
Sec.  323.  The  use  of  hatchets  and  wooden  blocks  for  chopping  meat  is  prohibited;  the 

meat  and  bones  must  be  cut  with  knives  and  saws  respectively,  the  handles  of  which  must 
be  made  of  metal. 

Sec.  324.  Meat  and  fish  seUers  shall  wear  during  the  sale  hours  a  clean  white  apron. 
WaUs,  counters,  etc.,  of  stands  shall  be  washed  after  the  sale  hours. 

Sec.  325.  The  sale  of  meat  shall  be  discontinued  at  11  a.  m.  Meat  remaining  from  the 
sale  of  the  day  must  be  placed  in  the  refrigerator  or  shall  be  salted;  if  said  meat  be  kept 
otherwise  it  shall  not  be  sold  the  next  day. 

The  use  of  preserving  substances  other  than  common  salt  (sodium  chloride)  is  prohibited. 

Sec.  326.  The  giblets  shall  be  placed  in  the  refrigerator  as  soon  as  they  are  received  from 
the  slaughterhouse. 

Sec.  327.  The  sale  of  fish  or  mollusks  shall  be  discontinued  at  10  a.  m.  during  the  summer 
and  at  11  a.  m.  during  the  winter.  The  remnants  from  the  sale  shall  be  salted  or  placed  in 
the  refrigerator. 

Sec.  328.  Crabs,  lobsters,  and  other  crustaceans  must  be  sold  alive,  precisely. 

Sec.  329.  The  sale  of  oysters  during  the  months  of  May  and  August,  inclusive,  is  pro- 
hibited, and  oysters  in  a  decaying  condition  shall  be  thrown  away  immediately. 


SECOND  intí:rnational  manitary  convention.        137 

Seo.  330.  The  sale  of  scaled,  flayed,  beheaded,  or  in  any  other  way  mutilated  fish,  is  pro- 
hibited, except  fish  which  is  usually  sold  in  round  slices. 

Seo.  331.  The  sale  of  fishes  which  are  liable  to  cause  ciguatera  (kind  of  jaundice)  is  pro- 
hibited. 

Seo.  332.  Fish  sellers  must  be  cleanly  dressed  and  wear  a  white  apron  during  the  sale 
hours;  they  shall  wash  the  counters,  tables,  etc.,  every  day. 

Seo.  333.  Vessels  used  for  washing  vegetables,  etc.,  must  be  made  of  enameled  iron  or 
other  impermeable  material. 

Seo.  334.  The  sale  of  decayed  or  noxious  fruits  is  prohibited. 

Seo.  335.  The  sale  of  dead  domestic  rabbits  is  prohibited. 

Sec.  336.  Dead  poultry  and  game  must  be  disemboweled  and  perfectly  fresh,  it  being  the 
duty  of  the  sellers  to  preserve  said  poultry  and  game  in  refrigerators. 

Seo.  337.  Other  animals  for  public  consumption,  such  as  suckling  pigs,  kidlings,  rabbits, 
etc.,  must  be  perfectly  healthy,  fat,  and  clean. 

Seo.  338.  Throwing  refuse  matter  on  the  floors  is  prohibited.  All  refuse  matter  shall  be 
deposited  in  galvanized-iron  receptacles  provided  with  lids;  said  receptacles  shall  be 
placed  in  the  stands  and  marked  with  the  corresponding  number.  When  the  cleaning  of  a 
stand  has  been  completed,  said  receptacles  shall  be  placed  at  the  entrance  in  order  that  they 
may  be  collected  by  the  persons  in  charge  of  the  service. 

Seo.  339.  The  sewers  shall  be  kept  covered,  and  every  market,  in  towns  where  it  be 

{)racticable,  shall  be  provided  with  sanitary  water-closets  and  urinals  approved  by  the 
ocal  sanitary  board. 

Seo.  340.  The  general  cleaning  of  a  market  shall  be  made  twice  a  day  and  at  the  hour 
prescribed  in  the  administrative  regulations  of  the  market.  The  persons  in  charge  of  the 
cleaning  shaU  collect  the  garbage  from  each  stand,  washing  the  receptacles  and  putting 
them  back  in  their  places.  They  shall  also  clean  the  water-closets  and  urinals,  every  night, 
as  well  as  the  sink  inlets,  disinfecting  all  of  them  with  hme,  creoUne,  etc. 

Seo.  341.  Wooden  walls  and  other  wooden  constructions  shall  not  be  permitted  in  stands. 

Seo.  342.  There  shall  be  in  each  market  a  place  where,  during  the  hours  of  cleaning, 
all  articles  which  may  have  been  seized,  on  account  of  being  unfit  for  consumption,  shall  be 
deposited  in  order  that  they  may  be  thrown  away  or  destroyed  together  with  the  garbage 
and  refuse. 

Seo.  343.  The  inspection  of  markets  shall  be  made  daily  and  at  different  hours. 

Seo.  344.  The  existence  of  cellars,  cafés,  establishments,  etc.,  is  prohibited  within 
markets. 

Seo.  345.  It  shall  be  the  duty  of  inspectors:  (a)  To  examine  carefully  all  stands;  (b)  to 
report  to  the  sanitary  chief  whatever  they  may  deem  necessary  for  the  cleaning  and  main- 
tenance of  the  premises  of  markets;  (c)  to  inspect  meats,  fish,  poidtry,  and  other  animal 
products;  (d)  to  order  the  withdrawal  from  sale  of  all  articles  unfit  for  consumption, 
notifj^ing  the  sanitary  chief  immediately;  (e)  to  take  samples  of  all  articles  which  may  be 
considered  suspicious,  in  bad  condition,  or  adulterated,  giving  the  interested  party  a  receipt 
specifying  the  article  from  which  the  sample  is  taken,  in  order  to  avoid  doubts  or  discus- 
sions; (f)  to  examine  the  water-closets,  urinals,  and  inlets  to  sewers,  reporting  to  the 
sanitary  chief  any  violations  which  they  may  observe. 

Chapter  XII. 

MEAT   MARKETS   AND    SALE    OF   MEATS. 

Sec.  346.  Before  a  meat  market  is  opened  the  favorable  report  of  the  local  sanitary 
board  shall  be  necessary  in  regard  to  its  proper  sanitary  conditions. 

Seo.  347.  Meat  markets,  besides  being  well  ventilated  and  kept  in  a  cleanly  condition, 
shall  have  the  following  requirements: 

(a)  White  marble  counters,  well  poHshed. 

(b)  Marble  or  cement  pavements. 

(c)  Smooth  ceilings. 

(d)  The  walls  must  be  covered  with  glaze  tiles  to  height  of  2  meters. 

(e)  The  stanchion  therein  must  be  4  or  5  meters  high,  except  in  those  already  existing 
and  which  have  sufficient  ventilation. 

(f)  They  shall  be  provided  with  abundant  water  supply. 

(g)  They  shall  be  provided  with  refrigerators  or  ice  boxes  of  suflBcient  capacity  in  accord- 
ance with  the  importance  of  each  establisliment. 

(h)  They  shall  be  provided  with  iron-grating  doors  facing  the  street. 

(i)  The  meat  must  be  hung  on  steel  hooks.  Said  hooks  must  be  beyond  the  reach  of 
hands  of  purchasers  and  attached  to  a  steel  bar,  all  of  which  shall  be  kept  pohshed. 

(j)  The  sanitary  plumbing  therein  shall  be  adapted  to  the  prescriptions  of  the  sanitary 
board.     No  water-closets  shall  be  permitted  in  meat  markets. 


138  SECOND    INTERNATIONAL    SANITARV    CONVENTION. 

(k)  The  premises  must  be  kept  in  the  best  cleanly  condition ;  the  pavements  must  be 
washed  one  or  more  times  daily,  and  the  walls,  etc.,  oil  painted  whenever  necessarj'-. 

(1)  No  other  industry  or  commerce  sliall  be  conducted  in  meat  markets;  bones,  refuse, 
garbage,  etc.,  must  not  be  deposited  therein;  meat  markets  must  be  separated  from  other 
establishments  by  complete  stone  walls. 

Sec.  348.  Meat  and  fish  remaining  ft-om  the  daily  sale  shall  be  placed  in  the  refrigerators 
or  ice  boxes  of  the  model  prescribed  by  the  local  sanitary  board. 

Sec.  3+9.  The  sellers  must  wear  a  white  clean  apron. 

Sec.  350.  No  aneat  market  shall  be  permitted  in  wooden  buildings,  except  when,  on 
account  of  special  circumstances  of  location,  the  consent  in  ^vl■iting  of  the  local  sanitary 
board  be  secured. 

Sec.  351.  Meat  markets  already  established  and  which  have  not  the  requirements  pre- 
scribed by  these  ordinances  shall  be  allowed  a  period  of  six  months  from  the  date  in  which 
these  ordinances  shall  go  into  effect.  Meat  markets  which  shall  not  have  complied  with 
said  requirements  shall  be  closed. 

Sec.  352.  Premises  of  meat  markets  shall  not  be  used  for  dwelling  or  sleeping  purposes. 

Sec.  353.  Meats  shall  be  kept  hanging  outside  or  inside  of  the  refrigerator  from  the 
time  of  their  arrival  to  the  establishment  until  10  o'clock  in  the  morning;  after  that  time 
they  shall  be  placed  in  the  refrigerator,  which  shall  be  provided  with  sufficient  amount  of  ice. 

Sec.  354.  The  use  of  hatches  and  wooden  blocks  for  chopping  meat  is  prohibited;  the 
meat  and  bones  must  be  cut  with  knives  and  saws,  respectively,  the  handles  of  which  must 
be  made  of  metal. 

Sec.  355.  The  sale  of  meat  from  animals  which  shall  not  have  been  slaughtered  expressly 
for  consumption,  in  slaughterhouses,  is  prohibited. 

Sec.  356.  When  the  owner  of  a  meat  market  suspects  that  the  meat  which  he  has  is 
derived  from  a  diseased  animal,  he  shall  suspend  the  sale  of  said  meat  and  immediately 
report  the  fact  to  ihe  sanitary  chief. 

Sec.  357.  AU  utensils  used  in  meat  markets  shall  always  be  kept  perfectly  clean. 

Sec.  358.  No  meat  other  than  pork  or  beef,  nor  other  salt  than  sodium  chloride,  shall  be 
employed  in  the  confection  of  sausages,  and  utensils  made  of  other  material  than  wood, 
ii'on,  or  stone  must  not  be  used  for  said  purpose,  which  utensils  shall  be  kept  perfectly  clean. 

Sec.  359.  The  importation  of  meat  from  one  town  into  another  shall  not  be  permitted 
unless  such  meat  is  marked  with  the  stamp  of  the  slaughterhouse,  and  accompanied  with  a 
certificate  from  the  veterinarian  thereof,  approved  by  the  alcalde. 

Sec.  360.  Meats  not  proceeding  ft'om  authorized  slaughterhouses,  or  which  have  not  been 
examined  by  the  inspectors,  shall  be  considered  as  clandestine,  and  be  seized.  Such  meats 
shall  at  once  be  sent  to  the  respective  officer  for  sanitary  examination. 

Sec.  361.  The  tanning  of  hides  or  the  preparation  of  tallow  in  meat  markets  or  other 
places  within  city  limits,  without  the  written  consent  of  the  local  sanitary  board,  is 
prohibited. 

Sec.  362.  The  delivery  ft-om  house  to  house  of  meats,  bones,  giblets,  lard,  etc.,  shall  be 
done  in  boards  made  of  polished  metal  or  wood  covered  with  metal  foil,  which  boards 
shall  be  kept  clean;  they  shall  be  provided  with  covers  in  order  to  prevent  dust,  insects, 
or  hands  from  coming  in  contact  with  them. 

Sec.  363.  The  use  of  preserving  substances  other  than  common  salt  (sodium  chloride) 
for  the  preservation  of  meats  is  prohibited. 

Chapter  XIII. 

GABBAGE   AND   REFUSE. 

Sec.  364.  In  houses  where  the  service  of  transportation  of  garbage  to  sea  shall  not  have 
been  established,  the  garbage  and  refuse  shall  be  deposited  in  dumping  places  located  at  a 
distance  of  not  less  than  1  kilometer  from  the  city  limits  and  in  places  where  they  can  not 
be  detrimental  to  public  health.  "V\1ien  crematories  for  garbage  and  refuse  shall  have  been 
established,  the  garbage  and  refuse  shall  be  transported  to  the  same. 

Sec.  365.  Each  ayuntamiento,  when  the  servics  is  not  provided  for  by  the  Government, 
shall  establish  a  pubhc  service  for  the  collection  of  filthy  water,  garbage,  and  refuse  of 
streets,  squares,  and  houses  in  the  manner  prescribed  by  the  sanitary  board. 

Sec.  366.  House  refuse  and  garbage  shall  be  deposited  in  metal  receptacles,  which  shall 
be  placed  in  the  streets  near  the  sidewalk  a  few  moments  before  the  wagon  for  the  collection 
of  such  refuse  and  garbage  passes  by;  if  the  service  be  made  during  the  day  time,  it  shall 
be  early  in  the  morning;  if  it  be  at  night,  after  10  o'clock. 

In  places  where  there  is  no  organized  service  for  the  collection  of  house  refuse,  and 
when  it  can  not  be  transported  outside  the  city  limits,  it  shall  be  cremated  in  the  yards 
of  the  respective  houses  eveiy  forty-eight  hours,  or  before  if  necessaiy  to  prevent  decom- 
position. 


SECOND    INTERNATIONAL    SANITARY    OONVKNTION.  139 

Seo.  307.  Tenants  must  be  provided  with  a  suflicicnt  numbur  of  waterproof  receptacles, 
made  of  metal,  or  interiorly  covered  with  nict-al  foil,  of  a  capacity  sufficient  ti>  contain 
all  garbaf^e,  refuse,  etc.,  wliieli  may  have  Ixcn  aecuuiulated  ihjrir:^^  the  day.  Jn  places 
where  there  a7'(i  no  stiwers,  (svery  occupant  of  a  hous(?  shall  be  providtsd  with  vchhcIh  to 
contain  the  waste  lic(ai<]s,  in  the  same  conditions  as  garbage,  lie  shall  seo  that  the  recep- 
tacles ar(^  witlidi'awn  fr'om  tlie  street  as  soon  as  they  have  í)een  emptiísd. 

Sec.  368.  Passers-by  must  not  shake,  scatter,  or  ivniove  the  contents  of  sucfi  receptacles 
or  take  possession  of  the  latter. 

Sec.  309.  In  places  where  there  is  no  public  service  of  ckianing,  garbagf;  and  refuse 
from  industrial  and  commercial  establishments  shall  bi;  transported  to  th(i  dumping  places 
at  the  expense  of  the  owners. 

Sec.  37Q,  The  throwing  of  fecal  matter  and  dead  animals  into  dumping  places  is  pro- 
hibited. 

Sec.  371.  The  ayuntamientos  shall  pi-escrilx'  that  the  garbage  and  refus(!  thrown  into 
dumping  places  be  cremated  or  destroyed  by  the  contractors  when  the  service  is  made  by 
contract;  in  case  the  removal  of  garbage,  artick's,  or  materials  from  dumping  places  for 
industrial  purposes  shall  be  permitted,  they  shall  be  previously  disinfected,  and  with  the 
consent  of  the  sanitary  board. 

Sec.  372.  Accumulating  or  depositing  garbage,  rcfaise,  bones,  or  other  matter  susceptible 
of  decomposition,  or  which  may  be  annoying  to  neighbors,  or  produce  fetid  odors,  in  rooms, 
cellars,  yards,  etc.,  is  prohibited. 

Chapter  XIV. 

TRANSPORTATION   OF   GARBAGE   AND   MANURE. 

Sec.  373.  The  transportation  of  garbage  and  manure  from  stables  within  city  limits  is 
prohibited,  unless  it  be  made  in  special  wagons  built  for  the  purpose  and  in  accordance 
with  the  model  prescribed  by  the  sanitary  board. 

Sec.  374.  The  wagons  for  the  transportation  of  manure  and  garbage  shall  be  loaded 
inside  the  stables  or  in  the  yards  therein,  and  in  no  case  in  the  street.  The  contents  shall 
be  so  transported  that  no  fetid  odors  can  be  produced. 

Sec.  375.  The  manure  and  refuse  to  be  transported  shall  be  so  placed  that  no  portion 
thereof  shall  fall  out  of  the  wagon. 

Sec.  376.  Unloading  garbage,  manure,  or  refuse  at  a  distance  of  less  than  1  meter  from 
an  inhabited  place  is  prohibited.  Garbage  and  refuse  shall  not  be  kept  over  twenty-four 
hours  in  stables. 

Sec.  377.  The  construction  or  use  of  vaults  or  cellars  for  the  deposit  of  garbage,  etc.,  is 
prohibited,  unless  the  sanitary  board  shall  give  its  consent  in  writing  on  account  of  special 
reasons. 

Sec.  378.  The  transportation  by  railroad  of  garbage  or  manure  shall  be  made  subject 
to  the  following  requirements : 

(a)  The  transportation  shall  be  made  in  covered  and  inclosed  wagons. 

(b)  The  wagon  must  be  kept  closed  while  containing  such  garbage  and  manure,  and 
immediately  after  it  has  been  emptied  it  shall  be  mechanically  washed  by  means  of  water 
flowing  under  pressure.     It  shall  be  left  open  until  loaded  again. 

(c)  If  it  is  not  practicable  to  wash  the  wagon  upon  being  emptied,  it  shall  be  kept 
closed  until  it  can  be  washed.  The  washing  of  such  wagons  must  not  be  omitted  before 
reloading  the  same. 

(d)  Wagons  assigned  to  the  transportation  of  garbage  and  manure  must  not  be  used 
for  any  other  purpose  whatever,  and  the  word  "Garbage"  shall  be  printed  on  both  sides 
of  the  wagon  in  types  visible  from  afar. 

(e)  The  operation  of  loading  apd  unloading  shall  be  made  from  wagon  to  wagon  and  at 
a  distance  of  not  less  than  100  meters  from  inhabited  places. 

(f)  The  pavements  of  premises  assigned  exclusively  to  the  loading  and  unloading  of 
garbage  must  be  impermeable. 

(g)  Loading  and  unloading  of  garbage  shall  be  made  during  the  nighttime. 

(h)  The  same  proAásions  regarding  the  loading  and  unloading  shall  be  followed  whenever 
garbage  is  to  be  used  for  fertilizing  purposes. 

(i)  Lighters,  barges,  etc.,  assigned  to  the  transportation  of  garbage,  when  loaded,  shall 
not  be  permitted  to  be  anchored  in  wharves  for  over  twelve  hours.  They  shall  be  frequently 
disinfected. 

Chapter  XV. 

cleaning   of   privies   and   CESSPOOLS. 

Sec.  379.  Before  granting  the  permit  for  the  establishment  of  a  plant  for  the  cleaning  of 
cesspools  and  privies,  the  favorable  report  of  the  local  sanitary  board  shall  be  necessary. 


140  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sec.  380.  Such  establishments  or  plants  shall  be  located  outside  of  the  town,  and  it 
shall  be  the  duty  of  the  o\vners  thereof  to  file  their  names  and  addi'esses  with  the  local 
sanitary  board. 

Sec.  3S1.  Owners  of  plants  for  the  cleaning  of  cesspools  and  privies  shall  send  to  the 
sanitary  chief  a  daily  report  of  the  pri\'ies  and  cesspools  cleaned  during  the  previous  night, 
stating  the  street  and  number  of  the  house,  name  of  its  owner,  his  residence,  number  of 
wagons,  and  capacity  and  condition  of  each  cesspool  or  privy  cleaned. 

Sec.  382.  Partial  cleaning  of  privies  and  cesspools  is  prohibited.  If  the  operation  of 
cleaning  be  interrupted,  it  shall  be  continued  the  next  night.  Privies  and  cesspools  shall 
be  duly  disinfected  with  iron  sulphate  and  lime  twelve  hours  before  the  cleaning.  They 
shall  also  be  disinfected  after  the  operation  and  totally  emptied. 

Sec.  383.  When  the  suppression  of  cesspools,  sinks,  gutters,  etc.,  be  ordered,  they  shall 
be  filled  after  having  been  cleaned  and  disinfected.  The  material  to  be  employed  in  the 
filling  shall  be  mixed  with  lime. 

Sec.  384.  The  cleaning  of  cesspools  and  privies  shall  be  done  from  11  p.  m.  to  5  a.  m. 
A  green  light  shall  be  placed  in  the  door  of  the  house  where  the  cleaning  is  being  carried  out. 

Sec.  385.  The  person  in  charge  of  the  cleaning  of  a  privy  or  cesspool  which  on  accoimt 
of  the  conditions  of  its  constmction  might  cause  accidents  due  to  the  escape  of  gases  shall 
take  the  necessary  precautions  in  order  to  prevent  mishaps. 

Sec.  386.  In  towns  where  the  service  is  not  made  with  modern  apparatus,  the  matter 
extracted,  after  being  duty  disinfected,  shall  be  placed  in  air-tight  receptacles,  which  shall 
be  transported  in  wagons  provided  with  a  green  light  to  the  places  assigned  for  the  purpose 
outside  of  the  town  limits  and  where  such  matter  can  not  be  detrimental  to  pubhc  health. 

Sec.  387.  Wagons  assigned  to  these  purposes  shall  not  be  permitted  in  the  streets  outside 
of  the  hours  prescribed  for  the  cleaning,  even  though  they  be  empty.  Wagons  and  utensils 
used  in  the  operation  of  cleaning  shall  be  duly  disinfected  and  kept  outside  of  the  town. 

Sec.  388.  The  wagons  above  referred  to  shall  be  of  solid  construction  and  so  conveyed 
in  the  streets  as  to  prevent  the  contents  from  leaking.  The  receptacles  shall  be  tightly 
covered. 

Sec.  389.  The  persons  employed  in  the  cleaning  of  a  privy  or  cesspool  shall,  after  the 
operation,  wash,  scrub,  and  clean  all  places  in  the  house  which  might  have  been  soiled  on 
account  of  the  operation. 

Sec.  390.  In  case  the  contents  of  a  wagon  or  receptacle  should,  on  account  of  an  accident, 
be  poured  out  partially  or  totally,  the  conductors  shall  gather  such  contents  at  once  and 
wash  the  soiled  places  thoroughly  well. 

Sec.  391.  The  wagons  shall  always  be  kept  clean  in  order  to  prevent  the  emanation  of 
fetid  odors. 

Sec.  392.  The  throwing  into  cesspools  and  privies  of  garbage,  refuse,  dead  animals, 
decayed  vegetables,  or  other  matter  foreign  to  the  purpose  for  which  they  were  constructed 
is  prohibited. 

Sec.  393.  It  shall  be  the  duty  of  owners  or  tenants,  as  the  case  may  be,  to  keep  all 
receptacles  of  refuse  or  sewage  of  the  house  in  the  best  condition  and  perfectly  clean. 

Sec.  394.  No  fecal  or  other  filthy  matter  shall  be  thrown  into  rivers,  harbors,  bays, 
streams,  lakes,  etc. 

Chapter  XVI. 

RAILROADS,  STREET   CARS,  AND   OMNIBUSES. 

Sec.  395.  All  vehicles  for  the  transportation  of  persons  must  be  well  painted,  washed, 
cleaned,  and  free  from  insects. 

Sec.  396.  The  thromng  out  of  refuse,  ashes,  and  other  similar  waste  matter  from  railroads, 
tramways,  or  omnibuses  within  city  limits  is  prohibited,  excepting  the  sand  usually 
employed  between  the  rails  and  wheels  of  engines. 

Sec.  397.  All  vehicles  for  the  transportation  of  passengers  shall  have  sufficient  ventilation. 

Sec.  398.  Soiled  linen  or  other  similar  material  shall  not  be  pennitted  in  the  places 
assigned  to  passengers,  but  only  in  front  platforms  of  cars  or  in  the  tops  of  omnibuses. 

Sec.  399.  All  railroad  cars  shall  be  provided  Avith  water-closets  for  both  sexes,  constructed 
with  impermeable  materials  and  kept  perfectly  clean.  Omnibuses,  tramways,  and  railway 
coaches  shall  be  provided  with  a  sufficient  number  of  cuspidors  containing  a  disinfecting 
solutjon  and  shall  be  cleaned  every  day. 

Sec.  400.  Stations  and  outbuildings  thereof  shall  also  be  kept  perfectly  clean;  the  walls, 
doors,  and  windows  shall  be  whitewashed  or  painted  whenever  necessary;  there  shall  be  a 
sufficient  number  of  cuspidors  containing  a  disinfecting  solution  and  which  shall  be  cleaned 
every  day;  there  shall  also  be  water-closets  in  perfect  sersáceable  and  clean  condition. 

Sec.  401.  Spitting  upon  floors  of  cars  and  stations  is  prohibited.  Signs  with  this  prohi- 
bition shall  be  posted  in  cars  and  stations. 


SECOND    INTERNATIONAL    SANITARY    OONVKN'IION.  141 

Seo.  402.  Station  yards  shall  be  kept  clean  and  in  good  condition,  as  well  as  the  gutters 
and  drains. 

Sec.  403.  Railroad  companies  shall  be  compelled  to  cany,  with  the  passenger  coaches  and 
at  the  rate  prescribed  by  the  committee  on  railroads,  a  special  car,  the  property  of  the 
Superior  Sanitary  Board,  for  the  transportation  of  persons  suirering  from  transmissible 
diseases.  Said  cars  shall  be  disinfected  at  the  expense  of  the  sanitaiy  board  whenever  used 
and  shall  be  kept  in  one  of  the  central  stations. 

Chapter  XVII. 

STREETS   AND   OTHER   PUBLIC   PLACES. 

Sec.  404.  No  garbage,  refuse,  offal,  filthy  or  fetid  liquids  shall  be  thrown  upon  the  streets, 
squares,  avenues,  yards,  etc. 

Sec.  405.  No  other  matter  or  liquid  than  rain  water  shall  be  permitted  to  flow  out  through 
drain  pipes  discharging  in  streets. 

Sec.  406.  No  garbage,  animal  or  vegetable  refuse,  or  other  matter  liable  to  decomposition 
shall  be  used  in  the  filling  up  of  streets,  lands,  etc. 

Sec.  407.  Street's,  squares,  avenues,  etc.,  shall  be  so  kept  as  to  prevent  water  from 
forming  puddles  thereon,  and  no  grass  shall  be  permitted  to  grow  except  in  the  places 
where  it  is  necessary  for  ornamental  purposes. 

Sec.  408.  It  shall  be  the  duty  of  tenants  to  keep  the  sidewalks  and  conduits  in  a  per- 
fectly clean  condition. 

Sec.  409.  Personal  voidances  in  streets,  etc.,  shall  not  be  permitted. 

Sec.  410.  In  towns  where  there  is  no  public  service  of  sprinltling  the  streets  the  residents 
shall  sprinkle  the  same  once  a  day  during  the  dry  season. 

Sec.  411.  It  shall  be  the  duty  of  the  contractor  in  charge  of  the  service  to  collect  the  dead 
animals  found  in  the  streets. 

Sec.  412.  It  shall  be  the  duty  of  street  sweepers  to  collect  all  refuse  matter  found  in 
the  streets. 

Sec.  413.  Shaking  and  beating  carpets,  etc.,  in  streets  is  prohibited. 

Sec.  414.  Hitching  or  turning  loose  pigs,  horses,  or  other  animals  in  the  streets  or  public 
places  is  prohibited.  The  owners  or  persons  in  charge  of  the  animals  shall  be  responsible  for 
the  violation  of  this  article. 

Sec.  415.  Unloading  of  cattle  in  public  places  shall  not  be  permitted  until  after  10  p.  m. 
and  before  5  a.  m.  Cattle  shall  be  taken  to  their  point  of  destination  through  the  remotest 
streets  of  the  town,  and  in  such  a  manner  that  it  shall  not  be  dangerous  to  the  health  or  life 
of  the  residents. 

Sec.  416.  The  transit  of  milch  cows  through  the  streets  shall  not  be  permitted  without  the 
consent  in  writing  of  the  sanitary  board. 

Sec.  417.  Persons  in  charge  of  the  cleaning  of  streets  shall,  before  sweeping  the  same, 
moisten  them  in  order  to  prevent  the  dust  from  scattering. 

Chapter  XVIII. 

HOSPITALS,  SANITARIUMS,  AND   INFIRMARIES. 

Sec.  418.  Public  or  private  hospitals,  sanitariums,  infirmaries,  etc.,  shall  be  established 
outside  of  towns.  This  prohibition  shall  not  apply  to  such  institutions  as  are  already 
established. 

Sec.  419.  No  hospital,  sanitarium,  etc.,  shall  be  built,  enlarged,  or  removed  without  the 
advice  and  consent  of  the  Superior  Sanitary  Board,  to  which  the  specifications,  plans,  etc., 
of  the  building  sought  to  be  constructed  or  enlarged  shall  be  submitted. 

Sec.  420.  Hospitals,  lazarettos,  sanitariums,  etc.,  which  may  be  established  hereafter  for 
the  isolation  and  attendance  of  persons  suffering  from  contagious  diseases  shall  be  sepa- 
rated from  other  buildings  by  a  distance  of  not  less  than  30  meters  and  shall  be  surrounded 
by  trees  and  gardens. 

Sec.  421.  There  shall  be  in  every  hospital,  sanitarium,  etc.,  one  or  more  places  provided 
with  double  doors  and  windows  protected  with  wire  gauze  against  the  access  of  mosquitoes, 
the  interior  of  which  places  shall  be  properly  arranged  for  the  isolation  of  cases  of  any  of 
the  following  diseases:  Measles,  diphtheria,  croup,  yellow  fever,  scarlet  fever,  smallpox, 
Asiatic  cholera,  exanthematous  typhus,  bubonic  plague,  whooping  cough,  leprosy,  puerperal 
fever,  phylariasis,  and  malaria. 

Sec.  422.  Hospitals,  etc.,  shaU  be  provided  with  apparatus  and  places  for  disinfection. 

Sec.  423.  Any  case  of  the  diseases  mentioned  in  section  421  shall  be  isolated  immediately 
after  its  appearance,  and  the  director  of  the  institution  shall  notify  the  sanitaiy  chief , at  once. 


142  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sec.  424.  Persons  suffering  from  infectious  diseases  shall  not  be  admitted  or  attended  to  in 
general  hospitals.  Such  persons  shall  be  removed  to  isolation  hospitals  or  buildings  with 
the  necessary  precautions. 

Sec.  425.  Hospitals,  sanitariums,  etc.,  shall  disinfect  frequentlj^  the  wards  assigned  to 
infectious  diseases. 

Sec.  426.  Convalescents  from  infectious  diseases  and  the  persons  who  have  attended  them 
shall  be  disinfected  before  leaving  the  hospital. 

Sec.  427.  Public  or  private  liospitals,  sanitariums,  lazarettos,  etc.,  shall  be  subject  to 
inspection  hj  the  sanitary  board. 

Sec.  428.  Sañitariimis  shall  be  established  and  governed  in  accordance  with  the  pro- 
visions contained  in  the  follo\\Ting  sections. 

Sec.  429.  Sanitarium  is  an  establishment,  maintained  by  a  company  or  person,  where 
medical  attendance  is  given  to  patients  at  rates  agreed  to  by  the  interested  parties. 

Sec.  430.  Buildings  used  for  sanitariums  must  have  good  conditions  of  height,  sufBcient 
ventilation  and  capacity,  and  shall  be  located  in  dry  places,  far  from  streams,  lakes,  swamps, 
and  deposits  for  organic  substances  in  state  of  decomposition. 

Sec.  431.  Companies  or  persons  owning  this  kind  of  establishments  must  keep  them 
constantly  and  perfectly  clean,  beautify  them  as  much  as  possible,  and  provide  them  with 
all  necessary  requirements  for  the  best  attendance  and  comfort  of  patients.  Said  estab- 
lishments shall  also  be  provided  with  one  water-closet,  one  washstand,  and  one  bathroom  for 
every  20  persons,  and  shall  have  gardens  and  yards. 

Sec.  432.  No  license  shall  be  granted  for  the  establishment  of  a  sanitarium  without  the 
favorable  report  of  the  local  sanitary  board,  duly  approved  by  the  Superior  Sanitary  Board. 
Said  report  shall  be  made  upon  the  sanitaiy  conditions  of  the  building,  its  construction, 
capacity,  and  other  particulars  which  the  board  may  deem  proper  to  insert.  The  municipal 
architect  shall  report  upon  the  conditions  of  solidity,  etc.,  of  the  building. 

Sec.  433.  Together  with  the  application  for  such  license  plans  and  specifications  of  the 
building  shall  be  fiJed,  stating  in  detail  the  number  of  bathrooms,  water-closets,  wells, 
water  supply,  etc.,  sought  to  be  installed.  A  copy  of  the  regulations  for  the  management  of 
the  sanitarium  shall  also  be  filed  with  the  application,  where  the  kind  of  professional  services 
sought  to  be  rendered  and  rates  to  be  charged  for  the  same  shall  be  stated. 

Sec.  434.  The  application  shall  be  filed  with  the  alcalde,  who  shall  forward  it  to  the  local 
sanitary  board  for  its  report.  After  the  local  sanitary  board  shall  have  submitted  its  report 
the  municipal  architect  shall  make  a  report  upon  the  conditions  of  safety  of  the  building. 
Both  reports  must  be  favorable  and  approved  by  the  Superior  Sanitary  Board. 

Sec.  435.  The  regulations  for  the  management  of  a  sanitarium  after  being  approved  shall 
be  printed,  and  the  manager  of  the  institution  shall  distribute  copies  thereof  to  the  interested 
persons. 

Sec.  436.  All  sanitariums  shall  be  provided  with  a  sufficient  number  of  boarding  physi- 
cians, nurses,  and  attendants.  The  nurses  must  be  graduates  of  the  University  of  Habana. 
A  period  of  three  years  from  the  date  of  the  enactment  of  these  ordinances  is  granted  for  the 
compliance  of  this  requirement. 

Sec.  437.  There  shall  be  in  each  sanitarimn  one  attending  physician  for  eveiy  twenty 
patients,  and  three  boarding  physicians  for  every  two  hundred  patients,  in  order  that  the 
service  be  eflicient. 

Sec.  438.  Pharmacies  of  sanitariums  shall  be  placed  in  charge  of  professional  pharma- 
cists. 

Sec.  439.  Directors  of  sanitariums  shall  send  a  daily  report  to  the  local  sanitary  board  of 
the  cases  of  contagious  diseases  admitted  therein,  as  well  as  of  the  patients  discharged  or 
dead.  For  the  purposes  of  section  423,  a  dailj"  record  shall  be  kept  where  the  date  of  admit- 
tance, disharge,  and  attendance  of  patients,  and  the  diagnosis  of  the  disease  in  each  case 
shall  be  registered.  Said  record  shall  be  inspected  by  the  local  sanitary  chief,  or  his  deputy, 
whenever  he  shall  deem  it  necessary. 

Sec.  440.  Every  sanitarium  shall  be  provided  with  two  independent  pavilions  for  the 
isolation  of  infectious  diseases,  one  of  which  pavilions  shall  be  assigned  to  diseases  trans- 
missible by  mosquitoes,  and  the  other  to  those  transmissible  by  contagion. 

Sec.  441.  The  first  of  said  pavilions  shall  be  provided  with  doors  and  windows  protected 
with  wire  gauze  against  the  access  of  mosquitoes.     The  door  of  said  pavilion  shall  be  double. 

Sec.  442.  The  pavilion  for  diseases  transmissible  by  contagion  shall  be  divided  into  two 
or  more  wards  for  the  dift'erent  diseases  and  to  prevent  the  infection  by  a  patient  of  a 
disease  different  from  that  with  which  he  may  be  affected. 

Sec.  443.  The  wards  shall  be  divided  into  small  rooms,  in  each  of  which  not  more  than 
two  beds  shall  be  allowed. 

There  shall  be,  besides,  one  pavilion  or  special  ward  for  persons  suffering  from  tubercu- 
losis, said  pavilion  to  be  at  a  sufficient  distance  from  the  rest  of  the  patients  and  provided 
with  all  the  necessary  precautions  to  prevent  the  spread  of  said  disease. 

Sec.  444.  Nurses  and  attendants  in  wards  of  contagious  diseases  shall  by  no  means  come 
in  contact  with  the  rest  of  the  personnel  of  the  institution. 


SECOND    INTERNATIONAL    HANITAHY    CONVKNTION.  143 

Seo.  445.  Phywicians,  nurses,  and  attendants  in  said  wards  sfjall  wear  wranpei-s,  the 
collars  and  cuil's  of  which  must  be  perfectly  adjustable;  they  shall  take  oil'  saitl  wrappers 
before  leaving  the  wards. 

Sec.  446.  The  excreta  from  patients  must  Im!  duly  disinfected.  The  vessels,  bed  clothing, 
and  other  articles  which  might  have  come  in  contact  with  patients  shall  also  be  disinfected. 
Every  patient,  as  soon  as  ho  is  admitted  in  a  sanitarium,  shall  deliver  his  clothing  for  its 
disinfection,  and  must  w(iar  the  clothing  assigned  to  him. 

Sec.  447.  Sanitary  plumbing  of  saiiit.ai-iiuns  in  towns  where  there  are  sewer  and  water 
systems  shall  be  installed  in  accordance  witli  the  provisions  contained  in  these  ordinances. 

Sec.  448.  Sanitariums  in  towns  where  there  is  no  sewer  system  .shall  be  provided  with  a 
sufficient  number  of  cesspools,  tlie  bottom  and  walls  of  which  shall  be  cemented  and  which 
shall  have, other  requirements  whicli  the  local  sanitary  board  may  prescribe. 

Sec.  449;  Cesspools  shall  be  located  as  far  as  po.ssible  from  the  building  occupied  by  the 
patients,  and  shall  be  disinfected  daily  with  crude  petroleum  and  a  solution  of  iron  sulphate. 

Sec.  450.  Patients  who,  on  account  of  their  condition  of  health,  are  not  able  to  go  in 
person  to  the  water-closet,  may  make  their  evacuations  in  porcelain  vessels  which  shall  be 
provided  with  lids,  and  be  taken  out  of  the  wards  and  disinfected  immediately  after  they 
have  been  used. 

Sec.  451.  There  shall  be  in  every  sanitarium  an  isolated  place  where  cadavers  .shall  be 
deposited  until  their  burial.  Said  place  must  be  disinfected  whenever  it  shall  have  been 
occupied  by  a  cadaver. 

Sec.  452.  The  sanitariums  shall  be  inspected  by  the  local  sanitary  board,  and  the  sanitary 
chief  or  his  deputy. 

Sec.  453.  Sanitariums  established  without  the  prescribed  provisions  shall  be  immediately 
closed,  and  the  responsible  person  shall  be  punished  accordingly. 

Sec.  454.  Hospitals,  sanitariums,  etc.,  shall  furnish  the  local  sanitary  board  such  data 
from  their  private  statistics  and  such  other  information  as  it  may  require. 

Sec.  455.  The  provisions  prescribed  for  sanitariums  shall  be  equally  applicable  to  hos- 
pitals, infirmaries,  etc. 

Chapter  XIX. 

ANEMALS   AND   LIVE    STOCK. 

Sec.  456.  No  animal  affected  with  a  disease  transmissible  to  ±ankind,  or  which  shall 
have  been  in  contact  with  other  animals  suffering  from  contagious  diseases,  shall  be  brought 
or  kept  in  a  town.  The  owner  or  person  in  charge  of  animals,  and  aU  veterinarians  must 
notify  the  local  sanitary  chief  of  all  cases  coming  under  their  observation. 

Sec.  457.  Animals  suffering  from  contagious  diseases  shall  be  isolated  in  the  places 
designated  by  the  local  sanitary  board. 

The  appearance  in  the  Province  of  Habana  of  a  case  of  glanders  or  bovine  tuberculosis 
shall  be  reported  to  the  committee  created  by  order  66,  series  of  1901,  for  the  adoption  of 
the  measm-es  therein  prescribed.  In  other  provinces  the  provisions  of  these  ordinances  shall 
be  followed. 

Sec.  458.  Stables,  yards,  corrals,  etc.,  where  any  diseased  animals  may  have  been,  must 
not  be  used  again  until  they  have  been  thoroughly  disinfected,  and  the  consent  of  the  local 
sanitary  board  secured  for  the  purpose. 

Sec.  459.  The  owner,  person  in  charge,  or  veterinarian  who  shall  notice  in  an  animal 
symptoms  of  glanders  or  scrofula  shall  notify  the  case  to  the  sanitary  chief  immediately. 

Sec.  460.  Diseased  or  iU-treated  animals  found  in  the  streets  or  other  public  places  shall 
be  immediately  taken  by  the  police  to  the  place  assigned  for  the  purpose. 

Sec.  461.  The  transportation  of  animals  suff'ering  from  transmissible  diseases,  or  of 
cadavers  thereof,  shall  be  so  made  that  it  shaU  not  constitute  a  danger  to  public  health. 
Wagons  assigned  to  said  transportation  must  be  covered  and  inclosed  and  disinfected 
immediately  after  being  used. 

Sec.  462.  The  burial  of  dead  animals  within  the  city  limits  is  prohibited;  they  shall  be 
transported  before  becoming  decomposed  to  the  place  designated  for  their  interment  or 
cremation  as  the  case  may  be. 

Sec.  463.  Dogs  shall  not  be  permitted  loose  in  the  streets,  if  without  muzzles.  Dogs 
found  otherwise  shall  be  seized  by  the  municipal  employees  in  charge  of  the  service,  and 
who  shall  take  them  to  the  respectiA^e  pound. 

Sec.  464.  Whenever  a  person  shall  have  been  bitten  by  a  dog  or  other  animal,  the  local 
sanitary  chief  shall  be  notified,  which  officer  shall  cause  the  animal  to  be  placed  xmder 
observation,  and  if  it  turns  out  to  be  hydrophobic  he  shall  direct  the  measures  which  he  may 
deem  proper. 

Sec.  465.  Animals  suspected  of  hydi-ophobia  shall  be  captured  and  isolated,  and  the  fact 
shall  be  reported  to  the  sanitary  chief. 

Sec.  466.  Kennels  must  be  kept  perfectly  clean  always,  and  must  be  provided  with 
drinking  water. 


144  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sec.  467.  Domestic  animals  must  be  kept  clean  always  as  well  as  the  places  assigned  to 
them. 

Sec.  468.  Breeding  or  fattening  live  stock  of  any  kind  in  dung  yards,  muck  hills,  or  other 
places  where  animal  and  other  refuse  is  deposited  is  prohibited. 

Sec.  469.  The  removal  of  diseased  animals  from  one  district  to  another,  or  from  one  place 
to  another  in  the  same  district,  where  pereons  or  animals  may  be  infected  thereby,  is  pro- 
hibited. 

Sec.  470.  As  soon  as  the  local  sanitary  chief  or  the  cattle  owners  have  knowledge  of  the 
appearance  of  a  case  of  epidemic  disease  (such  as  rinderpest)  among  live  stock,  they  shall 
report  the  fact  immediately  to  the  superior  sanitary  chief,  who  shall  at  once  enforce  the 
measures  prescribed  in  the  circular  of  the  secretary  of  the  interior,  in  regard  to  rinderpest,  of 
February  17,  1903,  published  in  the  Official  Gazette  of  the  19th  of  the  same  month  and  year, 
the  provisions  of  which  are  hereby  ratified  and  confirmed. 

Sec.  471.  Parts  of  animals  dead  of  infectious  diseases  must  not  be  availed  for  any  pur- 
poses whatever. 

Sec.  472.  Animals  dead  of  infectious  diseases  must  be  completely  cremated,  and  those 
dead  of  other  diseases  may  be  buried. 

Sec.  473.  No  hospital  or  stables  for  animals  affected  with  diseases  transmissible  to 
mankind  shall  be  permitted  within  the  limits  of  any  municipality. 

Chapter  XX. 

COUNTRY   OE  RURAL  SANITATION. 

Sec.  474.  Coimtry  residences  shall  be  constructed  far  from  swamps  and  swampy  lands; 
high  and  dry  lands  must  be  selected  for  such  residences. 

Sec  475.  Owners  of  country  houses  shall  fill  and  drain  the  swamps  and  puddles  which 
may  exist  therein,  and  if  it  can  not  be  done  on  account  of  the  expense,  they  shall  pour  into 
the  same  sufficient  quantities  of  petroleum  every  two  weeks  in  order  to  prevent  the  pro- 
creation of  mosquitoes. 

Sec  476.  Country  houses  must  have,  as  much  as  possible,  similar  sanitary  conditions  to 
those  of  other  houses. 

Sec.  477.  The  crops  shall  not  be  deposited  in  dwelling  places,  and  the  keeping  of  domestic 
or  other  animals  therein  shall  not  be  permitted. 

Sec.  478.  Stables,  pigpens,  poultry  yards,  and  other  places  where  animals  are  kept  must 
be  separated  from  dwelling  places  and  must  be  kept  clean  always. 

Sec.  479.  Muck  hills  and  cesspools  must  be  situated  in  the  remotest  places  from  dwell- 
ings, wells,  cisterns,  streams,  and  rivers. 

Chapter  XXT. 
transmissible  diseases. 

Sec.  480.  It  shall  be  compulsory  for  physicians  to  report  to  the  local  sanitary  chief  all 
cases  of  any  of  the  following  diseases: 

Actinomycosis,  anquilostomiasis,  or  unnicariasis,  beriberi,  gangrenous  tumors,  Asiatic 
cholera,  cholera  nostras,  diphtheria  and  croup,  epidemic  dysentery,  enteritis  (any  kind), 
erysipelas,  scarlet  fever,  yellow  fever,  Malta  fever,  miliary  fever,  typhoid  fever,  phylariasis, 
grippe,  leprosy,  epidemic  cerehro-spinal  meningitis,  glanders,  pneumonia,  granulous  and  puru- 
lent ophthalmia,  malaria  (all  kinds),  mmnps  (epidemic  parotiditis),  bubonic  plague,  rabies, 
measles,  puerperal  septicemia  and  other  puerperal  diseases,  tetanus  neonatorum,  exanthe- 
matic  typhus,  favus,  whooping  cough,  tuberculosis  (all  kinds),  varicella,  and  smallpox. 

The  report  of  suspected  cases  of  quarantinable  diseases  is  also  compulsory. 

For  the  purposes  of  these  ordinances,  transmissible  diseases  are  those  printed  in  italic  in 
the  preceding  list,  and  quarantinable  diseases  are  bubonic  plague,  Asiatic  cholera,  exan- 
thematic  typhus,  smallpox,  yellow  fever,  and  leprosy. 

The  provisions  of  this  section  are  apphcable  to  private  as  well  as  to  official  and  municipal 
physicians. 

Sec.  481.  When  there  be  doubt  as  to  the  diagnosis,  the  physicians  shall  send  to  the 
local  sanitary  board  samples  of  the  sputum,  blood,  excreta,  etc.,  for  the  purpose  of  ascer- 
taining the  nature  of  the  disease.  The  local  sanitary  board  shall  promptly  consider  all 
consultations  submitted  to  it,  and  its  decision  shall  at  once  be  notified  to  the  physician. 

Sec.  482.  Physicians  shall  inform  the  local  sanitary  board  whether  there  are  any  chil- 
dren in  the  house  where  a  case  of  transmissible  disease  has  occurred.  The  same  information 
shall  be  given  to  the  principal  of  the  school  attended  by  said  children. 

Sec.  483.  The  local  sanitary  chief  shall  send  a  report  to  the  superior  sanitary  chief  of 
all  cases  of  yellow  fever,  smallpox,  bubonic  plague,  and  Asiatic  cholera  which  shall  have 
been  reported  to  them.  _ 


SFXJOND    INTERN /VTION  AL    SANITARY    (!i>N  VKNTKjN.  145 

Sec.  484.  The  Superior  Siuiitnry  Jioard  is  hereby  authorized  to  add  the  narne.s  oí  other 
diseases  to  the  list  coritiiincd  in  section  480,  giving  due  publication  to  such  additions  as  it 
may  make  for  the  information  of  all  concerned. 

Sko.  485.  The  report  presciibed  in  section  480  siialj  be  made  in  writing  within  twenty- 
four  hours  after  the  first  visit  or  consultation,  or  immediately  after  if  the  case  be,  suspected 
or  coirlinned,  of  Asiatic  cholera,  yellow  fever,  scarlet  fever,  measles,  hubonic  plague,  diph- 
theria oi'  croup,  glanders,  or  tetanus  nconatoium.  Said  report  shall  be  made  on  printed 
blanli  forms  furnished  by  the  sanitary  boajxl. 

Sec.  486.  Physicians  tittending  or  visiting  cases  of  transmissible  diseases  shall  send  to 
the  local  sanitary  chief  a  certificate  of  the  result  of  each  case. 

Sec.  487;  The  attention  of  physicians  is  paiticulai'ly  brought  to  the  fact  that  they  must 
report  all  cftses  of  tuberculosis  attended  by  them,  even  if  such  cases  may  have  been  attended 
previously  by  other  physicians. 

Sec.  488.  It  shall  be  the  duty  of  persons  affected  with  tuberculosis,  as  well  as  of  their 
relatives  and  attendants,  and  of  private  and  public  institutions,  to  comply  with  and  enforce 
all  regulations  and  measures  presci'ibcd,  in  ordei-  to  prevent  the  spiead  of  the  di.sease. 

Sec.  489.  When  two  or  more  physicians  have  visited  in  consultation  a  case  of  trans- 
missible disease,  the  one  taking  charge  of  the  attendance,  or,  if  none  of  them  take  charge 
of  it,  the  one  who  shall  have  visited  or  examined  the  patient  fh'st,  shall  report,  the  case. 

Sec.  490.  Physicians  shall  likewise  report  all  cases  of  transmissible  diseases  the  patients 
of  which  go  to  their  offices  in  consultation,  stating  this  fact  in  the  report,  as  well  as  the 
name,  residence,  etc.,  of  the  patient. 

Sec.  491.  Owners  or  managers  of  boarding  houses,  hotels,  lodging  houses,  colleges,  fac- 
tories, and  other  places  where  many  persons  dwell  or  sleep  shall  also  report  to  the  sanitary 
chief  within  twenty-four  hours,  all  cases  of  any  of  the  diseases  mentioned  in  section  480 
which  may  occur  in  their  respective  establishments. 

Sec.  492.  The  sanitary  chief,  the  medical  health  inspector,  or  the  committee  on  infec- 
tious diseases  shall  have  the  right  to  visit  any  case,  suspected  or  confirmed,  of  transmis- 
sible disease. 

Sec.  493.  Directors  of  hospitals,  sanitariums,  etc.,  shall  state  in  their  reports  the  resi- 
dence of  the  patient  or  the  place  where  it  be  supposed  he  contracted  the  disease. 

Sec.  494.  Any  person  having  knowledge  of  the  existence  of  a  case  of  transmissible  dis- 
ease, or  of  a  death  caused  therefrom,  without  medical  attendance,  must  report  the  same  to 
the  sanitary  chief. 

Se^.  495.  Any  physician  attending  a  case  of  transmissible  disease  shall  advise  the  head 
of  the  family,  or  the  person  in  charge  thereof,  as  to  what  measures  should  be  taken  to  pre- 
vent contagion  and  the  spread  of  the  disease. 

Sec.  496.  All  cases  of  diseases  easily  transmitted  shall  be  isolated  upon  order  of  the 
sanitary  chief,  either  in  the  patient's  house,  if  there  be  eflBcient  means  for  the  isolation,  or 
in  hospital,  lazaretto,  or  other  isolated  place. 

Sec.  497.  According  to  the  nature  of  the  disease,  the  isolation  may  include  the  entire 
house  inhabited  by  the  patient.  The  sanitary  chief  may,  at  his  discretion,  order  the  iso- 
lation of  all  or  some  of  the  persons  residing  in  said  house,  or  of  the  persons  coming  in  con- 
tact with  the  patient.  Such  persons  shall  be  subject,  after  the  isolation,  to  the  observation 
requirements  which  the  sanitary  chief  may  prescribe. 

Sec.  498.  Flags  and  placards  shall  be  placed  in  a  conspicuous  position  or  positions  upon 
houses  where  there  are  cases  of  cholera,  yellow  fever,  bubonic  plague,  exanthematic  typhus, 
smallpox,  scarlet  fever,  and  diphtheria  or  croup.  It  shall  be  unlawful  to  hinder  or  obstruct 
the  placing  of  said  flags  or  placards,  or,  when  placed,  to  deface,  obliterate,  or  in  any  man- 
ner conceal  the  same. 

Sec.  499.  The  attendance  of  persons  suiTering  from  cholera,  yellow  fever,  typhus,  typhoid 
fever,  smallpox,  scarlet  fever,  measles,  or  diphtheria  shall  not  be  permitted  in  colleges, 
hotels,  boarding  houses,  factories,  workshops,  barracks,  prisons,  and  other  places  where  a 
large  number  of  persons  dwell  or  gather,  except  when  such  places  are  provided  with  a  suit- 
able location  for  the  isolation  of  transmissible  diseases,  the  conditions  of  which  are  satis- 
factory to  the  sanitary  chief. 

Sec.  500.  Every  municipality  shall  be  provided  with  a  special  hospital  or  lazaretto 
properly  fitted  for  the  isolation  of  cases  of  transmissible  diseases. 

Sec.  501.  Physicians,  nurses,  and  other  persons  attending  patients  of  transmissible  dis- 
eases must  not  come  in  contact  with  other  per-sous  unless  they  have  previously  disinfected 
themselves  in  the  mamier  prescribed  by  the  local  sanitary  board. 

Sec.  502.  When  the  circumstances  of  the  case  shall  so  demand  it.  a  sanitary  watchman 
shall  be  stationed  in  houses  the  isolation  of  which  may  have  been  ordered  for  the  purposes 
of  securing  compliance  with  these  ordinances.  The  persons  in  charge  of  such  buildings 
sliall  be  held  responsible  for  the  violations  committed  by  the  persoimel  under  them. 

Sec.  503.  Persons  escaping  vigilance  or  breaking  the  isolation  shall  be  punished  accord- 
ingly- 

5610—06 10 


146  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sec.  504.  No  pereou  shall,  without  the  wi-ittcn  corsent  of  the  local  sanitaiy  chief,  cany 
or  remove,  or  cause  to  be  carried  or  removed,  from  place  to  place  any  person  suffering 
from  uuj'  transmissible  disease.  No  person  shall  expose  himself  while  sulfering  from  any 
transmissible  disease.  This  prohibition  includes  nurses  and  other  persons  who  have  been 
exposed  to  such  disease,  until  they  have  secured  the  consent  of  the  local  sanitaiy  chief, 
who,  before  granting  it,  shall  cause  all  necessaiy  precautions  to  prevent  contagion  to  lie 
taken. 

Sec.  505.  The  transportation  of  persons  suffering  from  transmissible  diseases  shall  be 
eflfected  in  suitable  ambulances,  which  must  be  disinfected  after  having  been  used.  In 
towns  where  there  be  no  such  vehicles  the  transportation  may  be  made  in  caniages, 
which  must  also  be  disinfected  in  the  manner  prescribed  by  the  local  sanitaiy  chief.  The 
ownei^s  or  conductors  of  said  carriages,  as  the  case  may  be,  shall  be  held  responsible  for  the 
noncompliance  with  this  provision. 

Sec.  506.  It  shall  be  unlawful  to  cany  or  transport  in  tiamways  or  omnibuses  persons 
suffering  from  transmissible  diseases.  Such  transportation  may  be  made  in  railroad  cars, 
provided  they  are  properly  fitted  for  it  and  isolated.  The  consent  of  the  local  sanitary 
chief,  approved  by  the  superior  sanitaiy  chief,  must  be  previously  secured  therefor.  Cars 
used  in  the  transportation  aforementioned  must  be  thoroughly  disinfected  before  being 
used  again.     Persons  violating  the  provisions  of  this  section  shall  be  punished  accordingly. 

Sec.  507.  BacteriologicaUy  confirmed  cases  of  leprosy  which  are  not  properly  isolated 
and  cared  for  shall  be  confined  in  the  San  Lázaro  Hospital  of  Habana  or  of  Santa  Clara, 
in  accordance  with  the  provisions  relating  thereto. 

Sec.  508.  Any  physician  attending  on  or  visiting  a  case  of  transmissible  disease  shall 
send  to  the  local  sanitaiy  chief  a  certificate  signed  by  him  certifying  to  the  recovery  of 
case  as  soon  as  he  becomes  aware  of  such  recoveiy.  No  person  who  has  sufl'ered  from  anj' 
transmissible  disease  shall  be  pennitted  to  go  out  until  he  shall  have  secured  an  official 
certificate  of  recovery. 

Sec.  509.  Children  suffering  from  transmissible  diseases,  or  children  living  in  houses 
where  cases  of  such  diseases  exist,  shaU  not  be  admitted  in  schools,  colleges,  workshops, 
etc.  This  prohibition  includes  laborers  or  employees  therein.  Teachers  and  foremen 
sbaU  report  to  the  sanitaiy  chief  any  case  of  transmissible  disease  which  they  may  notice. 
Parents,  guardians,  teachers,  and  foremen  shall  be  held  responsible  for  the  violations  of 
this  section. 

Sec.  510.  The  person  in  charge  of  the  house  in  which  there  is  a  case  of  transmissible  dis- 
ease must  strictly  comply  with  the  special  instmctions  given  him  by  the  sanitaiy  chief  in 
regard  to  the  patient,  his  room,  etc. 

Sec.  511.  No  house,  room,  etc.,  in  which  a  case  of  transmissible  disease  has  been  shall 
be  used  again  until  properly  disinfected. 

Sec.  512.  Local  sanitary  chiefs  shall  notify  the  superior  sanitary  chief  as  soon  as  they 
become  aware  of  the  appearance  of  any  case  of  acute  quarantinable  disease  (yellow  fever, 
Asiatic  cholera,  smallpox,  bubonic  plague,  exanthematic'  typhus)  and  shall  immediately 
enforce  the  necessaiy  preventive  measm-es. 

Sec.  513.  Besides  the  enforcement  of  the  provisions  of  these  ordinances,  in  regard  to  trans- 
missible diseases,  the  local  sanitary  board  shall,  as  soon  as  it  shall  become  aware  of  the 
appearance  in  its  locality  of  any  case  of  quarantinable  disease  (yellow  fever,  bubonic  plague, 
smallpox,  Asiatic  cholera,  exanthematic  typhus),  secure  the  strict  compliance  of  the 
preventive  measures  prescribed  by  the  Superior  Sanitary  Board  in  each  case,  such  as  the 
isolation  of  cases,  and,  if  practicable,  it  shall  order  the  removal  of  the  patients  to  a  place 
properly  fitted  for  the  absolute  isolation  and  suitable  attendance.  If  the  focuses  of  any  of 
such  diseases  be  several,  it  shall  secure  the  isolation  of  the  cases  in  places  distant  from  the 
inhabited  parts  of  the  town.  It  shall  request  the  competent  authorities  to  order  the  closure 
of  schools,  theaters,  etc.,  and  to  prohibit  sick  persons,  or  persons  suspected  of  being  sick,  from 
going  out  of  the  town. 

The  local  sanitary  board  shall  send  to  the  Superior  Sanitary  Board  a  daily  repoit  of  all 
measures  prescribed  by  it,  as  well  as  of  the  necessities  which  require  prompt  attention. 

The  official  announcement  of  the  existence  of  an  epidemic  in  any  place  of  the  Republic 
shaU  be  made  only  by  the  Chief  Executive  after  hearing  the  superior  sanitaiy  chief. 

Sec.  514.  The  local  sanitary  boards  of  other  municipalities  shall  exercise  the  gieatest  care 
in  watching  o^'er  the  means  of  communication  with  the  municipality  where  an  epidemic 
prevails,  disinfecting  everything  that  comes  therefrom,  and  exercising  a  careful  inspection 
over  persons  coming  also  therefrom.  If  the  enforcement  of  more  vigorous  measures  be 
necessary,  the  question  shall  be  submitted  to  the  Superior  Board. 

Sec.  515.  While  an  epidemic  prevails  the  local  sanitary  board  shaU  order  the  disinfec- 
tion of  all  premises  where  cases  of  the  disease  have  occurred. 

Sec.  516.  All  articles  in  use  in  the  loom  or  rooms  of  persons  sufl'ering  fi'om  transmissible 
diseases  .shall  be  disinfected,  as  well  as  all  other  articles  which  have  been  exposed  to  infection, 
and  school  books  and  supplies  to  be  taken  by  children  to  the  school. 


SECOND    INTKKNATIONAL    SANITARY    rONV  KNTION.  147 

Sec.  517.  Clothing  used  by  siidi  sick  porsoiis  inu.sfc  not  Ix!  tukcn  to  liiuriflrics  unlcs.s  the 
same  have  been  previously  (lisinrectcd  and  tlus  consent  of  the  sanitary  chiiif  therefor  been 
secured.  Tiio  same  prohibition  is  applicable  to  furniture,  utensils,  and  other  articles  from 
an  infected  house. 

Sec.  518.  It  shall  be  the  duty  of  tiu^  pe/.son  in  charge  of  an  inívcXcá  Iiímjsc  to  carry  out, 
within  the  time  prescribed  by  the  .sanitary  bf)ai(i,  the  works  or  niea,sures  which  at  the  dis- 
cretion of  the  latter  are  necessary  for  the  suppression  of  the  unhf^althful  conditions  of  the 
promises. 

Sec.  519.  The  sanitary  board  may  order  th<i  dislodging  of  any  hou.se  considered  as  a  focus 
of  infection,  or  which  constitutes  a  danger  to  public  health.  Said  house  shall  not  be 
occupied  9£ain  until  all  danger  of  inj'ection  shall  have  been  removed. 

Sec.  520.  It  shall  be  unlawl'ul  to  spread,  propagate,  or  circulate  false  reports  or  rumors  as 
to  the  appearance  of  any  transmissible  disease  in  any  part  of  the  Republic. 

Sec.  521.  All  measures  prescribed  in  accordance  with  the  piovisions  of  this  chapter  shall 
be  inunediateJy  enforced,  and  if  appeals  be  taken  tlicrei'rom,  such  appeals  shall  be  admitted 
without  suspending  the  operation  of  said  measures. 

Chapter  XXII. 

INHUMATIONS,  CEMETERIES,  UNDERTAKERS,    AND    EXHUMATIONS. 

Sec.  522.  Burials  shall  only  be  made  upon  written  order  ft-om  the  respective  court, 
which,  before  issuing  the  same,  shall  require  the  presentation  of  the  medical  death  certifi- 
cate. 

Sec.  523.  Death  certificates  shall  be  made  in  duplicate,  in  forms  prescribed  and  furnLshed 
by  the  Superior  Board  of  Health.  The  use  of  Bertillon's  international  Terminology  .shall  be 
compulsory.  The  respective  municipal  court  shall  keep  one  of  the  copies  of  the  certificate 
and  send  the  other  one  to  the  Superior  Board  of  Health  within  five  days. 

Sec.  524.  As  soon  as  a  cadaver  begins  to  decompose,  it  shall  be  inclosed  in  the  casket. 

Sec.  525.  Bodies  of  persons  who  have  died  of  any  contagious  disease  shall  be  kept 
enveloped  in  sheets  saturated  with  the  antiseptic  solutions  prescribed  by  the  sanitarj'  board, 
and  shall  be  inclosed  in  their  lespective  caskets  as  soon  as  possible. 

Sec.  526.  No  peisons  shall  gather  in  a  house  in  which  there  is  a  cadaver,  and,  when  it  has 
been  carried  awajr,  until  the  house  has  been  disinfected. 

Sec.  527.  Cadavers  shall  be  conveyed  to  the  cemetery  in  heiTnetically  closed  caskets,  in 
order  to  prevent  the  escape  of  gases  or  liquids;  the  transportation  shall  be  made  by  persons 
or  in  hearses;  no  other  kind  of  vehicles  shall  be  pemiitted  unless  it  be  necessarj^  and  the 
local  sanitary  chief  authorizes  it. 

The  caskets  for  cadavers  to  be  buried  in  the  ground  must  be  made  of  wood  in  order  to 
facilitate  the  organic  decomposition. 

Sec.  528.  The  conveyance  of  cadavers  of  persons  who  have  died  from  -transmissible  dis- 
eases shall  not  be  effected  by  persons ;  such  cadavers  shall  not  be  conveyed  to  churches  or 
other  public  places,  and  no  children  shajl  be  permitted  to  attend  the  funerals  of  such 
cadavers.  If  the  case  be  of  a  quarantinable  disease  no  other  person  but  strictly  necessary 
for  the  conveyance  shall  be  allowed. 

Sec.  529.  The  conveyance  of  cadavers  in  open  caskets  is  prohibited. 

Sec.  530.  The  burial  of  a  cadaver  shall  be  made  twenty-four  or  thirty  hours  after  the 
death  has  occurred  and  tlje  cadaver  begins  to  decompose,  unless  it  be  properly  embalmed, 
and  the  consent  in  writing  of  the  local  sanitary  chief  to  defer,  for  several  hours  only,  the 
number  of  which  shall  be  stated  in  the  permit,  the  burial  or  removal  thereof  to  the  deposit 
of  the  cemetery,  be  secured. 

Cadavers  deposited  in  the  morgue  or  other  place  by  judicial  order  are  excepted  from  this 
provision. 

Sec.  531.  Cadavers  of  persons  who  have  died  from  smallpox,  diphtheria  or  croup,  scarlet 
fever,  bubonic  plague,  Asiatic  cholera,  or  lepros}",  shall  be  conveyed  to  the  cemetery  within 
twelve  hours  aftei'  the  death  has  occm'red,  unless  they  be  embalmed  and  the  consent  in 
writing  from  the  local  sanitarj"  chief,  in  the  manner  prescribed  in  the  preceding  section,  be 
secured. 

Sec.  ¿32.  The  burial  of  a  cadaver  within  the  city  limits,  or  outside  of  the  cemeteries 
authorized  b}^  law,  is  prohibited.  Not  only  the  persons  intervening  in  the  interment  shall 
be  held  responsible  for  the  violation  of  this  section,  but  also  those  present  thereon  who  shall 
not  notify  the  fact  to  the  authorities  immediately. 

Sec.  533.  Cadavers  of  persons  who  have  died  in  hospitals,  sanitariimis,  lazarettos,  etc., 
of  exanthematic  typhus,  smallpox,  scarlet  fever,  diphtheria,  Asiatic  cholera,  bubonic  plague, 
or  leprosy,  shall  be  removed  to  the  cemetery  directly. 

Sec.  534.  No  casket  shall  be  used  more  than  once.  Caskets  used  in  hospitals  and  ana- 
tomical amphitheaters  excepted,  provided  they  are  metallic  boxes  and  thoroughly  disinfected 
whenever  used. 


148  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Sec.  535.  No  refrigerator  or  ice  box  for  cadavers  which  model  shall  uot  have  been 
approved  hj  the  sanitary  board  shall  be  permitted. 

Sec.  536.  The  use  of  ciutains,  tapestrj',  and  carpets  shall  not  be  permitted  in  places 
where  cadavers  are  exposed. 

Sec.  537.  The  construction  of  new  cemeteries  shall  be  subject  to  the  following  rules: 

(1)  No  new  cemetery  shall  be  laid  out  at  a  distance  of  less  than  1,000  meters  from  the 
boundaries  of  an  important  municipality;  or  of  less  than  500  meters  from  the  boundaries  of 
towns  of  lesser  importance;  or  of  less  than  200  metéis  from  remote  villages,  highways,  or 
roads.  The  probable  extension  of  the  town  or  village  toward  the  site  sought  for  such  con- 
struction must  also  be  taken  into  consideration. 

(2)  No  new  cemeter}'  shall  be  laid  out  at  a  distance  of  less  than  200  meters  from 
springs,  cisterns,  wells,  fountains,  or  ac|ueducts  containing  or  canying  water  for  drinking 
purposes. 

(3)  A  high  location,  slightly  sloping,  situated  leeward  of  the  to'mi,  and  which  ground  can 
be  easily  dug  to  a  depth  of  2  meters,  permeable  to  air  and  water  for  the  purposes  of 
orgauic  decomposition,  shall  be  selected  for  site  of  a  new  cemetery. 

(4)  The  area  of  the  site  must  be  in  proportion  with  the  nmnber  of  inhabitants  of  the 
town,  its  probable  increase,  its  morbility,  and  the  expiration  of  the  lease  of  each  grave, 
which  shall  be  for  the  term  of  five  years,  at  least;  such  proportion  shall  be  estunated  allow- 
ing 3  square  meters  for  each  grave,  and  taking  into  consideration  the  space  necessary  for 
passages,  buildings,  deposits,  moruments,  parks,  trees,  etc. 

(5)  Cemeteries  must  be  inclosed  with  good  and  sufficient  waUs  and  fences  not  more  than 
2  meters  high,  so  that  the  free  circulation  of  the  air,  or  the  action  of  the  sun,  shall  not  in 
any  way  be  obstructed. 

(6)  The  construction  of  niches  is  prohibited.  The  ground  of  vaults  or  gi-aves  must  be 
earthen  and  perfectly  permeable. 

(7)  There  shall  be  in  every  cemetery  a  special  room  for  the  deposit  of  cadavers  and 
another  one  for  autopsies,  jjroperly  provided  with  water,  tables,  washstauds,  etc. 

(8)  Other  sanitary  requiiements  to  which  the  interior  management  of  cemeteries  must  be 
subject  shall  be  specified  in  special  regulations. 

The  enlargement  or  alteration  of  cemeteries  existing  at  the  time  of  the  passage  of  these 
ordinances  shall  be  made  in  accordance  with  the  foregoing  provisions  in  so  far  as  they  are 
applicable. 

The  advice  of  the  local  sanitary  board  and  the  Superior  Board  shall  be  necessary  for  the 
establislmient  of  country  cemeteries. 

Sec.  £38.  The  following  requirements  shall  be  specified  in  the  special  regulations  for 
cemeteries: 

(1)  Size  of  and  minimum  distance  between  graves,  which  shall  be  as  follows:  Depth  for 
all  graves,  2  meters;  length,  for  cadavers  of  adults,  2  meters;  width,  85  centuneters;  dis- 
tance in  all  directions,  40  centimeters;  for  cadavers  of  children,  the  length  and  width  may 
be  reduced  in  proportion  with  the  age  of  each  cadaver. 

(2)  The  layer  of  compressed  earth  covering  the  grave  shall  be  1^  meters  thick;  the 
cadaver  shall  be  covered  before  with  a  layer  of  lime  2  or  3  centimeters  thick. 

(3)  The  burial  of  cadavers  in  ditches  shall  be  prohibited. 

(4)  The  advice  of  the  local  sanitary  board  shall  be  necessary  for  the  opening  or  removal 
of  graves,  etc.,  the  deposit  of  remains  in  ossariums,  the  partial  or  total  cleaning  of  closed 
cemeteries,  and  the  removal  therefrom  of  remains  to  other  cemeteries. 

(5)  Approval  of  the  special  regulations  by  the  Superior  Sanitary  Board,  upon  report  of 
the  local  board  of  the  respective  municipality. 

Sec.  539.  Every  cemetery  shall  have  an  isolated  place  suitable  for  the  cremation  of 
cofíins,  shrouds,  and  other  articles  collected  from  disinterments. 

Sec.  540.  No.  beverages,  candies,  and  other  food  products  shall  be  sold  or  offered  for 
sale,  or'kept  in  cemeteries. 

Sec.  541.  Hearses  which  have  been  used  in  the  transportation  of  cadavers  of  persons  who 
have  died  of  exanthematic  typhus,  typhoid  fever,  smallpox,  measles,  scarlet  fever,  diph- 
theria or  croup,  Asiatic  cholera,  bubonic  plague,  erysipelas,  puerperal  fever,  tuberculosis, 
or  glanders  shall  be  disinfected  by  the  undertaker  in  the  cemetery  immediately  after  being 
used,  in  the  manner  prescribed  by  the  sanitary  board. 

Sec.  542.  Private  carriages  which  have  been  used  in  the  transportation  of  cadavers  shall 
be  likewise  disinfected  by  the  respective  owners. 

Sec.  543.  It  shall  be  the  duty  of  undertakers  to  register  their  names,  residences,  etc.,  in 
a  record  kept  for  the  purpose  by  the  local  sanitary  board. 

Sec.  544.  Persons  desiring  to  open  an  undertaking  establishment,  or  to  engage  in  the 
practice  of  undertaking,  must  provide  themselves  with  the  necessary  license.  The  sanitary 
board  shall  issue  such  hcense  if  the  applicant  furnishes  satisfactory  proof  that  he  is  acquainted 
with  the  methods  of  disinfection  in  general,  and  the  handling  of  cadavers  of  persons  who- 
have  died  of  transmissible  diseases. 


SECOND    INTERNATIONAL    SANITARY    ÍJONVENTION.  14Í-) 

Seo.  545.  It  shall  be  the  duty  of  undertakors  to  send  to  the  local  sanitaiy  board  a  weekly 
report  of  all  burials  cil'cctcd  by  them  durinj^  the  week. 

Seo.  546.  No  disinterments  shall  be  inado  within  two  years  after  the  burial,  except  upon 
a  judicial  order,  or  when  tlie  cadaver  has  l>ocn  embalmed. 

Seo.  547.  No  disintei-ment  shall  be  made  witliout  the  wi'itten  consent  of  the  local  sanitary 
board,  wiiere  it  shall  be  stated  that  such  disinterment  will  not  constitute  a  danger  to 
public  health. 

Sec.  548.  Disinterments  shall  be  made  in  the  presence  of  a  physician  authorized  by  the 
sanitary  board  to  represent  it ;  said  physician  shall  take  the  greatest  precautions  to  prevent 
any  danger  to  jjublic  health,  ordering  the  disinfection  of  the  grave,  the  coilin,  and  the 
cadaver  or  its  remains. 

Seo.  549.  In  no  caso  shall  a  giave  be  opened  in  which  has  been  buried  the  body  of  any 

{)erson  wHo  has  died  of  bubonic  plague,  Asiatic  cholera,  diphtheria,  smallpox,  scailet  fever, 
eprosy,  or  glanders,  within  five  years  after  the  burial.  The  consent  of  the  local  sanitary 
board  shall  be  necessai-y  therefor. 

Chapter  XXIII. 

AUTOPSIES,  EMBALMINGS,  ETC. 

Seo.  550.  No  autopsy  shall  be  performed  outside  of  hospitals,  morgues,  cemeteries,  and 
medical  schools.  No  autopsy  shall  be  made  within  twelve  hours  after  the  death.  It  shall 
be  unlawÍTil  to  embalm,  mummify,  or  petrify  any  cadaver  within  twelve  hours  after  the 
death. 

It  is  likewise  prohibited  to  mold  the  face,  neck,  or  any  part  of  a  cadaver  within  twelve 
hours  after  the  death  and  without  the  consent  of  the  local  sanitary  chief.  Such  operation 
shall  never  be  permitted  in  cadavers  of  persons  who  have  died  of  smallpox,  measles,  scarlet 
fever,  bubonic  plague,  or  leprosy. 

Sec.  551.  The  following  requirements  shall  be  necessary  for  the  carrying  out  of  any  of 
the  operations  referred  to  in  the  preceding  section:  (a)  The  consent  of  relatives  of  the 
deceased  person,  (b)  the  death  certificate,  and  (c)  the  presence  of  the  local  sanitary  chief 
or  of  a  physician  authorized  by  him  to  represent  him.  The  presence  of  this  officer  shall 
not  be  necessary  in  autopsies. 

Sec.  552.  The  local  sanitary  board  may  order  the  carrying  out  of  any  of  such  operations 
whenever  the  interests  of  public  health  shall  so  demand  it. 

Seo.  553.  The  operations  above  referred  to  nuist  be  performed  by  professors  of  surgery 
or  medicine  exclusively. 

Sec.  554.  The  local  sanitary  chief,  his  deputy,  or  the  professors  performing  the  operation 
shall  diaw  up  and  execute  a  certificate,  to  be  signed  by  him  or  them  and  two  ^vitnesses,  in 
which  the  contents  of  the  death  certificate,  the  hour  and  day  of  the  operation,  the  process 
employed  for  the  embalming,  mummifying,  etc.,  and  the  composition  of  the  liquids  injected 
into  the  cadaver,  or  used  otherwise,  shall  be  stated. 

Sec.  555.  The  death  certificate  and  the  certificate  referred  to  in  the  preceding  section 
shall  be  sent  by  the  local  sanitary  chief  to  the  Superior  Sanitary  Board,  in  which  oflBce  the 
same  shall  be  filed. 

Sec.  556.  No  embalmed  cadaver  shall  be  deposited  in  a  house  or  church  for  more  than 
twenty-four  hours  after  it  has  been  embalmed,  except  with  the  consent  of  the  local  sanitary 
chief.  During  said  time  the  cadaver  shall  be  under  the  custody  of  the  physician  who  wit- 
nessed the  operation  of  embalming. 

Sec.  557.  The  provisions  of  this  chapter  may  be  suspended  or  amended  by  the  health 
authorities  in  time  of  epidemic. 

Chapter  XXIV. 

conveyance  of  cadavers. 

Sec.  558.  No  cadaver  of  a  person  who  has  died  of  smallpox  or  bubonic  plague  shall  be 
conveyed  from  one  municipality,  town,  or  province  to  another. 

Sec.  559.  The  conveyance  of  cadavers  of  persons  who  have  died  from  typhoid  fever, 
tuberculosis,  Asiatic  cholera,  yeUow  fever,  exanthemalic  typhus,  diphtheria  or  croup,  scarlet 
fever,  measles,  erysipelas,  puerperal  fever,  glanders,  anthi-ax,  or  leprosy  shall  cnly  be 
permitted  after  such  cadavers  have  been  prepared  therefor  and  disinfected  in  the  following 
manner:  (a)  Arterial  and  capilliary  injection  of  an  eflncient  antiseptic  solution,  (b)  disin- 
fection and  tamponage  with  absorbent  cotton  of  all  orifices,  and  (c)  exterior  washing  of 
the  body.  These  operations  shall  be  performed  by  a  physician  and  with  the  consent  of 
the  local  sanitary  chief. 

Sec.  560.  After  the  cadaver  has  been  disinfected  in  the  manner  prescribed  in  the  pre- 
ceding section  it  shall  be  enveloped,  fii'st,  in  a  cotton  coating  thi-ee  centimeters  thick,  and 
then  with  a  sheet  perfectly  adjusted;  then  it  shall  be  placed  on  a  case  made  of  zinc,  tin, 


150  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

copper,  or  iron,  and  which  shall  be  hermetically  sealed.  This  case  shall  be  inclosed  in  a 
wooden  box.  , 

Sec.  561.  Cadavers  of  persons  who  have  died  ft-om  diseases  different  from  those  mentioned 
in  the  preceding  sections  may  be  conveyed  to  places  thau  can  be  reached  within  thirty  hours 
after  the  death.  Sucli  cadavers  shall  be  inclosed  in  hermetically  sealed  metallic  cases, 
which  shall  be  placed  in  wooden  boxes.  If  the  place  of  destination  can  not  be  reached 
within  the  time  prescribed,  the  same  requirements  pi-escribed  in  the  preceding  section  shall 
be  followed. 

Sec.  562.  No  person  who  has  been  exposed  to  infection  shall  be  permitted  to  attend  the 
funeral  of  the  cadaver  of  a  person  who  has  died  of  any  of  the  diseases  mentioned  in  section 
559,  except  with  the  consent  of  the  sanitary  chief  certifjing  that  said  person  has  been 
properly  disinfected. 

Station  masters  shall  carefully  examine  the  permit  for  the  conveyance  of  the  cadaver,  in 
which  the  names  of  the  person  in  charge  of  the  conveyance,  and  of  those  authorized  to 
attend  the  funeral  shall  be  stated. 

Sec.  563.  The  local  sanitary  chief  shall  notify,  by  telegi'am,  the  local  chief  of  the  place 
where  the  cadaver  is  to  be  convej^ed,  stating  in  the  notice  the  name  of  the  disease,  the  date, 
hour,  train,  or  steamer  by  which  it  is  sent,  and  the  station  or  wharf  at  which  it  shall  arrive. 

Sec.  564.  Every  cadaver  transported  must  be  accompanied  by  a  person  who  shall  carry 
with  him  the  permit  from  the  local  sanitary  chief,  and  of  a  copy  of  the  death  certificate.  It 
shall  be  stated  in  said  permit  whether  the  disease  is  transmissible  or  not,  the  place  of  des- 
tination, and  the  names  of  the  persons  authorized  to  attend  the  funeral. 

Sec.  565.  A  certificate  ft-om  the  embalmer  as  to  the  manner  in  which  the  cadaver  has  been 
prepared  for  the  transportation  shall  also  be  necessary.  A  copy  of  this  certificate  shall  be 
attached  to  the  exterior  case. 

Sec.  566.  The  permit  for  the  conveyance  of  a  cadaver  shall  be  made  in  duplicate  and 
shall  be  signed  by  the  attending  physician,  the  local  sanitary  chiei,  and  the  embalmer. 
One  of  the  copies  shall  be|  delivered  to  the  person  in  charge  of  the  cadaver  and  the  other 
shall  be  sent  to  the  superior  sanitary  chief. 

Sec.  567.  The  exterior  case  shall  be  provided  with  four  handles,  at  least. 

Sec.  568.  The  transportation  of  cadavers  by  express  shall  be  made  in  accordance  with 
the  provisions  of  sections  559,  560,  561,  563,  564,  566,  and  567.  The  documents  mentioned 
in  said  sections  shall  be  sent  to  the  agent  in  the  place  of  destination. 

Sec.  569.  Disinterred  cadavers,  whatever  the  cause  of  death  may  have  been,  shall  be 
considered  as  infectious  and  dangerous  to  pubhc  health ;  the  consent  of  the  Superior  Board 
of  Health  and  the  favorable  report  of  the  local  sanitary  board  shall  be  necessary  for  the 
removal  thereof. 

Such  cadavers,  or  parts  thereof,  or  the  boxes  containing  them,  shall  be  enveloped  in  a 
woolen  blanket  saturated  with  a  solution  of  hydrargyric  bychloride  at  1  per  1000  and  inclosed 
in  a  metallic  case  which  shall  be  hermetically  sealed. 

Sec.  570.  Cadavers  which  have  been  embalmed  and  prepared  in  the  manner  prescribed, 
and  which  have  been  temporarily  deposited  in  a  vault,  shall  not  be  considered  as  disinterred 
if  the  transportation  be  made  within  thirty  days  after  the  death,  and  it  shall  not  be  neces- 
sary to  secure  the  permit  of  the  local  sanitary  chief  of  the  place  of  destination. 

Chapter  XXV. 

BARBER   SHOPS. 

Sec.  571.  Metallic  instruments  used  in  barber  shops,  such  as  razors,  combs,  scissors,  as 
well  as  shaving  brushes,  immediately  after  being  used  shall  be  sterilized  by  being  immersed 
in  boiling  water,  which  shall  be  changed  every  time,  and  to  which  50  grams  of  carbonate  of 
sodium  shall  be  added. 

Sec.  -572.  Onl}^  metallic  combs  and  razors  with  metallic  handles  shall  be  used,  so  that  the 
same  maj'  be  properly  disinfected. 

Sec.  573.  The  strop  must  not  be  used  until  the  razor  has  been  previously  disinfected. 
The  razor  must  be  cleansed  with  a  new  piece  of  paper  whenever  used,  or  wth  a  rubber  devise 
which  must  be  disinfected  in  the  same  manner  as  other  utensils. 

Sec.  574.  The  use  of  powder  puffs  and  sponges  is  prohibited;  cotton,  to  be  renewed 
every  time,  shall  be  substituted  therefor.  No  alum  or  other  material  shall  be  used  to  stop 
the  flow  of  blood  unless  the  same  be  used  in  powder  or  liquid  form. 

Sec.  575.  No  barber  shall  permit  any  person  to  use  the  head  rest  of  any  barber's  chair 
under  his  control  until  after  the  head  rest  has  been  covered  with  a  towel  that  has  been 
washed  since  having  been  used  before,  or  by  clean,  new  paper. 

Sec.  576.  Every  barber  shall  cleanse  his  hands  thoroughly  with  brush  and  soap  inmie- 
diately  before  serving  each  customer.  No  barber  shall  use  for  the  service  of  a  customer 
any  towel  or  wash  cloth  that  has  not  been  boiled  or  laundered  since  last  used. 


SECOND    INTERNATIONAL    HANfTARY    CONVENTION.  151 

Sec.  577.  No  person  sunVring  from  a  corniriunicablc,  disease  shall  be  permitted  to  act  aa 
barber.  -No  services  shall  be  rendered  to  persons  suffering  from  a  similar  disease,  unless 
such  persons  be  provided  with  their  own  uten.^ils. 

Sec.  578.  Every  manag(ir  of  a  barber  shof)  shall  keep  said  shop  and  all  furniture,  tools, 
appliances,  and  other  equipments  used  tlieivin  at  all  times  in  a  cleanly  condition. 

Sjoc.  .')7!).  Tin  ownei'  or  miUia<i;er  of  any  barbi'r  shop  shall  keep  a  Cüi)y  of  the  sections  of 
this  chapter,  and  other  provisions  of  law  conceiTiing  the  trade,  to  bi!  furnish-d  by  the  local 
sanitary  board,  posted  in  a  conspicuous  place  of  said  shop. 

ClIAI'TEH   XXVI. 
PUBLIC   BATH   HOUSES. 

Sec.  580.  The  favorable  report  of  the  local  sanitary  board  shall  be  necessary  for  the 
establishment  of  a  public  bath  house;  said  report  shall  be  rendered  after  duo  con.sidcra- 
tion  has  been  given  to  the  plans  and  specifications,  etc.,  of  the  establishment. 

Minero-medicinal  bath  houses  shall  be  governi-d  by  special  regulations. 

Sec.  581.  Every  public  bath  house  shall  be  provided  with  water-closets  and  urinals  in 
sufficient  numb?r. 

Sec.  582.  The  bath  tubs  must  be  made  of  marble,  porcelain,  or  enameled  iron,  with 
direct  outlets  to  the  general  sewer. 

Sec.  583.  The  pavements  of  each  bathroom  shall  be  kept  in  a  cleanly  condition,  and 
must  be  dried  before  any  person  is  permitted  to  use  it  again. 

Sec.  584.  Every  bathroom  shall  be  provided  with  windows,  electric  bells,  and  doors 
which  can  be  easily  opened  in  case  of  an  accident. 

Sec.  585.  Every  swimming  pool  must  be  provided  with  ropes,  cables,  etc.,  for  the  safety 
of  bathers;  the  water  therein  must  be  constantly  renewed;  children  imder  ten  years  of  age, 
unless  accompanied  by  a  person  to  take  care  of  them,  shall  not  be  permitted  to  bathe 
therein. 

Water  that  has  been  used  once  in  swimming  pools,  bath  tubs,  etc.,  must  not  be  utilized 
again. 

Sec.  586.  Clothing,  towels,  wash  cloths,  etc.,  must  not  be  used  for  the  service  of  any  cus- 
tomer unless  the  same  has  been  laundered  since  last  used,  and  must  be  sterilized  when  so 
ordered  by  the  local  sanitary  chief. 

Sec.  587.  Every  therapeutic  bathing  establishment  shall  be  under  the  management  of  a 
physician. 

Sec.  588.  No  person  suflFering  from  a  communicable  disease  shall  be  admitted  in  a  public 
bath  house,  and  if  this  prohibition  be  violated,  said  public  bath  house  shall  be  immediately 
disinfected,  irrespective  of  the  penalty  provided  for  such  violation. 

Sec.  589.  No  public  bath  house  shall  be  used  for  dwelling  purposes,  nor  rooms  therein 
shall  be  rented,  without  the  special  consent  in  writing  of  the  local  sanitary  board. 

Sec.  590.  A  copy  of  this  chapter,  to  be  furnished  by  the  local  sanitary  board,  shall  be 
posted  in  a  conspicuous  place  of  every  bath  house,  for  the  information  and  guidance  of  all 
concerned. 

Chapter  XXVII. 

GENERAL   PROVISIONS. 

Sec.  591.  Owners  of  uncultivated  lands  within  city  limits  must  keep  the  same  in  a 
cleanly  condition  and  free  from  excavations,  and  shall  prevent  the  deposit  therein  of  gar- 
bage or  any  other  matter  detrimental  to  public  health. 

Depositing  or  spreading  garbage  or  other  organic  matter  for  fertihzation  purposes  in 
j&rás  or  uncultivated  lands  in  towns  is  prohibited. 

Breaking  up  new  ground  within  city  limits  may  be  permitted,  provided  that  no  garbage 
or  other  filthy  matter  be  employed  for  fertilization  purposes. 

Sec.  592.  Spitting  or  expEctorating  on  sidewalks,  in  parks,  squares,  pubHc  buildings, 
railroad  cars,  tramways,  steamers,  public  vehicles,  etc.,  is  prohibited. 

It  shall  be  likewise  unlawful  to  spit  or  expectorate  on  the  pavements  or  walls  of  places 
where  it  is  compulsory  to  keep  cuspidors. 

Sec.  593.  Every  industrial  establishment,  factory,  hospital,  asylum,  chiuch,  school, 
prison,  pubhc  and  private  office,  café,  public  house,  etc.,  shall  be  properly  provided  with 
cuspidors,  of  the  model  prescribed  by  the  local  sanitary  board. 

Sec.  594.  Notices  forbidding  sucli  expectorating  or  spitting  shall  be  kept  posted  con- 
spicuouslj^  in  each  and  every  one  of  the  places  mentioned  in  the  two  preceding  sections. 

Sec.  595.  The  pohce  force  and  the  owners,  managers,  and  employees  shall  enforce  the 
foregoing  provisions;  they  shall  notify  the  sanitarj^  cMef  of  am^  violation  they  may  observe, 
giving  the  name  and  address  of  the  violator. 


152  SECCmO    INTERNATIONAL    SANITAKY    CONVENTION. 

Sec.  596.  Cuspidoi-s  shall  be  cleansed  every  day,  and  must  contain  water  or  an  antisep- 
tic solution.  In  public  places  designated  by  the  local  sanitarj'  board,  cuspidoi-s  shall  be 
aflSxtd  to  walls  at  a  sufficient  height. 

Sec.  597.  Calés  and  other  similar  places  must  be  kept  in  a  cleanly  condition  always. 

Sec.  59S.  Pavements  of  cafés,  bars,  hotels,  restaurants,  and  other  public  places  must  not 
be  covered  with  sawdust,  except  in  rainy  days. 

Sec.  599.  Pavements  of  public  places  must  be  washed  and  scrubbed  every  day. 

Sec.  600.  Door  mats  and  foot  scrapers  must  be  placed  at  the  entrance  of  evciy  public 
place  during  rainy  days. 

Sec.  601 .  Fiuit  stands  must  be  provid<  d  with  receptacli  s  for  peels  and  other  fruit  waste; 
no  decayed  fruits  shall  be  sold  or  offered  for  sale  in  such  fiaiit  stands,  and  must  be  kept  in 
a  cleanly  condition. 

Sec.  602.  Vehicles  of  all  kinds  must  be  kept  perfectly  clean  and  shall  be  disinfected 
whenever  the  local  sanitaiy  chief  shall  order  it. 

Sec.  603.  The  sale  of  wearing  apparel,  bed  clothing,  carpets,  curtains,  tapestrj-,  and 
other  articles  where  a  ca.se  of  any  transmissible  disease  has  occurred  shall  be  unlawful, 
unless  such  articles  have  been  duly  disinfected  before  being  taken  out  of  the  house.  The 
seller  or  the  purchasci-,  as  the  case  may  be,  shall  be  held  responsible  foi'  the  violation  of  this 
section.  The  disinfection  should  be  performed  in  such  a  manner  as  to  cause  the  least  pos- 
sible injury  to  the  articles. 

Sec.  604.  Second-hand  clothing  offered  for  sale  in  time  when  there  is  no  epidemic  in  the 
town  shall  be  duly  disinfected.  If  an  epidemic  prevails  at  the  time,  such  sale  shall  be 
prohibited. 

Sec.  605.  Rags  must  not  be  sold  or  offered  for  sale  unless  previously  disinfected. 

Deposits  for  rags  and  other  materials  which  may  constitute  a  focus  of  infection  must  be 
situated  outside  the  boundaries  of  the  municipality,  and  the  consent  of  the  local  sanitary 
board  shall  be  necessary  therefor. 

Sec.  606.  No  serums  or  vaccine  virus  shall  be  distributed  unless  they  be  derived  from 
laboratories  authorized  by  the  department  of  the  interior. 

Sec.  607.  Serums  and  vaccine  virus  must  be  distributed  on  theh-  original  receptacles,  and 
with  labels  stating  the  name  of  the  laboratorj^,  date  of  preparation,  and  directions  for  use. 

Sec.  608.  The  cultivation  of  germs  of  communicable  diseases  which  do  not  exist  in  the 
Republic  is  prohibited. 

Sec.  609.  All  public  laboratories  and  the  products  therefrom  are  hereby  made  subject 
to  inspection  by  the  local  sanitary  board. 

Sec.  610.  Physicians,  surgeons,  pharmacists,  veterinarians,  accouchers,  midwives,  and 
dentists  must  register  their  names,  signatures,  and  addresses  in  the  office  of  the  local  sani- 
tary board. 

Sec.  611.  It  shall  be  the  duty  of  physicians,  surgeons,  etc.,  to  call  upon  the  local  sanitary 
chief  on  any  matter  concerning  public  health. 

Sec.  612.  Plumbers  shall  secure  a  license  from  the  local  sanitary  board,  and  register 
their  names  and  addresses  in  a  book  kept  for  the  purpose  by  said  board.  They  shall  be 
subject  to  special  regulations,  which  shall  be  duly  published. 

S^c.  613.  Any  person  who  renders  medical  assistance  in  an  accouchement,  or  who 
separates  the  umbilical  cord,  without  the  necessary  antiseptic  precautions,  shaU  incur 
criminal  responsibility. 

Sec.  614.  Every  municipality  shall  be  provided  with  antiseptic  substances  for  the  treat- 
ment of  navels  of  newly  born  infants,  for  free  distribution  among  persons  applying  for 
the  same. 

Sec.  615.  Any  physician  who  deliberately  makes  alterations  in  a  diagnosis  or  in  a  death 
certificate,  or  who  fiomishes  the  local  sanitary  board  with  false  information  for  the  purpose 
of  concealing  a  case  of  any  particular  disease,  shall  incur  criminal  responsibility. 

Sec.  616.  No  wells,  cisterns,  etc.,  which  may  constitute  a  danger  to  pubhc  health,  or 
which  are  not  properly  protected  against  the  access  of  mosquitoes,  shall  be  permitted  in 
houses  within  city  limits. 

Sec.  617.  No  birds  or  other  animals  which  may  be  detrimental  to  health  or  annoy 
neighbors  shall  be  permitted  in  any  place  of  the  town. 

Sec.  618.  Besides  the  general  sanitary  provisions,  the  following  special  ones  shall  be 
observed  in  churches  and  public  chapels:  (1)  They  shall  be  provided  with  the  number  of 
cuspidors  prescribed  by  the  local  sanitary  board;  such  cuspidors  shall  contain  an  antiseptic 
solution  and  be  washed  daily;  (2)  the  confessionals  must  be  provided  with  metal  lattices 
which  shall  be  cleansed  f recjuently ;  (3)  the  pavements  shall  be  kept  in  a  cleanly  condition 
and  washed  frequently;  (4)  the  holy  water  must  be  changed  daily  and  the  fonts  disinfected 
with  boiling  water  or  other  antiseptic  solution;  (5)  notices  prohibiting  spitting  or  expecto- 
rating on  the  pavements,  etc.,  shall  be  kept  posted  in  conspicuoas  places  therein. 

Sec.  619.  Wells  or  excavations  containing  ffithy  or  decayed  matter  are  prohibited  in 
orchards  or  cultivated  lands.  It  shall  be  unlawlul  to  irrigate  or  fertilize  lands  with  such 
matter. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  153 

Sec.  620.  Before  any  municipality  undertakes  the  construction  of  any  public  work 
relating  to  public  health,  such  as  the  watijr  supply,  slaughterhouses,  cemeteries,  etc.,  the 
report  of  the  local  sanitary  board  shall  be  necessary,  wliieh  report  shall  be  submitted  to 
the  Superior  Board  for  approval. 

Sec.  621.  The  local  sanitary  board  shall  give  tlie  necessary  orders  for  the  desiccation  of 
swamps,  puddles,  etc.,  and  if  such  desiccation  be  impracticable,  it  shall  order  tliat  suffi- 
cient quantities  of  crude  petroleum  be  poured  periodically  into  such  swamps,  puddles,  etc., 
for  the  eradication  of  mosquito  larvae. 

It  shall  also  enforce  the  necessary  measures  for  the  suppression  of  the  causes  of  spread 
of  malarial  fever. 

Sec.  622.  It  shall  be  the  duty  of  every  municipality  to  issue,  within  thirty  days,  the 
necessary  license  for  the  execution  of  the  woi'ks  ordered  by  the  local  sanitary  board.  If 
the  municipality  has  special  reasons  to  refuse  the  granting  of  such  license,  it  shall  submit 
said  reasons  to  the  local  sanitary  board  within  ten  days. 

If  the  execution  of  a  particular  work  be  ui'gent,  the  municipality  shall  issue  the  license 
within  the  time  suggested  by  the  local  sanitary  board. 

Sec.  623.  It  shall  be  unlawful  to  hinder  or  obstruct  the  inspection  by  the  sanitary  chief, 
or  by  the  inspectors  of  the  sanitary  board  duly  authorized. 

The  police  shall  render  its  assistance  whenever  requested  by  the  inspectors. 

Part  III. 

VIOLATIONS   AND   PENALTIES. 

Sec.  624.  Violations  of  these  ordinances  which  are  not  defined  in  the  penal  code  as  crimes, 
shall  be  considered  as  misdemeanors  against  public  health,  and  shall  be  prosecuted  before 
the  respective  courts. 

Sec.  625.  He  who  commits  a  misdemeanor  in  violation  of  these  ordinances,  or  who 
refuses  to  comply  with  the  orders  of  the  sanitary  chief,  shall  be  punished,  in  accordance 
with  the  provisions  of  paragraph  (e)  of  section  3  of  civil  order  No.  159,  series  of  1902,  with 
a  fine  from  $10  to  $100,  official  currency,  or  imprisonment  from  ten  to  thirty  days,  or  both, 
at  the  discretion  of  the  court. 

Sec.  626.  The  sanitary  chief,  or  his  duly  authorized  deputy,  shall  take  charge  of  the 
prosecution  of  said  violations. 

The  written  reports  of  the  sanitary  inspectors  shall  form  part  of  the  evidence  and  shall 
be  taken  by  the  court  into  consideration  in  accordance  with  the  rules  of  evidence. 

Sec.  627.  The  payment  of  the  fine  or  the  expiration  of  the  imprisonment  do  not  exempt 
the  violator  from  the  execution  of  the  work  ordered,  or  the  compliance  with  the  order 
given  by  the  sanitary  chief.  The  repetition  of  the  offense  shall  be  considered  as  an  aggra- 
vating circumstance. 

Sec.  628.  Whenever  an  official  corporation,  authority,  public  officer,  local  sanitary  board 
or  chief,  shall  refuse  to  comply  with  the  provisions  of  order  No.  159,  series  of  1902,  of  these 
ordinances  or  of  other  sanitary  regulations  approved  by  the  Executive,  the  superior  sanitary 
chief  shall  report  the  facts  to  the  secretary  of  the  interior  requesting  him  to  take  the  neces- 
sary steps  for  the  enforcement  thereof. 

Sec.  629.  The  misdemeanors  committed  by  sanitary  inspectors  in  violation  of  these 
ordinances  shall  be  punished  by  the  sanitary  chief,  by  admonition,  suspension  of  salary 
from  one  to  thirty  days,  or  removal,  with  the  advice  of  the  Superior  Board.  If  the  viola- 
tion constitutes  a  crime,  the  case  shall  be  brought  before  the  courts  of  justice. 

Sec.  630.  The  concealment  or  repetition  of  an  ofl'ense  shall  be  considered  as  an  aggra- 
vating circumstance. 

Sec.  631.  The  misdemeanors  shall  be  classified  as  minor  and  grave  in  accordance  with 
their  importance  in  regard  to  public  health. 

Sec.  632.  The  following  shall  always  be  considered  as  grave  misdemeanors:  (1)  Vio- 
lations committed  bj^  sanitary  officers,  if  the  offense  does  not  constitute  a  crime;  (2) 
concealment  of  cases  of  diseases  the  report  of  which  is  compulsory;  (3)  unjustified  delay 
in  making  such  report;  (4)  failure  to  take  the  necessary  precautions  of  disinfection  when- 
ever required;  (5)  the  admission  in  charitable  and  educational  institutions  of  persons 
suiTering  or  convalescing  from  communicable  diseases;  (6)  refusal  by  managers  of  char- 
itable and  educational  institvitions  to  furnish  information  requned  by  the  sanitary  chief, 
or  furnishing  false  information,  in  regard  to  the  sanitary  conditions  therein,  etc. 

Sec.  633.  Violations  of  the  chapters  which  shall  be  mentioned  in  this  section  shall  be 
considered  as  important  misdemeanors. 

Sec  634.  All  other  violations,  not  constituting  crimes,  shall  be  considered  as  minor 
misdemeanors. 

Sec.  635.  All  decrees,  ordinances,  regulations,  provisions,  etc.,  inconsistent  with  these 
ordinances  are  hereby  repealed. 


154  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

REPORT  FROM  THE  DELEGATES  FROM  ECUADOR,  DRS.  M.  H. 
ALCIVAR  AND  SERAFÍN  S.   WHITHERS. 

j\ir.  President:  In  compliance  with  the  programme  of  the  convention,  we  have  the 
honor  to  make  the  following  report : 

First.  From  February  1,  1904,  to  December  31  of  the  same  year  we  had  in  Guayaquil 
190  cases  of  yellow  fever.  Diu-ing  the  present  year,  due  to  the  radical  measures  taken  by 
the  superior  board  of  health  since  the  ihst  appearance  of  yellow  fever  in  1903,  which  was 
imported  from  Panama,  this  disease  has  disappeared  almost  entirely,  because,  although 
some  weeks  one  or  two  cases  are  recorded,  we  can  assure  that  they  come  ftom  distant 
points  from  the  city,  from  the  zone  included  between  Chimbo,  Bucay,  and  Yaguachi,  as 
the  border  of  the  Yaguachi  River  in  almost  all  its  extension,  and  the  quaking  bogs  and 
swamps  which  are  in  abundance  in  this  section  of  the  country  and  never  get  dried,  even  in 
summer,  oiler  a  very  adequate  place  for  breeding  the  larvffi  of  the  mosquito,  thus  facili- 
tating the  propagation  of  the  species  of  the  epidemic.  In  order  to  destroy  such  foci  and 
to  protect  the  patients  from  th.e  infection,  as  long  as  the  sanitation  of  Guayaquil  would 
be  almost  impossible  if  such  a  constant  menace  be  maintained,  the  superior  board  of  health 
is  going  to  commence  a  campaign  with  the  cleaning  all  foci  of  infection  and  the  construc- 
tion of  a  small  lazaretto,  protected  with  wire  screens  and  equipped  with  the  peisonncl  and 
utensils  which  an  institution  of  this  kind  requires,  in  accordance  with  all  modern  improve- 
ments. The  superior  board  of  health,  therefore,  expects  to  have  the  germs  of  yellow 
fever  totally  destroyed  within  a  short  time. 

Second.  Since  the  appearance  of  the  first  cases  of  plague  in  the  southern  Pacific  coast 
the  superior  board  of  health  of  Guayaquil  closed  all  ports  of  Ecuador  to  vessels  coming 
from  infected  ports  and  prescribed  energetic  sanitary  measures  for  the  sanitation  of  the 
coast  towns.  At  that  time  Dr.  IMiguel  H.  Alcivar,  who  had  been  in  Europe  and  witnessed 
remarkable  experiments  of  the  application  of  the  Clayton  gas,  recommended  to  the  board 
of  health  the  immediate  and  urgent  convenience  of  equipping  the  port  of  Guayaquil  with 
a  disinl'ectiou  plant  of  the  "Clayton"  system,  and  to  this  elYect  the  consul  in  New  York 
was  instruL'ted  by  cable  to  purchase  a  steam  launch  with  a  Clayton  apparatus.  Type  A, 
and  an  apparatus.  Type  B,  to  be  mounted  in  a  special  wagon.  Guayaquil  was,  therefore, 
the  fiirst  port  of  the  southern  coast  of  the  Pacific  to  have  a  disinfection  plant  of  the  Clayton 
sj^stem,  and  since  that  time  it  was  reopened  to  vessels  coming  from  ports  infected  with 
plague,  thus  making  quarantine  useless,  because  the  disinfection  by  means  of  the  Clayton 
sulphui-ous  gas  destroys  all  germs  completely.  A  remarkable  fact  is  that  the  plague 
invaded  ports  contiguous  to  Guaj^aquil  Gulf,  as  Paita,  in  Peru,  and  north  of  Ecuador;  in 
Panama  there  was  also  a  case  officially  recorded,  and  although  vessels  coming  from  infected 
ports  were  admitted  in  Guayaquil  tlie  port  has  been  preserved  free  from  the  disease,  due 
to  the  thorough  disinfection  to  which  the  superior  board  of  health  subjects  all  ships  which 
touch  the  port,  by  means,  as  we  have  said,  of  the  Clayton  process.  Another  fact  worthy 
of  notice  is  the  circumstance  that  the  only  vessel  fi-om  infected  ports  which  was  not  admitted 
in  Guayaquil  nor  disinfected  brought  the  infection  to  Panama.  From  these  experiences 
it  maybe  inferred  that  when  the  vessels  engaged  in  the  transportation  of  passengers  and 
merchandise  have  been  equipped  with  disinfection  apparatus  of  the  Clayton  system,  and 
the  disinfection  shall  be  carried  out  under  the  supervision  of  the  health  officers  in  the 
respective  ports,  then  the  iimnunity  against  flagellat  diseases,  as  the  plague,  will  be  accom- 
plished. 

During  the  second  half  of  the  year  1904,  there  were  94  vessels  fumigated  in  the  port  of 
Guayaquil  by  the  Clayton  process. 

We  inclose  herewith  the  regulations  concerning  the  disinfection  of  vessels  and  quarantine 
stations. 

In  order  to  expedite  trade  the  superior  board  of  health  has  established  in  Guayaquil 
Gulf,  in  Puna,  a  floating  sanitary  station  for  observation,  with  a  capacitj^  for  30  persons 
and  with  ail  modern  comforts,  disinfection  apparatus,  medical  attendance,  etc. 

This  plant  is  not  considered  sufficient,  and  for  this  reason  the  superior  board  of  health 
has  ordered  the  construction  of  another  one  of  the  same  kind  with  a  capacity  to  hold 
comfortably  60  passengers  in  observation. 

The  measures  which  the  supe-ior  board  of  health  has  prescribed  to  prevent  the  impor- 
tation as  well  as  the  snread  of  yellow  fever  are  as  follows:  (1)  Considering  the  fact  that 
quarantines  are  unquestionably  useless  to  prevent  the  introduction  of  yellow  fever,  when- 
ever a  suspected  or  confii-med  case  takes  place  in  a  vessel  the  patient  is  removed  in  a 
litter  screened  by  wire  netting  to  the  city  lazaretto,  sim.ilarly  protected  against  the  access 
of  mosquitoes.  The  other  passengers  remain  under  the  surveillance  of  the  health  officer 
during  the  period  of  incubation.  (2)  A  similar  procedure  is  followed  as  to  nonimported 
casesi  isolating  the  sick  immediately,  whether  confirmed  or  suspected,  and  removing  them 
to  the  lazaretto  with  the  same  precautions.  The  rooms  where  a  suspected  or  confirmed 
case  has  taken  place  are  immediately  disinfected  with  the  Clayton  apparatus.  Besides 
the  lazaretto  the  board  of  municipal  beneficence  has  given  the  board  of  health  possession 


SECOND    IJSTTJíliNATIONAL    SANITARY    CON  V  F<;NTIOxV.  155 

of  one  of  the  puvilioiis  of  thcii-  magiiiliccnt  hospital,  entirely  isolaterl  and  piolcííted  by 
wire  netting,  and  which  is  assigned  to  suspected  sick  who  come  to  the  hospital  wliile  under 
observation  and  Ijefoie  they  are  taken  to  the  lazaretto.  The  statistii^s  for  the  fiist  half 
of  this  year  show  that  all  the  nieasui'es  taken  by  the  superior  board  of  hcialth  liave  given 
as  results  the  i-eduction  and  almost  complete  destruction  of  the  disease  in  the  city,  bccauae 
the  very  few  cases  that  are  once  in  a  while  rocoi'ded  are  always  imported  from  Yaguachi 
and  its  subui'l)s. 

We  (;los(i  tills  I'cport  calling  the  attention  of  the  coni'crence  to  the  neaissity  of  inter- 
national quai'antine  regulations,  wliich  are  of  vital  importance  to  the  interests  of  commerce 
in  genei'al,  and  any  eh'ort  to  accomplish  an  agreement  in  this  respect  would  be  the  best 
^nd  most  practical  of  all  triumphs  of  the  Second  Sanitary  Convention  of  1905. 


Exhibit  1. 

REGULATIONS  GOVERNING  THE  DISINFECTION  OF  VESSELS  .iND  BAGGAGE. 

Section  1.  Vessels  coming  from  infected  ports  shall  be  subjected  to  the  following  pro- 
cedure of  disinfection: 

(1)  The  hold,  including  the  cargo,  shall  be  fumigated  and  disinfected  by  means  of  the 
Clayton  gas,  excepting  flour,  cereals,  and  other  food  products  which  might  be  damaged 
under  the  action  of  said  gas. 

(2)  After  the  decks  of  the  vessel  have  been  washed  with  considerable  amount  of  water, 
the  purpose  of  which  washing  is  to  soak  and  remove  the  organic  substances  that  aic  stuck 
to  the  floor  and  walls,  they  shall  be  sprinkled  with  a  solution  of  hypochlorite  of  lime  at  10 
per  cent.  This  solution  must  be  kept  in  action  for  an  hour  at  least,  after  which  time  the 
decks  shall  be  washed  again  with  ordinary  water.  This  operation  shall  be  made  by  the 
vessel. 

(3)  The  transportation  of  cargo  in  general  upon  deck  is  prohibited.  The  importation 
of  fruits  and  vegetables  is  strictly  prohibited  when  coming  from  infected  ports. 

(4)  The  walls,  floors,  doors,  and  windows  of  staterooms  and  saloons  shall  be  thoroughly 
washed  with  cloth  saturated  in  a  solution  of  boracic  acid  at  6  per  cent  after  the  ordinarj^ 
washing  of  the  ship. 

(5)  After  the  disinfection  of  the  vessel  all  dead  rats  and  animals,  and  also  the  garbage 
and  refuse,  shall  be  gathered,  and,  upon  order  of  the  health  officer,  they  shall  be  thrown 
into  the  furnace  for  their  complete  cremation,  but  in  no  ^vise  shall  they  be  thrown  overboard. 

(6)  Open  baggage  shall  be  thoroughly  disinfected  with  formol  steam  or  by  other  process, 
at  the  discretion  of  the  health  officer. 

(7)  Clean  wearing  apparel  in  use  by  the  passengers,  baggage  in  good  condition,  polished 
metal  aiticles,  cotton,  furniture,  and  timber,  wrought  or  uuwi-ought,  shall  also  be  subjected 
to  sanitation  and  disinfection,  at  the  discretion  of  the  health  oflacer. 

(8)  The  importation  of  the  following  articles  is  prohibited:  Old  and  soiled  wearing 
apparel,  mattresses,  pillows,  worn-out  carpets  and  mattings,  woolen,  feathers,  and  animal 
hides,  tanned  or  not;  and  in  general  all  kinds  of  articles  which  might  be  suspected  on 
account  of  their  soiled  condition;  as  well  as  all  animal  or  vegetable  substances  in  a  state 
of  decomposition.  Should  any  of  such  articles  be  fovmd  they  shall  be  cremated  in  the 
ship's  furnace. 

(9)  All  new  polished  metal  articles  and  iron  materials,  or  of  other  metals,  for  the  con- 
struction of  machinery,  shall  be  admitted  without  any  sanitary  precaution. 

PASSENGERS. 

Sec.  2.  All  passengers,  whatever  their  places  of  origin  may  be,  shall  be  admitted  under 
the  following  rules: 

(1)  The  health  officer  shall  make  a  thorough  medical  examination  of  the  passengers 
and  shall  not  allow  the  debarkation  of  am^  person  on  whom  he  might  have  found  the 
slightest  suspicious  symptom,  and  who  shaU  be  removed  to  the  observation  lazaretto,  where 
he  shall  be  held  under  observation  till  he  is  restored  to  health. 

(2)  Passengers  coming  from  infected  ports  shall  be  received  in  the  quarantine  station 
for  observation  and  isolation  for  a  period  of  ten  days,  if  necessary,  from  the  date  they  left 
the  infected  port. 

(3)  If  the  passengers  come  from  an  immune  port,  but  in  ships  which  have  touched  any 
infected  port,  they  shall  be  a,Uowed  to  disembark  after  individual  disinfection,  and  the 
health  officer  shall  issue  them  a  certificate  in  which  their  places  of  origin  and  destination 
shall  be  stated,  according  to  the  information  fui-nished  by  themselves. 


156  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

These  certificates  shall  be  unipersonal,  and  the  passengers  shall  exliibit  them  to  the  presi- 
dent of  the  board  of  health,  who  shall  order  the  health  officer  to  visit  the  residences  of  each 
one  of  them  dm-ing  ten  days,  and  to  report  in  regard  to  their  health. 

(4)  The  health  officer  shaU  order  the  isolation,  in  the  lazaretto,  of  any  passenger  on  whom 
he  might  have  found  the  slightest  symptom  of  sickness,  and  shall  cause  to  be  made  a  thor- 
ough disinfection  of  the  wearing  apparel,  articles  of  personal  use,  bed  clothing,  baggage, 
and  all  other  ell'ects  which  might  have  come  in  contact  with  said  passenger,  as  well  as 
the  room  occupied  by  him. 

(5)  The  individual  disinfection  of  passengers  shall  be  made  in  the  following  manner:  A 
general  bath  with  boricated  water;  special  disinfection  of  the  hands  by  means  of  the  brush, 
with  soap  and  water  first,  and  then  with  a  solution  at  1  per  cent  of  sublimate;  disinfection 
of  mouth  and  throat  with  boricated  water;  complete  change  of  clothing  for  another  that 
shall  have  been  previously  disinfected  by  means  of  the  formol  steam,  or  by  other  process 
at  the  discretion  of  the  health  officer. 

Traveling  clothing  shall  be  dehvered  to  an  employee  of  the  health  department  for  its  dis- 
infection. 

LIVE    STOCK,    POULTRY,    AND   DOMESTIC   ANIMALS. 

Sec.  3.  Sheep,  cows,  goats,  and  pigs  shall  not  be  subjected  to  other  procedure  than  the 
repose  and  observation  for  a  period  of  ten  days  in  clean,  large,  and  ventUated  corrals, 
under  the  daUy  inspection  of  the  municipal  veterinary. 

Sec.  4.  Mules,  horses,  asses,  and  other  animals  shall  also  be  subjected  to  inspection  in 
proper  corrals  and  for  the  same  period  of  time. 

Sec.  5.  Poultry  and  other  buds  shall  similarly  be  subjected  to  ventilation  and  repose 
during  the  same  length  of  time. 

Sec.  6.  All  articles  derived  from  animals,  which  might  be  vehicles  for  pathogenic  germs, 
shall  be  carefully  disinfected  or  cremated. 

Sec.  7.  All  instruments  used  in  the  debarkation  and  removal  of  animals  shall  be  thor- 
oughly disinfected  under  the  supervision  of  an  employee  of  the  health  department. 

TRANSITORY   PROVISIONS. 

Sec.  8.  While  the  superior  board  of  health  has  no  sanitary  stations  or  lazarettos  to  carry 
out  the  provisions  of  sections  1,  2,  and  3  of  these  regulations,  vessels  coming  from  an  infected 
port  shall  not  be  given  free  pratique  and  shall  be  held  incommunicated  during  the  time 
required  for  loading  and  unloading;  passengers  íb  these  vessels  shall  not  be  admitted  till 
fifteen  days  after  leaving  or  touching  an  infected  port,  or  disembarking  from  an  infected 
ship. 


Exhibit  2. 
REGULATIONS  CONCERNING  THE  SANITARY  STATION. 

Section  1.  There  shall  be  established  a  provisional  maritime,  sanitary  station  for  the 
isolation  and  observation  of  passengers  coming  from  infected  or  suspected  ports. 

Sec.  2.  The  sanitary  station  shall  be  located  in  a  place  to  be  previously  designated  by 
the  superior  board  of  health. 

Sec.  3.  The  sanitary  station  shall  be  provided  with  the  necessary  craft  for  the  purpose, 
as  well  as  with  the  furniture,  kitchen  and  table  utensus,  drugs,  and  other  articles  indispen- 
sable to  the  good  service  and  care  of  passengers. 

service  personnel. 

Sec.  4.  The  service  personnel  shall  consist  of: 

One  director  physician. 

One  inspector. 

One  practitioner. 

Two  attendants. 

One  female  attendant  for  ladies. 

One  cook. 

Two  nurses. 

Two  sauors. 

And  other  employees  for  the  disinfection  of  vessels. 


SECOND    INTKKNATIONAL    SANITARY    CONVKNTION.  157 

TJIE    PlIYSIOJAN. 

Seo.  5.  The  physician  in  charge  of  the  Puna  station  shall  be  thrs  diicct or  physician  of  the 
marit/ime  sanitary  sta1,ion.     ITi.s  duties  and  powers  are- 

(1)  To  nialie  the  sanitaiy  inspection  of  all  vessels  corriinfi  from  abroad,  in  accordance 
with  the  regulations  of  tiie  Ixmrd  of  iiealth,  and  thr;  regulations  which  it  may  uereaf tfr  dbps. 

(2)  To  make  the  disinfection  of  all  vessels  coming  from  infected  and  suspected  ports  in 
accordance  with  the  instructions  of  the  board  of  health. 

(3)  To  visit  the  passengers  sul)jected  to  quarantine  observation  twice,  or  oftener  if  neces- 
sary, and  to  inform  the  board  of  health  of  any  event  that  might  happen. 

(4)  If  any  passenger  subjected  to  observation  be  taken  sick  the  healtii  physician  shall 
render  him  medical  attendance  after  having  been  isolated,  if  the  illness  be  infectious. 

(5)  In  such  a  case  the  health  physician  shall  immediately  noiify  the  board  of  health  in 
order  that  it  may  at  once  send  another  physician  to  take  charge  of  the  sanitary  service  in 
the  port. 

(6)  To  see  thai  the  disinfections  are  thoroughly  made,  and  that  the  employees  charged 
with  this  duty  fulfill  ir.  satisfactorily. 

(7)  To  see  that  the  passengers  are  attended  and  cared  for  in  the  best  possible  way,  and 
that  their  wishes  are  satisfied  in  all  that  is  not  in  conflict  with  the  provision^:  of  these  regu- 
lations. 

(8)  To  see  that  all  employees  strictly  fulfill  their  respective  duties,  and  to  make  a  weekly 
report  to  the  board  of  health  of  all  the  transactions  of  the  service. 

THE   INSPECTOR   AND   SUBORDINATE   EMPLOYEES. 

Sec.  6.  It  shall  be  the  duty  of  the  inspector: 

(1)  To  make  the  disinfection  of  the  vessels  under  the  supervision  of  the  physician, 
endeavoring  to  carry  it  out  in  accordance  with  the  instructions  of  the  board. 

(2)  To  see  that  good  order  and  service  are  maintained  in  the  craft  assigned  to  passengers, 
giving  them  all  accommodations  not  in  conflict  with  the  condition  and  isolation  to  which 
they  are  subjected. 

(3)  To  arrange  and  look  after  the  kitchen  and  table  service  and  the  cleanliness  of  the 
craft,  and  he  shall  watch  the  discipline  and  behavior  of  his  subordinates,  specially  in  regard 
to  the  good  treatment  which  must  be  given  to  passengers. 

(4)  To  accompany  the  physician  in  his  visits  whenever  requested  to  do  so,  and  shall 
receive  fxom  him  daily  the  instructions  regarding  the  service. 

(5)  To  see  that  the  craft  assigned  to  the  service  are  completely  isolated,  and  to  prevent 
the  passengers  from  coming  in  contact  with  other  persons. 

Sec.  7.  Servants  and  other  subordinate  employees  shall  be  under  the  inspector,  and  they 
shaU  strictly  execute  all  orders  which  he  might  give  them. 

THE   PRACTITIONER. 

Sec.  8.  The  practitioner  shall  performhis  duties  under  the  supervision  of  the  physician, 
and,  specially,  take  care  of  the  sick.  He  shall  accompany  the  physician  in  his  visits, 
keep  a  clinical  record  of  the  sick,  and  a  book  in  proper  form  with  the  physician's  instruc- 
tions for  treatment;  he  shall  see  that  the  physician's  prescriptions  are  filled,  and  that  the 
medicines  administered  are  apphed  to  the  sick;  he  shall  take  care  of  the  diet  of  the  sick 
and  shall  see  that  the  nurses  and  servants  give  them  careful  and  proper  attention. 

PASSENGERS. 

Sec.  9.  Passengers  coming  from  infected  or  suspected  ports  shall  be  held  in  quarantine 
in  craft  assigned  for  the  purpose. 

This  quarantine  shaU  be  for  a  period  of  ten  days  from  the  day  ia  which  they  left  the  last 
infected  or  suspected  port. 

If  any  passenger  should  prefer  to  spend  his  quarantine  in  another  vessel  hired  by  him, 
he  may  do  so,  provided  he  follows  the  provisions  of  these  regulations. 

Sec.  10.  Under  no  circumstances  shall  passengers  be  allowed  to  come  in  close  contact 
with  other  persons,  nor  abandon  the  ship  on  which  they  must  spend  thek  quarantine. 

If  any  passenger  be  taken  sick  during  the  period  of  the  quarantine,  he  shall  be  isolated 
or  not,  in  the  discretion  of  the  physician,  in  the  place  to  be  by  him  designated. 

Sec.  11.  Isolated  patients  shall  not  come  in  contact  with  anybody  but  the  physician, 
the  practitioner,  and  the  nm-ses.  The  isolation  shall  be  discontinued  when,  at  the  discre- 
tion of  the  physician,  the  patient  is  in  the  period  of  convalescence. 

Sec.  12.  If  any  passenger,  upon  his  aiTival  at  Puna,  is  afflicted  with  any  contagious 
disease,  such  as  plague,  yellow  fever,  tj^phoid  fever,  or  other  similar  fevers,  he  shall  not  be 
received  at  the  sanitary  station. 


15S  SECOND    INTEKNATIONAL    SANITARY    CONVENTION. 

Sec.  13.  All  passengers  are  subjected  to  the  daily  visit  of  the  physician  and  must  follow 
his  instructions. 

Sec.  14.  Passengers  shall  pay  $5  a  day,  besides  the  extraordinary  expenses  which  they 
might  make. 

These  regulations  shall  be  made  known  to  passengers  in  order  that  their  provisions  may 
bo  fully  complied  with. 

APPROPRIATION. 

One  physician. 

One  inspector. 

One  practitioner. 

Two  attendants. 

One  attendant  for  ladies. 

One  cook. 

One  assistant. 

Two  sailors. 

Two  nurses. 

Sec.  15.  The  board  shall  have  power  to  amend  these  regulations  whenever  they  may 
deem  it  necessary. 

Given  in  the  haU  of  sessions  of  the  superior  board  of  health  the  22d  day  of  September, 
1904. 

Antonio  Gil,  President. 

J.  Cueva  García,  Secretary. 

REPORT  FROM  THE   DELEGATE   FROM    GUATEMALA, 
DR.   JOAGliriN   YELA. 

Mr.  President  and  Gentlemen:  When  the  Republic  of  Guatemala  was  invited  to  take 
part  in  the  First  International  Sanitary  Convention  of  the  American  Republics,  which  took 
place  in  Washington,  D.  C,  in  December,  1902, 1  had  the  honor  to  be  officially  designated  by 
my  country  to  represent  it  before  such  an  important  and  eminent  congress.  As  at  that  time 
I  was  absent  from  the  United  States,  when  I  received  the  appointment  I  started  for  this 
country,  but,  unfortunately,  due  to  an  unf orseen  and  casual  accident,  I  arrived  in  this  capital 
when  the  conference  was  already  closed. 

Once  more  I  have  been  honored  with  the  appointment  by  cable  as  official  delegate  from 
Guatemala  to  the  Second  International  Sanitary  Convention.  At  the  same  time  I  have  been 
notified,  also  by  cable,  that  they  are  sending  me  by  mail  the  recent  governmental  regulations 
in  regard  to  public  health  and  important  clinic  observations  upon  the  present  yeUow-fever 
epidemic  in  the  towns  of  Zacapa  and  Galan  by  the  physicians  that  treat  the  patients. 
Unfortunately  up  to  the  present  time  I  have  not  received  this  document. 

On  account  of  the  foregoing  reasons  this  report  will  not  be  as  complete  as  it  should  be. 

Malaria,  under  its  various  forms,  has  been  the  conamonest  disease  in  the  coasts  of  the 
Republic  and  in  other  towns.  Pernicious  fevers  which  after  the  second  or  thh-d  access  would 
cause  the  death  of  the  patient  are  almost  unknown  at  present,  due  to  the  sanitary  measures 
enforced  by  the  authorities  and  the  health  service. 

Only  two  invasions  of  the  dreadful  cholera  morbus  have  been  recorded,  which  epidemics 
decimated  the  Republic  and  the  entire  territory  of  Central  America.  The  last  took  place  in 
1857,  and  was  imported  from  Nicaragua  at  the  return  of  the  soldiers  that  went  there  to  coop- 
erate in  the  expulsion  of  the  hosts  that  endangered  our  independence.  Since  that  time  a  few 
sporadic  cases  of  cholera  nostrus  take  place  once  in  a  while  during  each  year,  not  every  one,  at 
the  beginning  of  the  rainy  season,  but  they  are  always  overcome  by  proper  treatment. 

A  large  portion  of  the  population  of  Guatemala  consists  of  the  native  Indian.  The  native 
Indian  is  strong  and  active,  being  simple  in  his  habits  and  clean  minded.  His  only  vice  is  his 
fondness  for  alcoholic  drinks,  mainly  that  called  "chicha. "  He  never  suffers  from  syphilis, 
and  marries  as  soon  as  he  reaches  the  pubescent  age,  creating  a  numerous  family.  The  epi- 
demics are  the  only  causes  that  put  an  end  to  his  life,  smallpox  particularly,  because  he 
fears  vaccination  with  dreadful  horror.  As  pegple  of  this  race  always  live  piled  up  in  small 
dwellings  called  "  ranchos, "  when  one  of  them  is  taken  sick  the  whole  family  follow  and  then 
the  entire  to^vn.  Fortunately,  due  to  the  constant  efforts  of  the  Government  and  the  supe- 
rior council  of  hygiene,  which  compel  vaccination  and  revaccination  under  severe  penalties, 
we  no  longer  see  at  present  the  frequent  and  deadly  epidemics  of  old,  and  only  once  in  a  while 
we  have  a  few  single  cases  of  a  mild  character. 

In  the  important  towns  we  have  salaried  physicians,  and  the  people  from  small  towns  are 
brought  there  by  the  respective  authorities  for  vaccination,  taking  special  care  in  watching 
whether  the  inoculation  has  produced  good  results,  and  repeating  the  operation  until  the 
desired  effect  has  been  obtained. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  159 

No  new  cases  have  been  registered  of  elephantiasis,  wliifli  I'orrrierly  prevailed  throughout 
the  country  until  a  govciiimental  decree,  stricitly  enforced,  ordered  the  gath(!ring  and  arrrat 
of  all  persons  auííering  from  the  disease,  and  their  coniinement  in  the  asyJuin  called  "La 
Piedad,"  whei'e  they  aie  well  attended  and  have  all  they  want,  heing  ajjsolutely  isolated 
from  the  rest  of  the  woi'ld. 

Bubonic  plague,  which  during  the  last  few  years  has  made  many  victims  in  some  of  the 
American  countries  where  it  was  unknown,  has  never  invaded  Guatemala,  and  I  liope  that 
with  the  sanitary  measures  in  force  it  will  never  visit  our  shores. 

Thirty-live  years  ago  an  epidemic  of  scarlet  fever  caused  severe  damages  throughout  the 
country.  Since  that  unfortunate  time  not  a  single  case  has  been  registered,  although  ca.ses 
of  diphtheria,  which  caused  great  damage  among  children,  have  occurred  periodically  until 
the  serum-against  tins  dieadful  disease  was  discovered. 

Influenza  is  the  disease  wliich  has  appeared  most  frequently. 

Typhoid  fever  and  tubei'culosis  are  very  uncommon  in  Guatemala.  The  conditions  of  the 
country  are  fit  to  cure  tuberculosis  rather  than  to  produce  it.  So  much  so  that  persons  suf- 
fering from  it  come  to  Guatemala  from  distant  points  of  tlie  world  seeking  the  restoration  of 
their  health,  and  most  of  them  succeed. 

Yellow  fever  prevails  at  present  in  two  of  our  important  towns — Zacapa  and  Gualan.  A 
great  number  of  physicians,  for  the  sake  of  philanthropy,  have  gone  there  to  risk  their  lives 
on  behalf  of  their  fellow-creatures,  some  of  which  physicians  have  perished  while  in  the  per- 
formance of  their  professional  duties.  Among  those  that  died  appears  tlie  name  of  the  dis- 
tinguished Dr.  Jorge  Arrióla,  who,  as  I  have  been  informed,  expired  without  completing  an 
important  clinic  work  showing,  from  facts  that  have  come  under  his  observation  during  this 
epidemic,  that  the  Stegoimjia  fasciaia  is  the  only  means  of  transmitting  the  infection.  The 
epidemic  is  dying  out  A'ery  rapidly  thanks  to  the  active  measures  enforced  by  the  Govern- 
ment and  the  superior  council  of  hj'giene,  with  the  efficient  cooperation  of  the  medical  pro- 
fession, thus  restricting  its  invading  action  to  a  limited  zone.  This  disease  has  never  been 
endemic  in  Guatemala. 

There  is  a  superior  council  of  public  hygiene  in  the  ca'pital  of  the  nation,  under  the  secre- 
tary of  the  interior,  and  in  each  capital  of  department  a  special  board  of  health,  under  the 
supervision  and  control  of  the  superior  council.  By  a  special  law  the  military  health  corps 
was  organized  separately,  its  main  duty  being  to  take  care  of  the  health  of  the  soldiers. 

The  superior  council  has  advisory  powers  only,  its  resolutions  as  well  as  the  sanitary  laws 
being  enforced  by  the  secretary  of  the  interior. 

Among  the  several  and  interesting  sanitary  laws  passed  by  the  Government,  on  recom- 
mendation of  the  superior  council,  we  have  the  law  making  vaccination  and  revaccination 
compulsory:  that  regulating  prostitution,  and  the  one  requiring  the  report  of  cases  of  the  fol- 
lowing diseases:  Typhoid  fever,  exanthematous  typhus,  smallpox,  bubonic  plague,  cholera 
morbus,  diphtheria,  elephantiasis,  scarlet  fever,  and  measles.  The  physician  attending  a 
person  suflering  from  any  of  the  above-mentioned  distases  or  the  head  ol  the  familj^  to  which 
such  person  belongs,  is  compelled,  under  severe  penalties,  to  report  the  case  immediately  to 
the  competent  authority. 

The  medical  surveillance  in  the  ports  of  the  Republic  is  intrusted  to  competent  physi- 
cians, who  are  under  the  immediate  supervision  of  the  local  authorities  and  receive  orders 
from  the  superior  council.     Each  port  is  equipped  with  proper  apparatus  for  disinfection. 

As  soon  as  the  Government  has  reliable  infoimation  that  an  epidemic  prevails  in  one  of  the 
countries  with  which  it  maintains  commercial  relations,  it  prescribes  sanitaiy  provisions  and 
measures  in  order  to  prevent  the  importation  of  the  disease  into  the  Republic.  Among  the 
recent  decrees  relating  to  this  puipose  we  have  that  of  July  26,  last,  which  prescribes 
that,  for  consequent  results,  vessels  coming  from  Valparaiso,  Chile,  shall  be  considered  as 
suspected,  for  which  reason  the  authorities  of  the  ports  on  the  Pacific  shall  strictly  enforce 
all  laws  and  regulations  previously  passed  by  the  Government. 

On  September  6  last  the  President  of  the  Republic  ordered  that  the  ports  of  San  José, 
Champerico,  and  Ocas  on  the  Pacific  coast  be  closed  to  vessels  coming  from  Panama,  as  sus- 
pected of  yellow  fever  and  bubonic  plague. 

If  the  several  and  wise  sanitary  provisions  embodied  in  previous  laws  continue  to  be 
enforced  as  at  present,  we  could  almost  assure  without  hesitancy  that  no  other  diseases,  out- 
side of  the  traumatic  ones,  would  exist  in  the  capital  of  Guatemala,  and  that  its  inhabitants 
would  only  die  ñom  senility. 

There  is  a  magnificent  general  hospital  in  the  capital  of  Guatemala,  situated  on  the  east 
side  of  the  city.  It  has  500  beds,  contained  in  large  and  well  ventilated  wards.  Physicians, 
nurses,  medicines,  food,  comfortable  lodging,  and  everything  needed  for  the  restoration  of 
health  is  furnished  without  cost  to  the  patient.  This  hospital  has  a  competent  staff  of 
distinguished  phj-sicians  and  surgeons  and  able  practitioners  and  nmses.  It  is  equipped 
with  all  modei'n  scientific  improvements.  It  has  an  annex,  called  '"Casa  de  Salud,  "for 
people  that  are  able  to  pay  a  reasonable  fee,  which  is  also  provided  with  a  complete 
equipment  of  smgical  instruments  and  medicines,  frequently  imported  from  the  United 
States  and  Europe. 


160  SECOND    INTEKNATIOlSrAL    SANITAEY    CONVENTION. 

On  a  picturesque  site  called  La  Reforma  Park,  three  miles  from  the  city,  the  military  hos- 
pital is  located,  a  modern  institution  where  the  soldier  finds  the  remedy  for  his  Dlness. 

We  also  have  a  very  well-organized  insane  asylum. 

At  12  miles  north  of  the  city  La  Piedad  Asylum  is  situated,  where  all  those  suffering  from 
elephantiasis  are  confined.  There  they  find  all  that  is  necessary  to  make  their  life  more 
tolerable.     Near  to  it  is  the  cemetery  assigned  to  the  interment  of  their  corpses. 

The  Model  Hospital,  so  called  because  it  is  for  women  suffering  from  sj^pnilis,  is  situated 
east  of  the  city,  on  the  suburbs,  the  majorit}-  of  the  women  who  are  in  it  being  composed  of 
prostitutes.  The  organization  of  this  hospital  and  the  regulating  of  prostitution  have  con- 
tributed to  make  this  ch-eadful  disease  much  less  frequent,  and  that  the  few  cases  that  occm- 
are  of  a  rather  mild  tj'pe. 

For  cases  of  epidemic  and  contagious  diseases,  which  on  tliat  account  can  not  be  admitted 
to  other  hospitals,  we  have  a  very  large  one  in  the  suburbs  of  the  city,  with  competent  per- 
sonnel, medicines,  and  all  that  is  necessary  for  the  proper  attendance  of  the  patients,  thus 
curing  them  and  preventing  the  spread  of  disease. 

I  wish  to  make  special  mention  of  the  organization  of  a  highly  philanthropical  institution 
for  men  and  women  suffering  from  the  exceedingly  mortal  disease  for  which,  in  spite  of  the 
present  wondere  of  science,  no  remedj^  has  yet  been  found,  and  which  is  called  "senility;" 
there,  engaged  in  mild  occupations  proper  for  their  age,  they  wait  tranquilly  for  the  end 
of  their  days. 

There  are  also  private  sanitariums  conducted  by  distinguished  professors,  among  which 
institutions  I  have  the  pleasure  of  mentioning  that  of  the  brothers  Doctors  Ortega,  which, 
besides  an  excellent  medical  service,  has  the  last  scientific  improvements  in  apparatus, 
instruments,  and  all  that  is  necessary  for  the  clinic  attendance  of  patients. 

We  have  hospitals  not  only  in  the  capital  of  the  nation,  but  also  in  the  capitals  of  depart- 
ments. The  principal  ones  are  the  hospitals  in  Quezaltenango,  La  Antigua,  Amatitlan,  and 
Escuintla. 

Among  so  many  charitable  institutions  there  one  was  lacking  for  those  unfortunate  per- 
sons who,  though  not  being  considered  as  ill,  are  convalescent  from  severe  diseases.  For 
this  reason  Señor  Estrada  Cabrera,  President  of  the  Republic,  is  going  to  fill  so  great  a 
necessity  with  the  magnificent  and  large  building  which  is  being  constructed  south  of  the  city, 
on  the  same  site  formerly  occupied  by  the  Central-American  Exposition.  This  building 
shaU  be  assigned  especially  for  the  lodging  and  care  of  convalescents.  It  will  soon  be 
completed  because  the  cpnstruction  is  being  carried  out  with  assiduous  efforts,  the  President 
himself  inspecting  the  works  daily. 

To  close  this  report  I  will  only  make  mention  of  the  honor  which  has  been  conferred  upon 
Guatemala  by  the  selection  of  its  capital  for  the  place  where  the  Fourth  Pan-American 
Sanitary  Conference  is  to  be  held.  The  Government  and  the  faculty  of  medicine  and  phar- 
macy are  working  assiduously  in  order  to  make  the  stay  of  our  illustrious  guests  pleasant. 


REPORT  FROM  THE  DELEGATE  FROM  MEXICO,  DR.  EDUARDO 

LICÉAGA. 

[Translation  furnished  by  Doctor  Liéaga.] 

Gentlemen:  I  present  the  following  report  in  accordance  with  the  scientific  programme 
that  was  accepted  by  the  international  committee  of  the  American  RepubUcs. 

(a)  Data  regarding  the  "prevailing  diseases,  especialhj  plague,  yellow  fever,  and  malaria,  start- 
ing from  the  1st  of  January,  1904-,  being  approximately  the  date  on  which  the  convention 
should  have  met  in  Santiago  de  Chile. 

I.  BUBONIC  PLAGUE. 

In  a  collection  of  the  special  buUetiná  of  the  supreme  board  of  health,  which  were  published 
in  connection  with  the  appearance  of  the  bubonic  plague  in  the  port  of  Mazatlan,  State  of 
Sinaloa,  and  forwarded  to  the  international  commitiee  of  the  American  Repubhcs,  a 
detailed  report  was  presented  of  the  appearance  of  this  disease  in  December  1902,  of  the 
course  followed  by  the  epidemic,  and  of  the  series  of  measm-es  which  were  adopted  until 
the  chsease  was  finally  stamped  out  in  I\Iay,  1903.  _  _     , 

Incidentally  I  may  observe  that  from  the  adoption  by  the  previous  sanitary  convention 
of  the  resolution  that  each  one  of  the  Republics  hei'e  represented  should  be  boimd  to  declare 
the  existence  of  transmissible  disease  in  its  territory  to  the  international  committee  of 
the  American  Repubhcs,  that  Mexico  has  never  neglected  to  comply  with  this  obhgation, 
giving  weekly  reports  either  by  mail  or  by  wire  whenever  it  was  considered  necessary. 


SECOND    INTERNATIONAL    HANITAKY    CONVENTION.  161 

Under  No.  1. — I  present  a  collection  of  thoHc  bulletins  and  I  will  read  this  paper  in 
which  I  present  a  resume  of  that  epidemic,  bcicausci  1  believe  that  it  will  i^ive  a  knowledge 
of  the  measures  adopted  against  it,  and  which  not  only  extinguished  the  epidemic  in  its 
place  of  birth  but  liberated  the  rest  of  the  Mexican  Republic  and  the  whole  of  North 
America  from  all  danger  of  its  spread. 

I.    PROBABLE   ORIGIN    OF   'niE    EPIDEMIC. 

Mazatlan  is  a  port  situated  on  the  Pacific  coast  in  23°  11'  2"  of  north  latitude  and  7° 
17'  34"  of  longitude  west  of  Mexico.  It  is  in  the  torrid  zone  and  has  a  tropical  climate. 
The  population  is  about  25,000  inhabitants. 

This  port  has  frequent  communication  with  that  of  San  Francisco,  Cal.,  in  the  United 
States,  wliore  for  three  years  previously  the  bubonic  plague  prevailed  in  a  central  part  of 
that  city  called  "Chinatown." 

It  was  probably  through  fear  of  quarantine  restrictions  which  might  have  been  imposed 
on  the  foreign  trade  that  the  authorities  of  San  Francisco  had  carefully  maintained  secrecy 
on  the  existence  of  the  disease  and  issued  clean  bills  of  health  to  the  vessels  leaving  the  port. 

On  the  13th  of  October,  1902,  the  steamer  Curapao  reached  Mazatlan  with  a  cargo  of 
Chinese  goods  which  were  landed  in  that  port.  The  first  case  of  the  disease  was  oVjserved- 
seven  days  after,  but  no  diagnosis  could  be  made  because  it  had  never  been  seen  in  the 
Mexican  llepublic,  its  symptoms  were  unknovoi  by  the  physicians  and  for  this  rc'g,son  it 
was  supposed  that  the  patients  were  suffering  from  a  rare  and  malignant  form  of  malaria. 

It  has  never  as  yet  been  discovered  whether  these  goods  came  directly  from  "China- 
town," in  San  Francisco,  Cal.,  or  whether  they  were  transshipped  to  the  Curapao  from  some 
vessel  that  came  directly  from  Asia;  but  what  is  beyond  question  is  that  the  steamer  came 
from  San  Francisco  and  that  the  cargo  contained  goods  of  Chinese  origin. 

II.   FIRST   NEWS   OF   THE   APPEARANCE   OF   THE   EPIDEMIC   DISEASE. 

In  the  month  of  December,  1902,  the  delegates  of  the  supreme  board  of  health  in  Mazatlan 
reported  by  wii'e  tliat  a  rare  disease  had  appeared  in  the  locality;  that  of  the  nineteen 
cases  which  had  been  observed  eight  had  terminated  fatally,  all  \vithin  the  time  elapsed 
from  the  20th  of  October  to  the  13th  of  December  and  that  the  disease  presented  as  prin- 
cipal characteristics  a  violent  fever  and  the  appearance  of  buboes  in  the  groin,  axillse,  and 
neck. 

The  supreme  board  of  health,  which  is  by  law  charged  with  the  international  sanitary 
police  in  the  port,  had  no  knowledge  of  the  above  facts  during  the  first  days  of  the  month 
of  December  or  that  the  steamer  Curapao  had  brought  in  goods  of  Chinese  origin;  but 
bearing  in  mind  that  it  had  extra-ofScial  knowledge  of  the  existence  of  the  plague  in  a 
ward  of  San  Francisco,  Cal.,  and  that  the  only  transmissible  disease  that  is  accompanied 
by  fever  and  buboes  is  the  plague,  it  instructed  its  delegate  in  that  port  to  indorse  on  the 
bills  of  health  that  a  disease  prevailed  in  the  port  which  was  suspected  of  being  bubonic 
plague.  The  board  at  the  same  time  addressed  itself  to  the  local  authorities  of  Mazatlan 
and  to  the  governor  of  the  State  of  Sinaloa,  in  which  that  port  is  situated,  urging  on 
them  to  take  the  steps  that  are  provided  by  the  sanitary  code  for  stamping  out  any 
epidemic  disease. 

In  order  to  proceed  with  the  necessary  enumeration  of  these  measures,  I  will  first  deal 
with  those  that  were  adopted  against  the  disease  in  order  to  extinguish  it  in  the  locality 
in  which  it  made  its  fust  appearance,  after  which  I  will  describe  the  measures  taken  to 
prevent  its  propagation  by  sea,  and  lastly  the  measmes  taken  to  prevent  its  spread  by  land. 

in.   MEASURES  ADOPTED  TO  EXTINGUISH  THE  DISEASE  IN  THE  LOCAUTT  Di  WHICH  IT 

APPEARED. 

The  poUtical  authorities  of  Mazatlan  were  instructed  to  remind  the  physicians,  heads  of 
families,  managers  of  workshops  and  factories,  and  directors  of  schools  and  colleges  of  the 
duty  imposed  upon  them  by  the  sanitary  code,  of  reporting  the  cases  of  bubonic  plague 
which  might  come  within  their  knowledge. 

The  local  authorities  at  once  ordered  house-to-house  visits  to  be  made  in  order  to  discover 
the  patients  who  might  have  been  hidden  by  their  relations.  In  order  to  render  this  measure 
practicable  the  city  was  divided  into  wards,  and  the  physicians,  with  the  assistance  of 
125  men  of  the  sanitary  pohce,  were  commissioned  to  carry  on  the  investigations.  At 
the  same  time  and  in  compliance  with  the  provisions  of  the  Federal  sanitary  code  the 
isolation  of  the  patients  in  a  lazaret  was  strictly  enforced. 

In  order  to  make  this  isolation  really  effective,  the  lazaret  was  arranged  on  the  Belvedere 
Island,  where  a  department  was  established  in  which  to  receive  the  patients  suffering  from 
confirmed  cases  of  plague,  another  was  isolated  from  the  above  in  order  to  receive  those 

5610—06 11 


162  SECOND   INTERNATIONAL    SANITARY    CONVENTION. 

suspected  of  siiflering  from  the  plague,  and  another  for  the  convalescents,  dedicating 
rooms  in  the  latter  department  for  baths,  a  dispensary,  and  dwellings  for  the  medical 
assistants  as  well  as  for  the  staff  of  servants. 

The  estabhshment  of  the  lazaret  on  an  island  rendered  the  isolation  of  the  sick  easy  and 
secure.  But  considering  that  the  persons  who  had  been  attending  the  patients  before 
taking  them  to  the  lazaret  might  have  the  disease  in  the  state  of  incubation,  an  observation 
camp  was  estabhshed  on  the  slopes  of  the  Velódromo  Hill  close  to  the  beach  and  outside  of 
the  to^^"n. 

This  observation  camp  consisted  of  a  series  of  sheds  intended  to  furnish  shelter  for  the 
families  of  the  patients,  in  which  they  would  receive  the  food  required  for  their  sustenance 
and  be  kept  under  observation  for  ten  days  \sathout  their  being  allowed  to  leave  the  camp 
unless  they  were  in  enjoyment  of  good  health  on  the  expiration  of  that  period.  The 
poorer  people  were  suppüed  with  fresh  clothing  and  a  certain  amount  in  money  on  leaving 
the  camp. 

As  the  poorer  quarters  of  the  port  of  Mazatlan  contain  many  houses  crowded  with  people, 
orders  were  given  to  expel  the  extra  inhabitants  of  each  house  and  oblige  them  to  live  in 
tents. 

In  accordance  with  the  provisions  of  the  sanitary  code,  orders  were  also  given  for  the 
disinfection  of  the  houses  that  had  been  occupied  by  patients  as  well  as  of  the  clothing 
which  they  had  used,  and  whenever  this  was  of  slight  value  it  was  burned. 

In  prder  to  carry  on  the  disinfection  service  in  the  different  wards  of  the  city,  eight 
physicians  were  appointed  with  their  respective  staffs  and  they  employed  a  solution  of 
bichloride  of  mercury  at  one  per  thousand,  which  was  sprayed  by  means  of  force  pumps 
over  the  roofs,  walls,  and  floors  of  the  dwellings.  When  these  dwelUngs  were  of  slight 
value,  and  especially  when  they  could  not  be  disinfected,  they  were  destroyed  by  fire,  and 
in  this  way  375  houses  have  disappeared. 

As  the  epidemic  had  been  preceded  by  a  great  mortality  among  the  rats  and  mice, 
war  was  declared  on  these  animals  by  all  the  means  that  are  ordinarily  employed,  among 
which  was  a  virus  that  was  intended  to  produce  among  them  an  epizootia  that  could  not 
be  transmitted  to  man. 

At  the  same  time  the  local  authorities  gave  orders  for  a  thorough  cleaning  of  aU  the 
houses  and  to  enforce  the  sweeping  of  the  streets,  for  a  complete  cleansing  of  the  slaughter 
houses  and  markets  as  well  as  the  collection  and  incineration  of  all  garbage. 

The  fact  that  the  bubonic  plague  had  never  made  its  appearance  in  the  Mexican  Republic 
had  rendered  unnecessary  any  preparation  by  keeping  a  stock  of  serums  that  would  cure 
or  prevent  that  disease,  but  a  request  was  immediately  made  to  the  Pasteur  Institute  for 
1,000  flasks  of  Yersin  serum  and  500  flasks  of  Haffkine  serum,  although  other  and  much 
larger  quantities  were  subsequently  consumed. 

IV.   MEASURES   FOR   PREVENTING   THE    SPREAD   OF   THE   EPIDEMIC   DISEASE   BY    SEA. 

As  already  stated,  the  plague  had  never  presented  itself  in  the  Mexican  Republic.  During 
the  last  few  years,  when  it  again  invaded  Europe  and  some  towns  of  South  America,  it 
became  necessary  to  reform  the  maritime  sanitary  regulations  by  the  addition  of  a  special 
chapter  which  was  intended  to  protect  our  ports  against  the  invasion  of  the  plague,  as 
previous  to  that  there  was  no  mention  of  that  disease  in  our  sanitary  code  because  it  was 
thought  unnecessary.  The  additions  to  Chapter  II  of  the  maritime  sanitary  regulations, 
which  were  intended  to  give  us  protection  against  the  plague,  were  promulgated  on  the 
30th  of  May,  1900.  Since  that  time  they  have  been  in  full  force,  and  would  have  defended 
us  from  the  disease,  if  the  sanitaiy  authorities  of  San  Francisco  had  not  hidden  its  existence 
and  issued  clean  bills  of  health  to  the  vessels  leaving  that  port.  This  is  the  way  in  which 
the  plague  was  able  to  reach  Mazatlan. 

The  first  instruction  given  to  the  delegate  of  the  supreme  board  of  health  in  the  port  of 
Mazatlan  was  to  indorse  on  the  bills  of  health  the  statement  that  an  epidemic  disease 
had  made  its  appearance  there  which  was  suspected  of  being  bubonic  plague.  This  decla- 
ration was  made  in  order  to  protect,  not  only  our  own  ports,  but  also  foreign  ports  against 
arrivals  from  Mazatlan. 

The  steps  which  were  intended  to  prevent  the  spread  of  the  disease  by  sea  may  be 
divided  into  two  groups:  (a)  Those  which  were  taken  in  the  port  of  departm-e  and  (b)  those 
which  were  taken  in  the  ports  of  arrival. 

(a)  A  commission  of  physicians  was  appointed  to  issue  health  passports  to  the  persons 
who  might  reach  the  port  for  the  purpose  of  embarking,  thus  preventing  any  sick  or  sus- 
pected person  from  going  on  board.  This  commission  was  also  charged  with  the  disinfec- 
tion of  the  passengers,  baggage,  and  the  goods  that  might  be  shipped,  and  the  sanitary 
delegate  in  tlie  port  was  ordered  to  destroy  the  rats  and  mice  on  departing  vessels.  With 
these  precautions  safety  was  insured;  but  in  order  to  comply  with  the  provisions  of  our 
maritime  sanitary  regulations  as  amended,  all  the  delegates  in  the  Pacific  ports  were 
reminded  of  the  rules  to  which  I  make  reference  below. 


SECOND    INTERNATIONAL    HANl'J'AKY    OONVP.NTION.  103 

(b)  The  ports  on  tlio  Pacific;  coa.st  arc  very  numerous  and  as  some  of  them  have  no 
medical  delegate — who  is  tlie  sanitary  authority  charj^ed  witli  the  medical  visit  to  the  ships 
and  vi^ith  the  direction  of  the  disinfection  work  -  tliese  ports,  wliich  are  of  siif^lrt  commercral 
importance,  were  closed  for  all  dir'cct  tr-aille  witli  Ma/,atlan  whicii  was  only  allowed  with 
the  ports  of  Guaymas,  San  J3las,  Manzanillo,  and  Acapuico,  and  even  then  (wrtiiely  suhjeet 
to  the  legal  pr'ovrsions  above  mentioned  and  which  can  he  summarized  as  follows: 

The  ships  wer'e  to  he  kejjt  out  in  (iie  l>ay  on  a  special  anchorage  which  was  dedicated  to 
suspected  vessels;  the  sanitary  (U^legates  would  a[)jjr'oaclr  the  side  of  the  arriving  vessels  in 
order  to  notify  the  master  that  he  would  he  delaincid  for  ten  days  to  he  counted  from  the 
date  of  his  departure  from  tire  infected  por-t.  The  objc^ct  of  this  detention  was  to  asi;ertain 
that  no  person  amongst  the  passengers  or  crew  had  developed  tlie  disease.  Dur-ing  this 
period  of  observation  a  disinfection  would  be  carried  out  of  the  passengers'  baggage  and 
clothing  as  well  as  of  the  cargo  in  the  hold  and  the  rats  and  mice  would  be  killed  by  means 
of  sulphurous  acid,  by  burning  sulphur  in  tire  pr'oportion  of  40  gr-ammes  per  cubic  ureter  of 
space  in  the  hold,  which  was  left  her'metically  sealed  for  the  space  of  twenty-four  hours. 
¡Meanwhile,  a  disinfection  of  the  ship's  decks  was  carried  out  by  spraying  with  a  solution 
of  bichloride  of  mercury  of  one  to  a  thousand  or  of  carbolic  acid  at  5  per-  cent.  Only  the 
articles  which  were  to  be  subjected  to  a  surface  disinfection  were  treated  with  formaldehyde 
vapor.  Once  these  operations  were  terminated,  and  the  dischar'ge  commenced,  the  delegate 
revised  the  goods,  package  by  package,  so  as  to  make  certain  that  the  wrappers  or  cases 
carried  no  rats  or  mice  and  that  there  Vi^ere  no  holes  in  them.  If  any  package  was  found  in 
these  conditions  there  would  be  reason  to  fear  that  the  animals  might  have  penetrated  into 
its  interior  and  in  such  cases  it  was  opened  in  order  to  ascertain  the  truth.  Such  packages 
were  so  arranged,  that  should  the  rats  jump  out  they  would  fall  into  boiling  water  from 
which  they  were  only  extracted  with  the  help  of  forceps,  and  after  annointing  with  petroleum 
they  were  burned. 

If  the  vessels  should  arrive  with  sick  persons  on  board  or  if  the  plague  should  make  its 
appearance  during  the  ten-day  period  of  observation,  she  would  have  to  proceed  to  the  Port 
of  Acapuico,  where  there  is  a  lazaret  properly  adapted  to  receive  patients  who  are  suffering 
from  plague,  cholera,  or  yellow  fever. 

If  the  final  destination  of  the  ship  was  not  one  of  the  above-mentioned  ports,  after  the 
expiration  of  the  ten-day  period  and  the  disinfection  required,  the  delegate  would  give  the 
vessel  a  certificate  recording  the  above  facts  and  with  this  document  she  would  be  allowed 
to  enter  any  port  of  the  Pacific  coast. 

In  order  to  facilitate  the  introduction  of  provisions  into  Mazatlan  as  well  as  substances  for 
disinfection  and  other  objects  that  might  be  required,  special  permits  were  issued  to  certain 
vessels  by  the  supreme  board  of  health,  in  order  that  they  might  carry  those  goods  to 
Mazatlan,  but  without  entering  the  port.  In  these  cases  the  vessels  laid  off  at  sea  and  the 
vessels  that  carried  the  sanitary  delegate  would  go  alongside  and  receive  the  goods  that  were 
brought,  without  permitting  the  people  from  the  shore  to  communicate  with  those  on  board. 
The  delegate  would  issue  a  certificate  declaring  all  these  facts  and  the  vessel  would  be 
allowed  to  proceed  to  her  port  of  departure  or  any  other  without  being  subjected  to  quar- 
antine. 

These  measures  were  so  efficacious  that  not  a  single  case  of  plague  appeared  on  any  vessel, 
nor  was  any  carried  to  any  other  port  within  the  six  months  during  the  epidemic.  ' 

V.  MEASURES  FOR  PREVENTING  THE  SPREAD  OF  THE  PLAGUE  BY  LAND. 

The  most  efficacious  means  for  stopping  an  epidemic  is  to  diminish  the  number  of  inhabi- 
tants in  the  town  in  which  it  prevails,  as  we  can  easily  understand  that  this  diminishes  the 
material  on  which  the  disease  can  feed  itself.  The  public  authorities  can  not  order  such  a 
step  except  when  dealing  with  very  small  towns;  but  in  the  present  case,  the  residents  of 
Mazatlan  departed  and  it  is  estimated  that  the  emigrants  reached  as  many  as  8,000  persons. 
At  the  same  time  it  is  necessary  that  in  procuring  the  emigration  from  a  city  care  should 
be  taken  that  the  emigrants  do  not  carry  the  contagion  either  on  their  persons  or  in  their 
baggage.     In  order  to  avoid  this  danger  the  foUo^ving  measures  were  adopted. 

A  medical  commission  was  appointed  to  examine  the  persons  who  desired  or  attempted  to 
leave  Mazatlan ;  if  they  were  found  healthy  they  were  given  passports  which  recorded  their 
names  and  surnames,  their  state  of  health,  and  destination.  Tim  commission  forwarded  a 
similar  notice  to  the  authorities  of  the  place  to  which  the  passengers  were  traveling  and  at 
the  same  time  kept  a  record  of  all  this  iiiformation. 

In  the  roads  which  pass  from  Mazatlan  (as  yet  it  has  no  raüroad  communication)  to  other 
points  in  the  State  of  Sinaloa  and  to  the  other  States  and  territory  that  surroimd  it,  and  in 
the  most  frequented  parts  sanitary  stations  were  established  which  consisted  of  a  depart- 
ment for  the  persons  arriving  with  the  disease  already  confirmed;  another  which  was  dedi- 
cated to  those  who  were  simply  suspected  of  suñ'ering  ft-om  the  plague;  a  third  in  which  the 
convalescents  were  lodged  with  their  proper  bathrooms;  a  fourth  department  with  the 


164  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

disinfecting  stove — a  chamber  dedicated  to  the  fumigation  of  goods  by  means  of  sulphurous 
acid;  and  lastly,  dwelling  rooms  for  the  staff.  ^ 

These  stations  were  under  Khe  dii'ection  of  a  hygienic  physician. 

Besides  tliis  a  second  zone  of  sanitaiy  stations  was  established  at  a  certain  distance  from 
the  first  and  the  adjoining  States  also  organized  their  own  sanitary  stations  as  follows:  Two 
in  the  Territory  of  Topic;  two  in  the  State  of  Jalisco;  three  in  the  State  of  Durango;  and  one 
in  that  of  Sonora. 

The  defense  b}'  land  was  organized  as  follows :  In  the  first  place  an  inspection  was  made 
by  the  medical  commission  in  Mazallan  of  all  persons  who  attempted  to  leave  the  city;  if 
any  traveler  fellsick  before  the  second  day  from  his  departure  ho  would  be  received  into  the 
first  sanitary  station;  if  the  disease  showed  itself  before  the  second  and  fourth  day  he  woiüd 
be  detained  in  the  second  station,  and  if  it  made  its  appearance  when  the  traveler  loft  the 
State  of  Sinaloa  he  would  be  detamed  in  one^if  the  stations  of  the  adjoining  States;  but  even 
in  the  case  of  delayed  incubation  by  which  the  disease  would  become  evident  before  the 
tenth  day  the  traveler  would  still  be  under  the  vigilance  of  the  authorities  at  his  new  resi- 
dence, as  they  would  be  previously  notified  of  his  arrival  by  the  medical  commission  in 
Mazatlan. 

It  is  believed  that  over  8,000  persons  left  Mazatlan  in  a  comparatively  short  space  of  time 
and  we  can  therefore  understand  that  many  of  them  escaped  the  inspection  in  Mazatlan  and 
evaded  the  sanitary  stations.  This  explains  the  appearance  of  some  cases  in  three  villages 
that  I  will  refer  to  later  on,  but  their  number  was  so  limited  that  without  any  danger  of 
exaggerating  I  may  say  that  the  plague  was  concentrated  in  Mazatlan  and  consequently 
that  the  measures  adopted  to  prevent  the  spread  of  the  disease  by  land  brought  about  the 
desired  result. 

VI.    PLACES   TO   WHICH   THE    EPIDEMIC   SPREAD   FROM   MAZATLAN. 

A  small  village  of  400  inhabitants  called  Oso  and  situated  on  the  left  bank  of  the  river 
El  Fuerte  formed  a  small  focus  which  was  originated  as  follows:  A  family  left  Mazatlan 
on  the  24th  of  January  and  on  reaching  the  village  of  Elota,  on  the  27th,  a  girl  fell  sick, 
and  in  order  to  escape  the  sanitary  station  which  was  established  in  that  place  the  family 
fled  to  Oso,  wliere  they  arrived  seven  days  after.  The  girl  died  there,  after  having  passed 
the  contagion  to  her  mother,  from  whom  it  was  passed  to  the  grandmother,  and  these  two 
also  died.  As  soon  as  the  fact  was  known  a  physician  was  sent  from  Culiacan,  the  capital  of 
the  State  of  Sinaloa,  and  he  was  able  to  prove  that  the  patient  whom  he  saw  alive  was 
suffering  from  the  pneumonic  form  of  the  plague.  The  disease  was  propagated  to  three 
other  persons,  but  as  all  the  patients  were  isolated,  togethei  with  the  persons  who  attended 
them,  and  as  not  only  the  clothing  and  other  objects  which  might  have  any  infection  were 
burned,  the  houses  in  wliich  the  patients  hved  being  also  burned,  and  all  persons  who  ran 
any  danger  of  contagion  were  vaccinated  wth  Yersin  serum,  which  was  the  only  one  at  that 
time  available,  and  as  the  rats  and  mice  throughout  all  the  adjoining  houses  were  destroyed, 
the  epidemic  was  finally  stamped  out  in  that  place. 

I  should  state  that  the  callage  of  Oso,  which  is  situated  about  170  kilometers  from 
Mazatlan,  is  the  most  distant  that  has  been  reached  by  the  disease. 

The  village  of  ViUa  Unión,  situated  26  kilometers  to  the  southeast  of  Mazatlan,  was 
invaded  by  the  famihes  who  emigrated  from  the  port  when  the  epidemic  declared  itself  there, 
and  the  frequent  connection  which  they  maintained  with  the  port  gave  rise  to  the  develop- 
ment of  another  focus,  in  which  seven  persons  were  attacked,  but  with  only  one  death.  The 
first  patient  hardly  fell  sick  before  physicians,  disinfecting  stoves,  and  operators  were  sent, 
and  the  patients  were  isolated  as  well  as  all  suspected  persons  and  convalescents.  As  in 
Mazatlan  an  observation  camp  was  estabhshed  in  order  to  isolate  the  famihes  of  the  sick, 
the  houses  in  which  the  patients  had  lived  were  destroyed,  rats  were  exterminated,  and  the 
epidernic  was  stamped  out.  Two  important  factors  contributed  to  this  result;  the  first  was 
the  estabfishment  of  a  sanitary  organization  similar  to  that  of  Mazatlan,  and  the  second  was 
the  inoculation  with  Besredka  vaccine  of  645  persons  who  were  liable  to  take  the  disease. 

Another  vülage  called  Siqueros,  situated  34  Idlometers  from  Mazatlan  and  15  from  ViUa 
Unión,  received  the  emigrants  from  the  latter  village  and  with  them  the  disease,  but  the  same 
elements  to  fight  the  evil  were  accumulated  in  that  new  focus  as  in  Mazatlan  and  Villa  Unión, 
so  that  although  nine  cases  developed,  with  six  deaths,  the  epidemic  was  also  stamped  out  in 
this  village. 

Before  closing  my  report  of  the  measures  which  were  adopted  to  prevent  the  propagation 
of  the  epidemic  by  land,  I  must  mention  a  step  that  powerfully  contributed  to  preventing 
the  emigration  of  the  sick  people,  which  consisted  in  the  organization  of  a  flying  brigade 
of  sanitary  police,  accompanied  by  an  ambulance  and  under  the  orders  of  a  physician,  which 
traveled  over  the  road  and  visited  the  smaller  villages,  thus  exercising  a  very  efficient 
vigilance. 


SECOND    INTERNATIONAL    HANITAKY    OONVP:N'JTON.  105 

VII.    CONFIRMATION    OF   TIIIO    NATURE   OF   TIIK   IJIHKASE. 

As  stated  at  the  commencement  of  this  paper,  the  Hiipromo  l;oaid  of  iuialth  established  the 
struggle  against  the  plague  basing  its  operations  on  the  clinical  data  of  the  disease,  but  the 
present  scientiiic  conditions  required  its  nature  to  bo  coniirrnod  by  bacteriological  proof. 
For  this  purpose  the  board  sent  Dr.Octaviano  González  Fabcla,  the  learned  bacteriologist 
of  the  corporation,  properly  equip])cd  for  that  purpose  and  with  a  supply  of  snnall  animals 
with  which  to  caiiy  on  his  experiments.  As  soon  as  the  doctor  niached  Mazatlan  he  made  a 
clinical  study  of  a  patient  who  was  suffering  from  the  disease  in  its  pneumonic  form,  col- 
lected the  sputa  and  the  li(|uid  from  the  porigangi ionic  tissue  of  the  buboe,  and  thus  was  able 
to  prove  the  existence  of  the  Yersin  bacilus.  With  the  culture  of  this  pure  bacilus  he  inoc- 
ulated some  guinea  pigs  that  shortly  after  presented  all  the  characteristics  of  the  experi- 
mental disease.  On  receipt  of  this  diagnosis  by  wire,  on  the  31st  of  December,  the  supreme 
board  of  health  at  once  made  public  declaration  that  the  epidemic  which  had  made  its 
appearance  in  the  port  of  Mazatlan  was  the  bubonic  plague,  and  so  communicated  to  the 
Federal  authorities  of  the  Republic  and  of  the  States,  to  all  the  sanitary  delegates  in  the 
ports,  to  the  sanitary  authorities  of  the  United  States,  and  to  the  international  committee  of 
the  American  Republics  in  Washington. 

•  VIII.    NUMBER   OF   CASES   AND   DEATHS. 

The  numbet  of  cases  of  which  the  authorities  had  any  knowledge  numbered  3.51,  and  the 
number  of  deaths  is  entirely  correct,  because  under  Mexican  law  no  interment  can  take  place 
without  the  certificate  of  the  registrar,  which  records  the  cause  of  the  death. 

We  can  not  say  the  same  as  regards  the  number  of  cases,  as  the  same  thing  happened  in 
Mazatlan  that  has  been  seen  in  all  parts  of  the  Mi-orld — that  is,  that  many  cases  are  hidden  in 
order  to  prevent  the  transfer  of  the  patients  to  the  lazaret.  The  number  of  such  hidden 
cases  was  notably  diminished  from  the  moment  that  house  visits  were  established  together 
with  an  unceasing  watch  throughout  the  town.  The  fear  which  possessed  the  poor  and 
ignorant  people  of  being  carried  to  the  lazaret  led  to  the  emigration  of  some  unfortunates 
from  the  town,  while  others  were  picked  up  sick  on  the  roads  and  carried  to  the  lazaret,  and 
this  fact  explains  the  difference  between  the  cases  recorded  and  the  deaths.  . 

The  largest  number  of  cases  recorded  in  one  week  was  65  and  the  largest  number  of  deaths 
56.    The  decrease  was  rapid  and  pronounced  until  the  epidemic  entirely  disappeared. 

IX.   MEASURES   INTENDED   TO   PREVENT   THE   REAPPEARANCE   OF   THE   DISEASE. 

As  the  disappearance  of  the  disease  was  not  sufficient  to  guarantee  the  cessation  of  all 
danger  it  became  indispensably  necessary  to  adopt  a  series  of  measures  intended  to  prevent 
its  reappearance.  The  character  of  this  paper  does  not  allow  me  to  enter  into  details,  and  I 
will  confine  myself  to  a  statement  of  the  principal  measures  that  have  been  adopted  for  that 
purpose. 

In  the  first  place,  the  house  visits  were  kept  up,  especially  as  regards  those  houses  that  had 
been  occupied  by  the  first  patients  when  the  nature  of  the  epidemic  had  not  been  established. 
These  visits  were  repeated  in  the  houses  which  adjoined  those  which  had  been  inhabited  by 
sick  persons  who  were  directly  or  indirectly  in  contact  with  the  victims.  In  aU  of  these 
houses  a  second  disinfection  was  made  and  those  that  were  of  slight  value  were  destroj^ed,  if 
the  disinfection  was  found  difficult.  The  clothing  found  in  all  of  these  houses  was  also  dis- 
infected and  it  was  repeated  in  all  that  which  was  deposited  in  the  pawnshop.  Operations 
were  continued  for  the  cleansing  of  the  streets,  slaughterhouses,  markets,  and  other  meeting 
places,  as  well  as  for  the  destruction  of  all  garbage  by  fire.  Before  the  schools  were  re- 
opened after  they  had  been  closed  at  the  commencement  of  the  epidemic,  the  schoolhouses 
were  disinfected,  and  the  persons  who  attended  the  religious  services  in  the  churches  were 
required  to  present  themselves  in  clean  and  previously  disinl'ected  clothing,  with  a  certificate 
that  they  had  taken  a  bath.  The  destruction  of  rats  and  mice,  against  which  a  ceasless  war 
had  been  declared  during  the  whole  of  the  epidemic,  was  still  continued,  until  a  special  com- 
mission which  was  charged  with  the  special  study  of  the  blood  and  tissues  of  these  animals 
had  demonstrated  that  they  were  no  longer  infected  with  the  plague.  This  commission 
continued  its  labors  for  nearly  a  year.  The  medical  commission  which  issued  the  certifi- 
cates of  health  to  travelers  leaving  Mazatlan,  and  which  was  charged  with  the  disinfection  of 
their  clothing  and  baggage  as  well  as  all  goods  that  were  shipped  by  sea  or  land,  was  contin- 
ued in  the  full  exercise  of  its  office.  The  sanitary  stations  were  for  some  time  maintained  in 
activity  and  the  service  perfected, with  the  object  of  exercising  a  vigUance  on  the  passengers 
and  goods  which  left  the  port,  as  well  as  over  the  persons  who,  after  emigrating  during  the 
epidemic,  now  desired  to  return. 

In  the  %'illages  I  have  above  mentioned,  in  wliich  cases  of  plague  had  appeared,  the  same 
precautions  were  continued  as  in  Jtlazatlan. 


166  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

The  extermination  of  rats  was  advised  not  onl}-  in  the  places  that  were  invaded  by  the 
plague,  but  was  also  carried  out  m  many  cities  of  the  Republic,  and  specially  in  Culiacan, 
about  240  kilometers  distant  from  Mazatlan,  where  over  35,000  rats  were  killed. 

'With  these  measures  we  can  safely  assert  that  the  bubonic  plague  will  not  reappear  in 
Mazatlan  or  in  any  other  point  of  Mexican  territory. 

II.  YELLOW  FEVER. 

After  the  serious  epidemic  which  spread  from  the  State  of  Vera  Cruá  along  the  interior  of 
the  littoral  to  those  of  Tamaulipas,  Nuevo  León,  San  Luis  Potosí,  as  well  as  to  some  towns 
of  Coahuila,  to  one  in  the  State  of  Hidalgo,  to  Oaxaca,  and  to  Yucatan,  we  were  able  to 
extinguish  it  completely  in  all  those  places  which  were  situated  to  the  north  of  the  parallel 
which  passes  through  Vera  Cruz,  so  that  at  the  commencement  of  the  year  1904,  cases 
only  existed  in  the  State  of  Vera  Cruz,  part  of  Oaxaca,  and  in  Yucatan,  as  can  be  seen  from 
the  annexed  table,  marked  "No.  4." 

The  vigorous  campaign  which  has  been  undertaken,  and  the  details  of  which  will  be  found 
on  Table  No.  5,  can  be  summarized  in  the  following  statement,  which,  on  account  of  its 
brevity,  I  will  read: 

Before  yellow  fever  can  be  transmitted  it  is  necessaiy  to  have  a  combination  of  three 
factors:  A  yellow-fever  patient,  a  mosquito  of  the  genus  Stegornya  to  bit?  the  patient,  and  a 
nonimmune  person  to  be  afterwards  bitten  by  the  mosquito. 

The  problem  of  fighting  yellow  fever,  tlierefore,  consists  in  the  disassociation  of  these 
three  factors,  and  I  will  now  show  the  manner  in  which  we  arrive  at  the  solution  of  this 
problem. 

I.    ISOLATION    OF   THE   PATIENTS. 

In  order  to  isolate  a  patient,  the  first  thing  to  know  is  that  the  patient  exists,  and  in 
order  to  find  him  we  proceed  in  the  following  manner:  In  each  village  where  there  is  yellow 
fever,  or  it  is  feared  that  it  will  develop,  we  organize  a  sanitary  brigade.  Some  of  its  mem- 
bers busy  themselves  in  making  a  list  of  all  the  people  who  are  not  immune  and  who  live 
in  the  locality.  In  this  register  a  note  is  made- of  the  age,  sex,  and  nationality  of  each 
person  and  the  place  of  his  residence.  The  sanitary  agents  whg  form  part  of  this  brigade 
divide  the  city  or  town  in  which  the  fight  is  waged  against  the  yellow  fever  in  such  a  way 
as  to  be  able  to  visit  the  nonimmunes  daily.  "V\T3en  one  of  these  is  found  to  have  fever, 
whatever  its  origin  may  be,  the  patient  is  separated  immediately,  being  put  in  a  room 
whose  windows  have  been  provided  with  fine  wire  screens,  which  will  prevent  the  entrance 
of  the  mosquitoes,  and  a  double  door,  also  of  wire,  is  provided  and  so  arranged  that  when 
the  outside  door  is  opened  the  inside  one  will  automatically  close,  and  vice  versa.  This 
can  be  done  by  means  of  a  chain  of  a  certain  length  which  unites  the  two  doors.  This  is 
much  more  satisfactory  than  covering  the  beds  with  mosquito  netting,  for  the  latter  has 
to  be  opened  frequently  in  order  to  observe  the  patient,  to  give  him  medicine,  food,  etc., 
and  each  time  the  curtain  is  opened  you  run  the  risk  of  letting  a  mosquito  in,  or,  should 
the  curtain  accidently  come  in  contact  with  the  patient's  body,  the  mosquito  can  bite  the 
patient  from  the  outside  of  the  curtain;  whereas  if  the  patient  is  in  a  room  from  which  the 
mosquitoes  have  been  previously  driven  out,  and  where  they  can  not  come  in  again,  the 
contact  with  the  patient  is  impossible.  This  means  of  isolation  has  another  advantage;  that 
is,  that  you  may  put  in  the  same  room  a  patient  who  has  already  been  proved  to  have  yellow 
fever  and  another  whom  they  only  suspect  of  having  it,  without  the  latter  being  liable  to 
catch  the  disease. 

As  we  have  just  seen,  in  our  plan  of  campaign  we  do  not  wait  until  we  are  satisfied  of 
the  existence  of  yellow  fever,  but  we  isolate  the  patient  from  the  first  day  that  any  fever 
appears,  and  consequently  we  isolate  him  during  the  first  three  days,  which  are  the  danger- 
ous ones,  and  those  in  which  the  mosquitoes  become  infected.  Experience  has  demon- 
strated the  sufficiency  of  the  methods  we  have  adopted  for  the  isolation  of  the  sick. 

II._   DISINFECTION    OF   THE   HOME   OCCUPIED   BY   THE   PATIENT. 

During  the  time  which  elapses  between  the  moment  in  which  a  person  takes  the  yellow 
fever  and  that  in  which  it  is  discovered  by  our  agent,  he  may  have  been  bitten  by  the 
mosquitoes  and  infected  them,  so  that  they  are  ready  to  spread  the  disease.  In  order  to 
prevent  this  danger  we  proceed  to  disinfect  the  house  as  soon  as  it  is  left  empty  by  the 
patient.  The  disinl'ection  in  this  case  has  for  its  only  object  the  destruction  of  the  mos- 
quitoes. In  order  to  accomplish  this  we  close  the  room  as  it  is  ordinarily  closed,  pasting 
manila  paper  over  all  cracks,  and  after  this  has  been  done  we  proceed  to  burn  sulphur  in 
the  proportion  of  20  grams  per  cubic  meter  of  capacity.  The  sulphur  must  be  spread 
in  a  thin  layer,  so  that  all  will  be  burned.  In  this  practice,  which  is  so  common  and  known 
to  all,  we  have  introduced  another  innovation  which  seems  to  me  of  great  importance  and 


SECOND    INTERNATIONAL    8ANITARY    CONVENTION.  107 

it  is  this:  As  it  is  very  difficult  to  i<iiow  wlictlier  tiie  disirifíiction  iias  b(!(;n  i;ompi(;tc  or  not 
we  talie  some  moHtjuitooa  wliicii  have  not  been  infected  and  wfiicii  fiave  been  taken  from 
tiio  exterior  of  tlie  room  and  put  them  in  tiio  farthest  room  from  tiie  one  in  wliieh  the 
sulpliur  is  burned.  These  mosquitoes  arc  put  in  open  vessfiis,  or  wiiich  are  only  closed 
witn  a  coarse  cloth,  so  that  it  will  alow  the  hiÜ{)Iiui-ous  acid  to  penc^tratí;  into  the  vessel 
and  prevent  the  mosquito  from  getting  out.  These  mosquitoes  sisrvi;  us  as  witnesses. 
If,  at  the  close  of  the  disinfection,  these  mosquitoes,  which  were  in  unfavorable  conditions 
to  sull'er  from  the  action  of  the  sulphurous  acid,  are  found  dead,  we  have  proof  that  ail  the 
others  in  the  same  room  and  under  more  favorable  conditions  for  receivinfi  the  sulphurous 
acid  are  dead  also.  11',  on  the  contrary,  we  find  them  alive,  it  is  a  proof  that  the  disinfection 
was  not  well  done  and  that  it  will  have  to  be  repeated. 

I  have  already  explained  in  our  last  meeting  the  way  in  which  the  huts,  which  in  our 
country  are  called  "jacales,"  are  disinfected.  I  will  therefore  not  have  to  repeat  it  now, 
and  it  will  be  all-sufhcient  to  state  this  fact:  That  there  is  not  a  house  which  can  not 
be  made  perfectly  free  from  the  mosquito. 

In  disinfecting  the  Pullman  cars,  other  railroad  cars,  or  any  limited  space  where  there 
are  delicate  objects  which  can  be  damaged,  we  use  formaldehyde. 

In  dry-goods  stores,  where  the  sulphur,  the  pyrtheum,  and  even  the  formaldehyde  might 
alter  the  color  of  the  merchandise,  we  have  used  hydrocyanic  acid,  the  result  of  which  is 
as  satisfactory  as  that  of  the  sulphur  and  has  not  the  objectionable  effect  of  injuring  the 
merchandise,  but  on  the  other  hand  it  can  not  be  used  except  by  a  person  who  is  very 
skillful  in  its  use. 

in.    DESTRUCTION   OP   THE   MOSQUITO   LARVJE. 

Another  group  of  the  sanitary  agents  is  employed  in  making  a  daily  house-to-house 
inspection  of  the  cisterns  which  supply  the  families  with  water.  If  the  deposit  is  found 
to  contain  larvie  it  is  emptied  and  the  place  in  which  the  water  flows  is  covered  with  petro- 
leum, the  deposit  is  washed,  and  the  inside  surface  is  searched  in  such  a  way  that  not  a 
larva  is  left  alive ;  then  it  is  filled  with  pure  water  and  is  covered  with  a  close-fitting  lid, 
with  a  wire  netting,  or  with  a  layer  of  petroleum.  All  other  deposits  of  water  are  covered 
with  petroleum,  whatever  their  size,  even  when  they  are  very  small. 

As  you  have  just  heard,  those  methods  in  which  we  have  introduced  innovations  over 
those  adopted  in  other  countries  are  the  following: 

I.  Making  a  register  of  the  persons  not  immune. 

II.  Visiting  the  houses  daily,  so  that  the  patient  can  be  discovered  the  same  day  that 
the  disease  begins. 

III.  The  disuse  of  the  mosquito  curtains,  because  their  use  is  insufíicient  to  isolate  the 
patient,  and  the  placing  of  the  patients  in  rooms  whose  windows  are  screened  and  which 
have  double  doors  of  wire  screen. 

IV.  In  order  to  convince  ourselves  that  the  disinfection  has  been  complete  we  put  mos- 
quitoes in  the  house  under  unfavorable  conditions,  so  that  they  can  be  reached  by  the 
action  of  the  disuifectant.  If  at  the  close  of  the  disinfection  the  test  mosquitoes  are  dead 
we  can  be  sure  that  the  disinfection  was  weU  done. 

V.  We  have  the  means  of  making  impossible  the  escape  of  the  mosquito  from  the  dis- 
infected houses,  even  if  these  are  only  huts  whose  walls  and  roofs  are  made  of  grass,  or  of 
branches,  or  of  any  other  penetrable  material. 

To  prevent  the  disease  from  attacking  a  place  where  there  are  Stegomyia  we  have  pro- 
ceded  in  the  following  manner: 

In  all  towns  of  this  class  we  establish  an  inspection  upon  the  arrival  of  the  trains,  and 
in  other  places  where  passengers  reach  the  town  on  horseback,  on  foot,  or  in  carriages. 
Each  passenger  who  is  to  remain  in  the  locality  is  examined  and  is  kept  under  watch  by 
our  sanitary  agents  or  by  the  police  for  five  days  after  his  arrival.  In  the  places  already 
invaded  by  the  yellow  fever  the  same  inspection  is  made  of  all  the  passengers  who  take  the 
trains,  and  they  are  prevented  from  leaving  if  they  are  ill  and  if  they  are  not  immune  and 
have  fever.  Could  not  the  passengers  take  the  trains  between  the  points  where  the  inspec- 
tions are  made?  The  sanitary  agents  travel  continually  on  the  trains  which  traverse  the 
infected  districts,  which  are  at  present  the  small  to^vns  in  the  State  of  Veracruz  and  the 
towns  traversed  by  the  Tehuan tepee  Railroad,  so  that  agents  travel  between  Veracruz 
and  Tierra  Blanca,  from  Cordova  to  Tierra  Blanca,  from  Tierra  Blanca  to  Santa  Lucrecia, 
from  Coatzacoalcos  to  Santa  Lucrecia,  from  Santa  Lucrecia  to  Tehuantepec  and  Salina 
Cruz.  If  a  patient  is  found  on  any  of  these  routes  he  is  taken  to  the  nearest  hospital  and 
at  night  the  Pullman  or  railroad  car  in  which  the  patient  traveled  is  disinfected. 

Having  thus  organized  our  system  of  inspection,  we  have  followed  it  in  Yucatan,  not- 
withstanding the  fact  that  for  a  long  time  past  not  a  single  case  of  yellow  fever  has 
been  found  either  in  Merida,  Progreso,  or  in  any  of  the  other  towns  of  the  State  above  men- 
tioned. There  has  not  been  a  single  case  of  yellow  fever  in  Veracruz  since  December  29, 
1904,  up  to  this  year.     In  spite  of  the  vigilance  which  we  have  exercised  it  is  possible  that 


168  SECOND    INTEENATIONAL    SANITAEY    CONVENTION. 

a  patient  who  did  not  arrive  by  the  raih-oad  nor  by  the  most  frequented  roads  had  clandes- 
tinely entered  the  town  and  was  able  to  remain  hidden,  and  as  he  was  not  on  the  register 
he  was  not  visited  by  the  sanitary  agent.  This  is  the  only  explanation  which  we  can  give 
of  the  appearance  of  this  disease  in  the  harbor  of  Veracruz.  We  have  established  a  sanitary 
brigade  and  a  lazaret  in  Tehuantepec,  notwithstanding  the  fact  that  the  last  case  that 
originated  in  the  town  was  observed  many  months  ago.  iVnother  service  is  established 
in  Salina  Cruz  and,  lastly,  in  Tierra  Blanca,  where  a  small  focus  was  formed.  Tierra 
Blanca  is  a  village  at  the  junction  of  the  three  branches  of  the  Veracruz  and  Pacific  Kail- 
road.  The  viUage  is  inhabited  bj'  nonimmunes  who  are  employees  and  workmen  on  the 
railroad.  As  the  A'illage  is  cosmopolitan  and  very  poor  and  dirty,  it  has  been  ti-uly  difficult 
to  completely  extinguish  the  disease,  and  for  that  reason  a  brigade  has  been  established 
there. 

In  the  other  places  of  the  small  infected  zone,  when  isolated  cases  appear  a  physician 
and  sanitary  agents  of  some  experience  are  sent  immediately  to  proceed  with  the  house- 
to-house  inspection  and  to  disinfect  where  ever  it  is  necessary  and  to  destroy  the  mosquito 
larvte. 

The  inclosed  table  (No.  1)  shows  the  number  of  yellow-fever  cases  registered  in  the  above 
towns,  giving  the  number  of  cases  in  each  one  of  them,  and  that  of  the  deaths  caused 
from  this  disease  in  the  same  places  during  the  year  1904. 

It  can  be  seen  there  were  635  cases  registered  and  that  there  were  197  deaths  in  the  whole 
the  Republic. 

The  inclosed  table  (No.  2)  shows  the  number  of  cases  registered  and  the  deaths  caused 
in  each  one  of  the  towns  mentioned  in  the  statistics  from  the  first  day  of  January  to  the  3d 
of  August  of  the  present  year.  It  can  be  seen  that  70  cases  were  registered  and  33  deaths. 
As  you  can  see  by  comparing  the  numbers  in  these  registers  with  those  of  last  year,  there 
is  a  difference  of  565  as  the  result  of  the  campaign  made  during  that  period  of  time. 

Map  No.  1,  which  is  marked  with  yellow  dots,  shows  the  places  which  were  invaded 
by  that  disease,  and  the  red  dots  show  where  the  sanitary  agents  are  established. 

Table  No.  3  shows  the  number  of  domiciliary  visits  made  to  the  persons  who  are  not 
immune,  the  tanks  of  water  which  were  examined  and  cleaned  of  larvae,  the  number  of 
deposits  of  water  covered  with  petroleum  and  the  disinfections  made,  of  houses  and  back 
yards  cleaned,  and  the  notices  given  to  proprietors  for  the  improvement  of  their  houses. 

The  success  which  has  been  reached  in  Mexico  in  the  struggle  against  yeUow  fever  and 
the  certainty  that  in  a  not  far  distant  future  the. disease  will  be  completely  extinguished, 
as  has  been  done  in  the  island  of  Cuba,  can  be  easily  seen  from  the  statements  already 
made. 

(6)  Summary  of  the  sanitary  and  quarantine  laws  that  have  ieen  enacted  since  the  first 

convention. 

The  legal  enactments  that  have  been  issued  in  the  Mexican  Republic  since  the  conven- 
tion of  1902,  amending  the  sanitary  legislation  which  existed  before  that  date,  are  set 
forth  in  the  sarlitary  code  of  the  United  Mexican  States  under  Title  I,  Chapter  I,  and  in 
articles  24  to  30,  which  I  here  present: 

"Akt.  24.  The  consuls  will  report  by  wire  to  the  board  on  the  appearance  of  cholera, 
bubonic  plague,  or  yellow  fever  in  their  places  of  residence,  giving  the  dates  on  which  the 
first  cases  have  appeared,  and  as  long  as  the  epidemic  lasts  they  will  take  care  to  report  to 
the  same  board  when  any  ship  leaves  for  the  Mexican  Republic,  the  sanitary  condition  of 
the  same,  and  of  the  port  of  departure. 

"Art.  25.  In  the  foreign  ports  in  which  yellow  fever  is  endemic  the  consuls  at  the  time 
of  issuing  or  indorsing  the  bills  of  health  will  note  thereon  if  at  the  time  of  their  issue 
there  ars  any  cases  of  that  disease  in  the  port. 

"Art.  26.  The  prophylactic  measures  to  be  taken  in  Mexican  ports  with  the  object  of 
preventing  the  introduction  of  epidemic  and  transmissible  diseases  will  consist  of  the 
following: 

"  I.  Of  the  medical  sanitary  inspection  of  the  vessels. 

"  II.  Of  the  vigilance  over  and  even  isolation  of  suspected  passengers. 

"  III.  Of  the  isolation  of  the  patients  till  they  are  completely  cured  in  the  lazarets  or  other 
isolated  places  in  the  locality. 

"  rV.  Of  the  disinfection  of  the  vessels,  baggage,  and  merchandise  that  may  require  it. 

"  V.  Of  the  destruction  of  the  animals  that  might  carry  the  contagion. 

"  Art.  27.  The  prophylactic  measures  referred  to  in  the  preceding  article  will  be  in  every 
way  subject  to  the  provisions  of  the  sanitary  regulations,  and  both  the  supreme  board  of 
health  as  well  as  its  delegates  in  the  ports  will  be  authorized  to  detain  vessels  for  as  long 
as  may  be  necessary  for  the  execution  of  those  measures. 

"  Art.  28.  The  sanitary  control  of  the  ports  will  be  subject  to  the  maritime  sanitary  regu- 
ations  in  everj-thing  relating  to  the  admission  of  vessels,  the  visits  on  entry  and  departure, 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  169 

issue  of  bills  of  hcaltli,  prohi]>ition  against  the,  ini{)orlation  of  rncrchandiso,  the  destruction 
or  disinfcrtioji  of  the,  ^kxIh  as  well  as  of  the,  ljaíí<!;aK''  and  vessels. 

"Art.  29.  The  substances  wliieli  present  danfrer  of  (lontajiion  and  whoso  disinfection  can 
not  be  f^uaranteed  shall  not  be  cleared  for  consumption,  and  if  abandoned  by  the  vessel 
which  has  brouf^lit  the.m  will  bo  destroyed  by  fire. 

"Art.  30.  On  reports  prcscvnted  by  tli"-  supnüno  board  of  health  tho  executive  of  the  Union 
will  declare  when  foreign  poits  ai'e  to  be  considei'od  infected  or  suspected." 

I  would  call  your  special  attention  to  articles  26  and  27,  becaus'!  practically  they  tend  to 
abohsh  quarantine,,  substituting  for  it,  as  you  have  just  heard,  a  sanitary  inspection  of  the 
vessels,  a  vigilance  and  even  isolation  of  suspected  passengers,  isolation  of  this  sick  until 
they  are  completely  cured,  disinfection  of  the  vessels,  baggage,  and  merchandise  that  may 
require  it,  and  destmction  of  the  animals  that  might  carry  the  contagion.  Article  27 
declares  that  the  vessels  may  be  detained  in  the  ports  only  for  the  time  necessary  to  carry 
out  the  measures  that  I  have  just  mentioned. 

As  you  have  just  heard,  Mexican  legislation  is  entirely  in  accordance  with  the  formula 
which  I  had  the  honor  to  propose  in  the  convention  of  1902  relative  to  tlu;  doctrine,  which 
ought  to  govern  the  quarantine  measures  from  the  moment  that  sci(  nee  has  served  as  the 
basis  for  the  resolutions  which  are  adopted  in  conventions  of  this  character.  This  formula 
is  as  follows : 

To  protect  the  interests  of  public  health  without  injuring  more  than  is  absolutely  neces- 
sarj^^  the  interests  of  trade  and  the  free  communication  between  men. 

Among  the  resolutions  adopted  by  that  convention,  the  second  one  reads  as  follows: 

"Resolved,  That  the  period  of  detention  and  disinfection  in  the  maritime  quarantine  sta- 
tions shall  be  as  brief  as  possible,  bearing  in  mind  the  public  safety  and  the  teachings  of 
science." 

As  you  will  see,  in  issuing  its  sanitary  code  of  the  30th  of  December,  1902,  the  Mexican 
Republic  adhered  strictly  to  the  resolutions  adopted  by  that  convention  on  the  oth  of  the 
same  month  and  year. 

It  would  be  very  desirable,  gentlemen,  that  the  governments  of  the  Republics  which  are 
here  represented,  inspired  by  the  resolution  unanimously  adopted  by  the  convention  of  1902, 
should  bring  their  sanitary  laws  into  accord  with  this  resolution,  which  has  already  been 
converted  into  law  by  the  Mexican  Government. 

It  is  necessary  that  we  should  understand  that  the  present  state  of  civilization  requires 
of  the  governments  of  all  countries  that  fear  should  no  longer  be  the  moving  sentiment  of 
quarantine  provisions,  because  in  that  way  they  will  always  be  excessive  in  their  severity, 
will  go  beyond  the  object  desired,  will  be  inefficient,  as  shown  in  my  paper  in  1902,  and 
that  they  should  be  substituted  by  measures  enacted  under  calm  reasoning  and  founded 
on  the  one  side,  on  the  exact  knowledge  which  is  now  furnished  to  us  by  sanitary  science, 
and,  on  the  other  side,  on  a  zealous  desire  not  to  injure  more  than  is  absolutely  necessary 
the  interests  of  trade  and  free  communication  between  men. 

As  in  our  last  meeting  I  heard  an  opinion  expressed  that  my  proposals  were  to  some 
extent  theoretical  and  would  encounter  difficulties  in  daily  practice,  as  by  shortening  the 
periods  for  the  detention  of  suspected  vessels  we  would  incur  the  danger  of  not  sufficiently 
protecting  the  interests  of  public  health,  I  will  now  take  the  liberty  of  calling  the  attention 
of  those  who  kindly  listen  to  me  to  this  consideration: 

Our  sanitary  laws,  which  are  inspired  by  the  two  precepts  that  I  have  just  mentioned 
have  enabled  us  to  defend  our  ports  on  the  Pacific  coast,  and  consequently  to  defend  for- 
eign ports,  during  the  epidemic  of  bubonic  plague  which  invaded  the  port  of  Mazatlan 
from  the  month  of  October,  1902,  to  the  month  of  May,  1903.  These  same  sanitary  laws 
have  enabled  us  to  prevent  the  yellow  fever,  which  still  prevailed  during  the  past  j-ear  in 
the  ports  of  Veracruz,  Coatzacoalcos,  and  Progreso,  from  spreading  to  that  of  Tampico 
and  our  other  ports  on  the  Gulf  coast.  These  laws,  without  any  amendment  or  modifica- 
tion whatever,  have  served  for  our  defense  against  the  epidemic  in  Befize  and  at  this  moment 
are  defending  us  against  the  great  epidemic  in  New  Orleans  without  our  having  to  add  a 
single  restrictive  measure  with  regard  to  the  vessels  which  arrive  from  the  above-mentioned 
places,  and  they  continue  to  give  us  the  protection  we  require  against  the  plague  that  has 
continued  to  prevail  in  the  RepubHc  of  Chile.  We  can  therefore  assert  that  our  sanitary 
laws,  being  inspired  by  the  doctrine  that  for  a  long  time  I  have  sustained — that  we  must 
protect  the  interests  of  public  health  with  the  least  possible  injury  to  trade  and  personal 
communication — are  not  a  Utopia,  but  a  precept  that  can  be  enforced  in  our  daily  practice 
and  that  has  triumphantly  supported  the  test  of  experience. 

Our  legislation  on  international  sanitary  police  is  as  liberal,  or  more  so,  than  the  English, 
but  is-unquestionably  more  liberal  than  the  legislation  of  all  other  countries,  and  I  now  come 
to  beg  of  the  convention  that  the  Republics  here  represented  should  adopt  a  practice  simi- 
lar to  ours,  which  is  founded  on  scientific  precept,  guaranteed  by  experience,  and  more 
than  any  other  favors  the  interests  of  trade  and  the  free  communication  between  men. 


170  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Although  not  of  a  legal  character,  but  on  account  of  th(?  interest  which  they  bear  for 
all  nations  that  are  suffering  the  invasion  of  yellow  fever,  I  bt-lieve  that  some  interest  will 
be  felt  in  the  statement  of  the  measures  \v'liich  have  successively  been  adopted  by  the  Mex- 
ican Kepublic  in  the  struggle  against  that  disease,  and  which,  respectively,  bear  the  titles 
of  "Defens,'  against  yellow  fever"  and  "Niw  plan  of  campaign  against  yellow  fever,"  and 
lastly,  the  summary  which  I  read  at  the  commencement  of  this  paper.  I  present  the  two 
first  pamphlets  as  annexes,  with  the  numbers  7  and  8. 

I  desire  not  to  close  this  part  of  my  paper  without  stating,  even  if  only  in  a  summary 
manner,  the  measures  which  are  about  to  be  adopted  for  the  purpose  of  stamping  out 
malarial  fever. 

III.  MALARIA. 

One  of  the  contagious  diseases  that  has  caused  the  greatest  number  of  deaths  is  malarial 
fever.  Tlie  bubonic  plague,  cholera,  yellow  fever,  etc.,  can  not  be  compared  with  it  from 
this  point  of  view,  because  these  diseases  are  acute  and  locahzed,  while  their  geographical 
distribution  is  limited:  but  malarial  fever  is  chronic  and  universal,  and  all  countries  of  the 
world  have  had  and  still  have  reason  to  lament  its  presence. 

The  scientific  knowledge  which  we  now  have  regarding  the  etiology,  pathogeny,  diagnos- 
tics, progress,  varieties,  and  treatment  of  malaria  will  allow  us  to  reach  the  complete  extinc- 
tion of  this  plague,  which  has  been  one  of  the  calamities  that  have  inflicted  most  injuiy  on 
humanity. 

Malarial  fever  requires  for  its  production  a  malaria  patient,  anopheles  mosquitoes,  and 
an  individual  who  is  predisposed  to  take  the  disease. 

When  the  patient  is  bitten  by  a  mosquito  of  the  genus  anopheles,  the  latter  takes  from 
the  blood  a  parasite  which  has  been  called  by  its  discoverer,  Laveran,  "  hematozoaria  of 
paludism." 

The  Laveran  "hematozoaria"  is  found  in  the  blood  of  malaria  patients  in  four  principal 
forms,  which  are  called  spherical  bodies,  flagellata,  semilunar  bodies,  and  segmented  or 
rosaceous  bodies. 

The  only  infallible  means  of  discovering  whether  a  patient  has  malaria  is  that  furnished 
bj^  the  microscopic  examination  of  the  blood.  In  fact,  our  practice  has  taught  us  that  the 
symptom  of  "intermittent  fever"  is  not  an  exclusive  accompaniment  of  malaria,  but  is  also 
found  in  other  and  different  morbid  conditions.  In  order  to  diagnose  malaria  with  cer- 
tainty, a  microscopic  examination  of  the  blood  is  absolutely  necessary.  The  observation 
of  any  of  the  parasites  above  described  in  a  globule  is  sufficient  to  establish  the  diagnosis, 
as  these  parasites  are  exclusively  found  in  the  blood  of  malaria  patients. 

The  evolution  of  Laveran  "  hematozoaria  "  requires  that  it  should  go  through  two  entirely 
different  organisms  in  order  to  run  through  all  the  phases  of  its  evolutive  cycle.  One  of 
those  organisms  is  man  and  the  other  is  the  body  of  the  anopheles  mosquito. 

The  females  of  the  insects  deposit  their  eggs  in  shallow  pools  of  clear  water  on  the  edges 
of  the  streams  or  swamps,  and  even  in  the  small  hollows  that  are  left  by  animals  in  passing 
over  soft  ground.     The  eggs,  lai^vse,  and  pupae  require  water  for  their  development. 

As  in  the  case  of  yellow  fever,  the  propagation  of  paludism  requires  the  concurrence  of 
these  three  elements: 

Fii-stly.  A  patient  suffering  from  malarial  fever; 

Secondly.  A  mosquito  of  the  genus  anopheles  to  bite  him;  and 

Thirdly.  A  predisposed  person  to  receive  inoculation  through  the  bite  of  the  mosquito. 

It  is  therefore  necessary,  in  order  to  prevent  the  propagation  of  malaria,  that  we  should 
be  able  to  disassociate  the  first  two  elements  and  give  immunity  to  patients  and  other  per- 
sons who  may  be  predisposed  by  the  administration  of  quinine,  which  exercises  a  special 
action  on  the  hematozoaria  of  Laveran. 

These  .considerations  bring  us  to  the  measures  which  should  be  adopted  in  order  to  pre- 
vent the  propagation  of  this  disease,  and  which  are  the  following: 

Firstly.  The  isolation  and  cure  of  the  patients. 

Secondly.  The  destruction  of  the  mosquitoes  that  are  already  infected. 

Thirdly.  The  immunization  of  predisposed  persons. 

Fourthly.  The  means  which  are  intended  to  prevent  the  development  of  new  generations 
of  mosquitoes  and  the  destruction  of  the  larvte  that  may  have  been  formed. 

I.    THE    ISOLATION   AND   CURE   OF   THE   PATIENTS. 

The  first  of  these  measures,  the  isolation,  is  in  this  case  more  difficult  of  execution  than 
in  that  of  yellow  fever,  because  it  is  an  acute  disease,  which  obliges  the  patient  to  keep  his 
bed.  The  rapidity  with  which  the  disease  passes  and  the  necessitj^  of  the  patient's  keeping 
his  bed  renders  the  isolation  easy  and  short.  On  the  other  hand,  in  cases  of  malaria  the 
patient  does  not  find  himself  obliged  to  keep  his  bed  except  when  the  disease  assumes  an 
acute  form  or  is  very  intense.  Other  persons  suffering  from  malaria  can  go  about  their 
ordinary  business,  and  are  thus  liable  to  be  bitten  by  anopheles. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  171 

Tho  isolation  is  tlicrcforc  a  not  very  ciiicicnt  method  for  the  prevention  of  tlie  first  requi- 
sito; that  is  to  say,  a  patient  who  can  Ixs  bitten  })y  a  mosquito. 

But,  insuflicicint  as  this  ini-tiiod  is,  it  sfiould  b(i  employed  whenever  poasiblo,  as  every 
patient  who  is  piacxid  in  a  situation  in  which  Ik;  can  not  he,  stunj^  by  the  anopheles  mosquito 
is  one  focus  less  in  tho  propagation  of  the,  disease.  'J'he  isolation  of  the  patient  in  this  case, 
as  well  as  in  that  of  yellow  iVvor,  consists  in  phicinf;  hirn  in  a  room  the  windows  of.  which 
aro  provided  with  iin(!  wire  gauze.  s(!i-e.ens,  whicii  will  not  allow  the  passage  of  th"  mosquitoes, 
and  double  doors,  whicli  should  also  be  screeni  d  and  arranged  in  such  a  manner  that  on 
opening  the  outer  one  the  inmir  door  automatically  closes,  and  vice  versa.  This  can  bo 
arranged  by  means  of  a  chain  of  a  certain  length. 

Anothijr  method  of  isolation  consists  in  placing  a  mosquito  curtain  around  the  bed,  but 
in  spoakiltig  of  yellow  fever  I  have  already  related  the  objections  that  I  find  against  this 
method,  that,  on  the  other  hand,  may  bo  very  useful  if  it  is  employed  as  a  prophylactic 
measure. 

Tho  second  of  those  measures,  which  is  intended  to  euro  thii  patient,  is  demanded  by  this 
special  circumstance:  That  an  attack  of  yellow  fever  confers  immunity  on  the  person  who 
sufl'ers  from  it  for  tho  first  time,  but  this  immunity  is  not  conferred  on  tho  person  who  suf- 
fers from  malarial  fever.  Another  reason  is  that  the  yellow-fever  patiíínt  can  not  furnish 
the  germ  which  produces  the  disease  except  during  the  first  three  days  of  the  attack,  while 
the  malaria  patient  preserves  the  hematozoaria  as  long  as  the  disease  lasts.  F'rom  these 
observed  facts  we  conclude  that  the  yellow-fever  patient  ceases  to  be  a  focus  of  infection  as 
soon  as  the  first  three  days  of  the  attack  have  passed,  while  the  malaria  patient  is  a  focus 
of  propagation  as  long  as  he  continues  sick,  and  as  the  disease  often  allows  the  persons 
who  are  attacked  to  attend  to  their  ordinary  business,  they  are  continually  exposed  to  the 
bites  of  tho  mosquitoes,  which  are  thus  infected.  Hence  the  necessity  of  not  only  isolating 
the  patients,  but  also  of  attending  them  until  they  are  thoroughly  cured. 

Fortunately  we  have  two  resources  on  which  we  can  rely.  The  first  is  to  oblige  them  to 
leave  the  place  in  which  anopheles  are  found  that  might  bite  them.  This  means  has  been 
known  from  the  most  ancient  times.  The  other  resource  consists  in  the  administration  of 
salts  of  quinine,  as  it  is  known  that  this  medical  substance  possesses  the  property  of  destroy- 
ing the  hematozoaria  in  the  blood. 

I  will  not  at  present  enter  into  the  detail  of  the  method  of  curing  this  disease  with  the 
help  of  quinine,  as  that  would  go  outside  of  the  plan  which  I  have  proposed  to  follow  in 
this  paper,  but  from  what  I  have  above  stated  we  can  form  these  two  conclusions:  First, 
that  it  is  necessary  to  isolate  the  patient  whenever  possible;  second,  that  it  is  nec?ssary  to- 
Cure  him,  so  as  to  obtain  the  disappearance  from  the  blood  of  the  hematozoaria  of  Laveran. 

As  can  be  seen,  these  methods  are  not  as  efficacious  in  dealing  with  yellow  fever.  The 
ideal  plan  would  be  to  obtain,  the  complete  isolation  of  a  malaria  patient  for  as  long  as  he 
is  suflering  from  the  disease;  but  as  this  is  not  always  practicable,  it  should  be  done  as  far 
as  the  circumstances  will  allow. 

II;    THE   DESTRUCTION   OF   MOSQUITOES    ALREADY    INFECTED. 

The  second  measure  is  as  efficacious  in  dealing  with  malaria  as  it  has  been  found  in  cases 
of  yellow  fever.  As  a  matter  of  fact,  the  malaria  patient  is  only  dangerous  because  he  is 
liable  to  be  bitten  by  the  mosquitoes  of  the  genus  anopheles,  which  are  infected  by  sucking 
up  the  hematozoaria  of  Laveran  in  the  blood  of  the  patient. 

The  destruction  of  these  mosquitoes  is  efi'ected  by  the  same  means  that  are  used  in  deal- 
ing with  yellow  fever,  and  for  that  reason  there  is  no  need  for  me  to  enter  into  a  description 
of  them. 

III.    THE    IMMUNIZATION   OF   PREDISPOSED   PERSONS. 

If,  unfortunately,  the  person  who  suiTers  a  first  attack  of  malaria  does  not  acquire  immu- 
nity against  that  disease,. and  if  as  yet  we  have  not  discovered  any  substance  that  will 
serve  as  a  vaccine  that  would  grant  that  immunity,  we  still  have  the  resource  that  lies  in 
quinine,  and  which,  administered  in  small  doses  and  for  a  long  period,  produces  the  desired 
immunity.  From  this  comes  the  rule  of  administering  small  doses  of  quinine  to  all  persons 
who  live  in  swampy  countries  during  those  seasons  in  which  malarial  eqidemics  make  their 
appearance. 

Repeated  experiments  and  continuous  observations  have  demonstrated  that  the  daUy 
administration  of  10  to  20  centigrams  of  quinine  is  suflBcient  to  confer  immunity  on  persons 
who  have  any  predisposition  to  take  the  disease. 

The  experiments  that  the  supreme  board  of  health  has  been  carrying  on  in  a  rural  prop- 
erty denominated  "El  Dorado,"  situated  in  the  State  of  Sinaloa,  and  one  of  those  places 


172  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

in  which  that  disease  is  a  scourge,  as  can  be  seen  from  the  map  that  I  present  herewith, 
have  been  highly  satisfactory,  as  is  showoi  by  the  following  table : 

Prophylactic  resvlis  of  the  daily  administration  of  a  small  dose  of  10  centigrams  of  quinine 
during  the  cane-cutting  season. 


Number  of  persons— 

Not 
attacked. 

Attacked. 

Total. 

"^Tio  took  it  rpgulaiiv 

85 
33 

2 
12 

87 

AVho  took  it  irregularly 

45 

In  whom  the  effect  could  not  be  observed  because  they  left  the  locality. 

18 

To  whom  it  was  given  in  a  period  of  3i  months 

150 

IV.  THE  MEANS  ■S\'HICH  ARE  INTENDED  TO  PREVENT  THE  DEVELOPMENT  OF  NEW  GENERA- 
TIONS OF  MOSQUITOES  AND  THE  DESTRUCTION  OF  THE  LARViE  THAT  MAY  HAVE  BEEN 
FORMED. 

As  it  may  not  be  possible  to  enter  into  the  details  of  every  one  of  the  methods  that 
have  been  taught,  firstly  by  observation  and  secondly  by  practical  experiments,  I  will  now 
proceed  simply  to  enumerate  them. 

A  very  old  experiment  that  was  systematically  carried  on  in  England  three-quarters  of  a 
century  ago  has  shown  that  the  drainage  of  swamps,  the  furnishing  of  an  easy  outlet  to 
the  waters,  and  the  conversion  of  swampy  lands  into  arable  lands,  together  with  the  plant- 
ing of  trees  of  rapid  growth  which  require  for  their  nutrition  and  development  a  great 
quantity  of  water,  as  in  the  case  of  the  eucalyptus,  are  all  measures  that  have  entirely 
reestablished  the  health  of  a  district  that  had  previously  been  for  many  years  a  focus  of 
malaria,  and  at  the  same  time  has  opened  up  those  lands  to  agriculture.  This  measure  is 
therefore  of  unquestionable  efficacy  as  a  prophj^lactic  against  malaria,  because  it  prevents 
the  development  of  mosquitoes  of  the  genus  anopheles,  the  vehicles  for  the  transmission 
of  the  disease. 

The  small  swamps  and  pools,  that  on  account  of  the  conditions  of  the  ground  can  not  be 
drained,  can  be  filled  up  with  earth,  and  in  this  way  we  can  obtain  the  disappearance  of  the 
waters  in  which  the  female  anopheles  could  deposit  her  egg. 

Those  other  water  ponds,  which  for  some  circumstances  can  not  be  drained,  planted 
with  trees,  or  filled  up  with  eartíi,  we  can  always  cover  with  a  thin  layer  of  crude  and 
refined  petroleum  mixed. 

And  lastly,  the  destiTiction  of  the  larvse  in  the  water  cisterns  inside  of  the  dwellings  or  in 
the  immediate  neighborhood,  and  carried  out  in  the  form  that  is  employed  for  the  destruc- 
tion of  the  larvse  of  the  stegomyia  mosquito,  to  which  I  have  referred  at  length  in  dealing 
with  yellow  fever,  is  another  resource  of  which  we  can  avail  ourselves  to  diminish  the  gen- 
erations of  the  anopheles  mosquito  in  places  in  which  these  insects  habitually  live. 

I  have  here  presented  a  very  brief  summary  of  the  measures  which  the  Mexican  Govern- 
ment proposes  to  adopt  in  its  campaign  against  malaria. 

In  order  to  comply  with  the  programme  that  has  been  adopted  by  the  convention,  I  beg 
to  present  to  the  delegates  a  map  which  shows  the  geographical  distribution  and  the  com- 
parative intensity  of  malaria  in  the  different  States  of  the  Eepublic;  a  diagram  which 
shows  the  mortality  from  this  disease  in  those  States;  and  lastly,  a  diagram  which  shows 
the  mortality  caused  in  difl^erent  parts  of  the  ]\iexican  Repubíic  during  a  period  of  ten 
years. 

(c)  All  special  sanitary  worJc  now  in  execution  or  which  it  is  proposed  to  execute. 

The  Mexican  Government  intends  to  establish  sanitary  conditions  in  all  the  important 
ports  of  the  Republic,  and  has  already  commenced  and  is  about  to  terminate  the  sanita- 
tion and  water-supply  works,  in  accordance  with  the  necessities  of  the  inhabitants,  together 
with  a  good  system  of  paving  on  the  streets  where  it  is  possible  to  preserve  them,  in  the 
ports  of  Tampico,  Veraci-uz,  Coatzacoalcos,  Salina  Cruz,  and  Manzanillo,  and  has  undertaken 
investigations  in  the  port  of  Mazatlan  and  others  for  that  same  purpose. 

The  sanitation  works  in  Tampico  are  approaching  their  termination,  as  out  of  the  pro- 
jected system  of  sewers  with  a  total  length  of  12,500  meters,  10,000  have  already  been  laid 
while  the  whole  of  the  mains  and  10,500  meters  of  distributing  pipes  have  been  laid. 

The  water-supply  works  are  practically  complete,  as  the  only  thing  left  to  be  done  is  a 
part  of  the  settling  tank  in  Camalóte  and  some  filling  up  in  the  low  grounds  of  the  town. 
The  drainage  in  front  of  the  Government  wharf  has  been  completed,  and  a  continuation  is 
being  made  in  front  of  the  lateral  wharves. 


SECOND    IN'J'KIiNATK^NAJ.    HANITAHY    CONVENTION. 


173 


In  Veracruz  the  construction  of  the  main  sower  and  of  tfie  outfall  sewer  has  been  com- 
pleted, together  with  the  erection  of  the  pumps  on  the  water's  edge.  The  sanitation  works 
in  the  most  crowded  part  of  tluí  city  liave  been  completed  and  a  commencement  made  on 
the  construction  of  the  main  drains  for  tlie  surface  drainage  of  the  land  that  was  reclaimed 
from  the  sea. 

The  water  dedicated  to  the  necessities  of  the  inhabitants  is  propfsrly  piped  and  distrib- 
uted to  the  different  houses. 

A  contract  has  been  granted  for  the  paving  of  the  city,  and  the  work  will  shortly  be 
commenced.  The  principal  streets  will  be  paved  with  asj)halt  and  the  others  with  stone 
blocks  or  bowlders. 

A  sanitary  station  has  been  erected  in  the  port  of  Veracruz  which  contains  the  offices  of 
the  delegation,  warehouse,  incinerating  linnace,  department  for  disinfection  by  means  of 
sulphurous  acid  or  formaldehyde;  first,  second,  and  tliiid  class  baths  for  men;  ladies'  and 
gentlemen's  toilet  rooms,  and  disinfecting  stoves  of  the  latest  models.  In  Veracruz  there  is 
also  a  lazaretto  for  sick  and  suspected  persons  which  is  erected  on  a  small  island  called 
Sacrificios. 

Sanitation  works  have  also  been  commenced  in  the  port  of  Coatzacoalcos  and  have 
already  improved  the  sanitary  conditions  of  that  town.  Seventy  thousand  square  meters 
of  land  have  been  reclaimed  from  the  river,  while  all  the  streets  and  houses  have  received 
a  thorough  cleansing. 

A  well-fitted-up  lazaretto  has  also  been  established  in  this  port. 

On  the  Pacific  coast  we  have  a  lazaretto  in  Acapulco,  that  has  been  erected  on  the  "  Isla 
de  la  Roqueta." 

In  the  port  of  Manzanillo  work  has  commenced  on  a  canal  to  connect  the  northern  part 
of  the  Cuyatlan  Lagoon  with  the  ocean  so  as  to  keep  the  waters  pure,  and  this  is  divided 
from  the  southern  part  of  the  lagoon  by.  a  dike  so  that  the  salt  beds  there  can  be  worked. 
A  canal  has  also  been  excavated  for  the  purpose  of  either  draining  the  San  Pedrito  Lagoon 
or  of  allowing  the  entrance  of  the  sea  water. 

Sanitary  stations  similar  to  that  in  Veracruz  are  being  constructed  in  the  ports  of  Tara- 
pico,  Mazatlan,  Coatzacoalcos,  and  Salina  Cruz,  and  the  construction  of  similar  establish- 
ments is  under  consideration  for  the  ports  of  San  Bias,  Manzanillo,  and  Progreso. 

Disinfecting  stoves  have  been  established  in  the  ports  of  Tampico,  Veracruz,  and  Pro- 
greso, on  the  Gulf,  and  in  Acapulco,  Salina  Cruz,  Mazatlan,  and  Guaymas,  on  the  Pacific 
coast.  Similar  stoves  are  about  to  be  erected  in  Manzanillo,  San  Bias,  La  Paz,  Santa  Rosa- 
lia, and  Enseñada,  on  the  Pacific,  as  well  as  in  Coatzacoalcos,  on  the  Gulf  of  Mexico. 

Disinfecting  stoves  have  also  been  erected  in  the  cities  of  Laredo,  Porfirio  Diaz,  Juarez, 
and  Nogales. 

Cases  and  deaths  caused  by  yellow  fever  in. the  Republic  during  the  year  1904. 


Cases.., 
Deaths. 


Veracruz. 


Vera- 
cruz. 


Jam- 
pan. 


Coat- 
zacoal- 
cos. 


Tejis- 
tepec. 


253 

77 


Acayu- 
can. 


Méri- 


Pro- 
greso. 


Oaxaca. 


Te- 
huan- 
tepec. 


Salina 
Cruz. 


Total. 


635 
197 


Oases  and  deaths  caused  by  yellow  fever  in  the  Republic  from  January  to  August,  1905. 

Veracruz. 

Yucatan. 

Oaxaca. 

Vera- 
cruz. 

Coatza- 
coalcos. 

Tierra 
Blanca. 

Pro- 
greso. 

Mérida. 

Tehuan- 
tepec. 

Total. 
Juchitan.i 

Cases 

18 

4 

15 

4 

27 
18 

1 

1 
2 

5 

1 

3            70 

Deaths 

3  i           33 

174  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

REPORT    FROM    THE    DELEGATE     FROM     NICARAGUA,    DR.    J.    L. 

MEDINA. 

Gentlemen  and  Members  op  the  Sanitary  Conference:  I  feel  that  I  am  greatly 
honored  to  have  the  opportunity  to  address  you  on  this  occasion.  In  compliance  with 
the  I'equirements  of  the  scientific  programme  of  this  conference,  I  am  pleased  to  make  the 
following  brief  statements: 

bubonic  plague. 

I  am  happy  to  state,  with  all  certainty,  that  in  Nicaragua  we  have  not  had  one  single 
case  of  plague. 

Since  the  appearance  of  this  scourge  in  Panama  and  other  places  in  the  American 
continent  radical  measures  were  taken  in  Nicaragua  to  protect  ourselves  against  this 
most  di'eaded  disease. 

YELLOW   fever. 

We  had  two  cases  of  yellow  fever  in  Managua  during  the  past  year.  One  of  the  cases 
was  that  of  a  passenger  brought  by  a  vessel  from  Panama,  developing  the  disease  right 
after  his  arrival  in  Nicaragua.  The  second  case  also  had  been  exposed  to  the  infection. 
Both  were  treated  according  to  the  latest  methods,  isolating  the  patient  and  protecting 
him  with  the  usual  wire  netting,  preventing  in  this  way  the  spread  of  the  disease. 

On  the  Atlantic  side,  although  our  ports  are  so  near  to  New  Orleans,  where  for  months 
yellow  fever  has  prevailed,  not  a  single  case  of  the  fever  has  been  reported,  and  we  expect 
to  continue  free  fiom  all  infection. 


Cases  of  malarial  infection,  under  different  forms,  are  very  common  in  Nicaragua,  just 
the  same  as  in  most  of  the  tropical  regions.  The  treatment  is  usually  rewarded  with 
great  success  wnth  the  usual  drugs,  but  more  so  with  the  change  of  chmate. 

Our  climate  is  extremely  favorable  to  the  general  health  of  the  natives  as  well  as  for- 
eigners. We  enjoy  a  nearly  uniform  temperature  the  whole  year,  ranging  from  70°  to 
80°  F. 

Nicaragua  has  fairly  good  hospitals  in  all  the  principal  cities,  provided  with  separate 
pavilions  for  the  isolation  of  cases  of  contagious  diseases  and  supplied  with  modern  appH- 
ances  in  the  hands  of  competent  men.  * 

The  municipalities  under  the  supervision  of  the  governor  of  each  State  have  charge  of 
the  formation  of  local  sanitaiy  boards  of  health,  performing  their  duties  to  the  best  of 
their  ability,  with  power  to  enact  and  institute  the  necessary  laws  for  the  efficiency  of  their 
measures  in  the  interest  of  sanitation  of  their  locality. 

The  importance  of  marine  board  of  health,  under  uniform  laws  and  regulations,  is  felt 
greater  to-day  than  ever  before  in  Central  America,  due  to  the  construction  of  the  Panama 
Canal.  The  work  on  the  Isthmus  is  to-day  and  will  be  for  years  to  come  a  constant  threat 
to  the  health  of  all  the  neighboring  countries. 

This  being  an  international  and  purely  American  sanitary  conference,  each  one  of  the 
different  countries  here  represented,  I  am  sure,  will  do  their  utmost  for  the  success  of  the 
conference  by  carrying  out  faithfully  to  a  practical  point  all  its  suggestions. 

The  Republic  of  Nicaragua,  being  well  aware  of  the  progi'ess  of  the  world  in  the  science 
of  medicine  and  sanitation,  is  wiUing  to  do  all  that  lies  in  its  power  to  bring  to  the  public 
and  our  neighbors  the  confidence  that  only  a  well-estabHshed  marine  sanitary  corps  can 
bring  to  a  civilized  country. 

This  conference  has  under  consideration  now  the  enactment  of  treaties  binding  the 
Governments  here  represented  to  the  observance  of  prescribed  rules  regarding  quarantine 
service,  insuring  in  this  way  the  health  of  the  people  of  those  countries  and  avoiding  at 
the  same  time  unnecessary  interference  with  commerce. 

To  carry  out  fully  the  agreements  of  this  conference,  it  seems  to  me  that  our  Central 
American  Republics  ought  to  do  what  Cuba  and  Mexico  have  already  done;  with  most 
wonderful  results  and  the  applause  of  the  whole  world.  The  reorganization  in  Central 
America  of  the  different  boards  of  health  for  the  quarantine  service,  under  uniform  laws 
and  regulations,  and  purely  scientific  basis,  would  be  the  first  step  to  accomplish  this 
project;  and  if  this  conference  should  help  us  in  this  direction,  it  wiU  deserve  our  lasting 
gratitude. 


SEOOND    INTEEKATIONAL    SANITARY    CONVENTION.  175 

REPORT    FROM    THE    DELEGATE     FROM     PERU,    DR.    DANIEL    E. 

LAVORERIA. 

The  Republic  of  Peru,  in  whose  name  I  have  the  honor  of  speaking,  for  reasons  regretted 
in  my  country,  did  not  have  any  official  roprosontation  at  t\\o.  First  Internationa,]  Sanitary 
Conference,  which  met  in  tliis  city  on  D(!c-(ini|jc,r  2,  3,  and  4,  1002,  at.  wliicli  rnatlers  of  such 
interest  were  discussed  and  at  which  conclusions  of  so  much  iinjjoitancc  were  reached. 
On  this  occasion  the  Government  of  Peru  did  not  desire  the  same  to  occur,  and  on  receipt 
of  the  invitation  from  the  Bureau  of  the  American  Itepuhlics  for  the  meeting  of  the  Second 
Convention,  intrusted  to  mo  the  high  honor  of  representing  it  at  this  illustrious  meeting. 

A  short  time  since  my  country  entered  on  a  new  era  of  life.  After  the  misfortunes  it 
suffered  in  the  war  of  1879  to  1881  and  the  inteinal  convulsions  which  followed  it,  which 
caused  so  much  damage  to  its  progi'css  and  the  normal  progression  of  its  institutions,  it  has 
entered  on  a  path  of  concord  and  labor,  the  beneficent  results  of  which  are  already  being 
felt,  notwithstanding  the  few  years  it  has  been  on  said  road.  The  various  branches  of  the 
public  administration  are  becoming  systematized  and  perfected,  there  being  taken  as  an 
example  that  which  is  done  in  countries  more  advanced  than  Peru  in  civilization  and  in 
culture,  and  among  those  which  are  not  left  behind  in  the  general  advance  movement  is 
public  hygiene. 

In  accordance  with  the  recommendation  of  the  International  Conference  of  Mexico,  "all 
measures  on  matters  related  to  the  international  sanitary  police,  the  purpose  of  which  is 
to  prevent  the  invasion  of  contagious  diseases  and  the  establishment  and  vigilance  of  inter- 
national maritime  and  land  detentions — that  is  to  say,  health  stations — are  completely 
under  the  charge  of  the  National  Government,"  being  in  charge  of  a  special  technical 
institution,  forming  part  of  the  department  of  fomento,  the  bureau  of  public  health,  to 
which  I  have  the  honor  of  belonging.  This  oflSce,  created  by  a  law  of  November,  1903, 
but  which  did  not  enter  on  its  duties  until  February,  1904,  is  at  the  present  time  endeav- 
oring to  place  the  country,  from  a  sanitary  point  of  view,  in  the  most  advanced  possible 
situation  with  the  means  at  its  disposal,  and,  due  to  its  establishment,  it  is  possible  for  me 
to  give  the  information  contained  in  this  report,  in  which  I  make  an  attempt  to  confine 
myself  to  the  programme  published  by  the  Bureau  of  the  American  Republics. 

W.  l.  > 

(a)    data   on   the   prevalence   of   contagious   diseases,    ESJPECIALLT   PLAGUE,   YELLOW 

FEVER,    AND   MALARIA. 

The  infectious  diseases  present  in  Peru  are,  with  little  difference,  those  found  in  other 
American  countries.  There  is  only  one,  the  Peruvian  "verruga"  or  "Carrion"  disease, 
which  is  peculiar  to  the  country,  and  even  this  disease  is  to  be  found  only  in  some  valleys 
in  the  mountain  range,  such  as  those  in  the  province  of  Huarochiri,  in  the  department  of 
Lima;  others  in  the  province  of  Canta,  of  the  same  department,  and  some  of  the  Callejón 
de  Huailas,  in  the  department  of  Anachs.  Although  its  geographical  distribution  is  at  the 
present  time  limited,  it  appears  that  it  was  not  so  in  remote  times,  because,  according  to 
the  statements  of  the  historians  of  the  times  of  the  conquest  of  the  country  by  the  Span- 
iards, it  existed  also  in  other  sections  of  Peru,  Ecuador,  and  even  Colombia.  At  any  rate, 
at  the  present  time  it  is  to  be  found  only  in  the  valleys  of  the  said  provinces,  either  because 
conditions  have  changed  or  for  other  unknown  causes. 

This  peculiar  disease,  which  may  be  inoculated,  which  attacks  man  and  some  species 
of  animals,  is  not  contagious  from  person  to  person,  and  does  not  develop  an  epidemic 
character.  In  order  to  take  it  it  is  necessary  to  go  to  the  sections  where  it  is  produced, 
which,  as  has  been  said,  are  small  valleys  in  the  mountainous  section  of  the  country.  It 
is  characterized  clinically  by  fever  of  a  very  variable  type;  by  anemia,  or  a  considerable 
reduction  in  the  number  of  red  corpuscles  of  the  blood,  the  number  of  which  sometimes 
descends  to  a  million,  or  even  less,  per  cubic  millimeter;  by  pains  in  the  bones  and  articu- 
lar pains,  and  by  an  eiizption  of  the  skin,  and  even  of  the  mucous  membranes,  especially 
on  uncovered  portions,  consisting  of  pimples  of  a  red  appearance,  the  size  of  which  varies 
between  that  of  a  millet  seed  and  an  orange  seed,  which  bleed  easily  and  dry  up,  assuming 
a  callous  appearance  and  falling  off  without  leaving  any  traces.  They  consist  of  conjunc- 
tive and  vascular  tissue,  resembling  a  sarcomatous  production.  This  disease,  as  has  been 
said,  is  not  contagious.  Cases  of  "verruga"  are  constantly  seen  in  the  hospitals  of  Lima 
without  its  transmission  to  the  persons  in  the  vicinity  of  or  attending  the  patients  having 
been  proved. 

Malaria  is  endemic  in  Peru  in  many  places  in  the  coast  regions  of  the  country.  The  val- 
leys— that  is  to  say,  the  sections  irrigated  by  the  rivers  rising  in  the  Andes  and  emptying 
in  the  Pacific,  most  of  which  sections  are  used  for  the  growing  of  sugar  cane,  cotton,  rice, 
and  some  other  vegetable  products — are  the  places  in  which  malaria  is  most  prevalent. 


176  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Even  though  it  has  somewhat  decreased  in  the  last  few  years,  especially  in  Lima,  it  still 
reraaiiis  the  disease  responsible  for  the  greatest  number  of  deaths  in  Peiii,  and  although, 
as  a  general  rule,  the  forms  most  commonly  observed  are  the  intermittent  fevers  of  the 
tertian  or  quartan  type,  which  are  easilj^  cured  by  the  quinical  treatment  when  taken  in 
time,  all  other  forms  known  are  seen,  cases  of  pernicious  and  chronic  types  with  cachexia 
and  extreme  denutrition  not  being  rare,  although  not  frequent.  The  last-named  form  is 
seen  only  when  the  patient  neglects  placing  himself  under  the  proper  treatment  in  time. 
The  bureau  of  public  health  is  at  present  studying  the  most  adequate  means  for  destroy- 
ing the  anopheles,  in  order  to  extii-pate  malaria  or  reduce  it  to  the  lowest  possible  minimum. 

A  few  cases  of  malaria  are  also  found  in  the  high  or  mountainous  sections  of  the  country 
in  some  valleys  where,  on  account  of  their  warm  climate,  in  spite  of  their  height,  the  devel- 
opment of  the  anopheles  is  favored  and  in  which,  on  account  of  their  peculiar  topograph- 
ical conditions,  small  lakes  or  ponds  maj^  be  found,  favoring  the  reproduction  of  these 
insects;  but,  as  a  general  rule,  it  may  be  said  that  the  Pei-uvian  mountain  region  is  not  a 
malarial  country. 

In  the  transandino  section,  where  the  climate  is  hot  and  damp  and  the  vegetation  exu- 
berant and  luxurious,  in  the  region  of  forests  and  rubber,  malaria  also  exists  in  some  places, 
but  there  are  others  entirely  free  from  malaria. 

If  the  morbility  due  to  malaria  is  relatively  great  in  Peru,  the  mortality,  on  the  other 
hand,  is  small.  Excepting  in  very  backward  hamlets  or  towns  whose  inhabitants  are 
ignorant  of  or  reject  the  quinical  treatment,  the  deaths  from  malaria,  even  in  the  per- 
nicious forms,  are  relatively  rare. 

YeUow  fever  does  not  exist  in  any  section  of  the  Peruvian  territory.  After  the  epi- 
demics which  took  place  on  the  coast  of  Pern  in  the  years  1854,  1868,  and  1881  no  other 
cases  of  this  disease  have  occurred.  On  rare  occasions,  escaping  the  sanitaiy  restrictions, 
there  have  arrived  at  our  ports,  coming  from  Guayaquil  or  Panama,  passengers  or  mem- 
bers of  crews  of  vessels  suffering  from  this  disease,  but,  being  immediately  isolated  in  the 
lazarettos  and  protected  against  the  sting  of  the  Stegomya,  no  foci  were  formed. 

The  danger  to  Peru  of  being  infected  by  yellow  fever  is  her  proximity  to  Ecuador  and 
Panama,  countries  in  which  this  disease  is  endemic.  This  proximity  makes  the  duration 
of  the  trip  by  water  from  Panama  or  Guayaquil  to  Paita  and  other  northern  Peruvian 
ports  a  short  one,  consequently  permitting  of  the  arrival  there  of  apparently  healthy  per- 
sons, but  already  infected,  within  the  period  of  incubation  of  the  fever.  On  the  other  hand, 
the  Stegomya  may  be  found  in  some  of  our  ports,  and  by  stinging  a  sick  passenger  coming 
to  our  coast  might  at  any  moment  cause  a  more  or  less  serious  epidemic.  In  order  to  avoid 
this,  the  Government  of  Peru  is  directing  its  efforts,  first,  to  prevent  the  importation  of 
sick  persons  or  infected  mosquitoes,  and,  second,  to  the  destruction  of  the  mosquitoes  sus- 
ceptible of  becoming  infected.  With  this  end  in  view,  upon  the  arrival  of  vessels  at  the 
port  of  Paita,  which  is  the  first  port  at  which  vessels  engaged  in  the  Peruvian  coastwise 
trade  stop,  they  are  subjected  to  disinfection  by  sulphurous  anhydride,  the  puipose  of 
which  is  to  destroy  any  mosquitoes  which  may  be  on  board  the  vessel,  and  after  this  dis- 
infection— that  is  to  say,  after  the  persons  on  board  can  not  be  infected — the  vessel  is 
permitted  to  load  or  unload  freely  and  take  on  new  passengers,  but  the  arriving  passengers 
are  subjected  to  observation  for  seven  days;  and,  on.  the  other  hand,  a  supreme  resolution 
was  issued  under  date  of  August  1  of  the  present  year  commissioning  Dr.  A.  Barton  to 
consider  and  execute  the  works  to  be  undertaken  for  the  purpose  of  destroying  the  mos- 
quitoes which  transmit  yellow  fever,  at  the  principal  points  on  the  coast. 

With  the  same  end  in  view,  and  the  fruit  trade  between  Guayaquil  and  Panama  and  the 
Peruvian  coast  constituting  a  danger  of  the  importation  of  mosquitoes  which  might  be 
infected,  the  supreme  resolution  of  September  1  of  the  present  year  was  issued,  which  pre- 
scribes that  such  fruits  must  be  placed  on  the  vessels  in  compartments  permitting  the 
destruction  of  the  mosquitoes,  which,  as  is  known,  in  tropical  countries  conceal  themselves 
in  the  frait  and  even  feed  on  it,  this  being  especially  so  with  bananas  (banana  edulis). 

With  regard  to  bubonic  plague,  it  was  urJmown  in  Peru  until  the  month  of  April,  1903. 
The  ravages  this  tei'rible  plague  of  the  Ganges  caused  this  year  and  the  previous  ones  in 
the  western  part  of  America  had  not  extended  to  the  Peruvian  coast.  San  Francisco  and 
Mazatlan  were  attacked  before  we  were,  but  it  is  difficult  to  say  whether  it  was  from  one 
of  these  places  or  from  the  ports  of  Australia  or  of  India  that  the  epidemic  was  imported 
to  Peru,  because  the  trade  in  products  susceptible  of  carrying  the  Yersin  germ  or  rodents 
infected  with  it  existed  at  that  time  in  aU  of  the  ports  mentioned.  It  is,  nevertheless, 
very  possible  that  the  plague  came  to  Peru  in  a  cargo  of  rice  and  wheat  left  by  a  German 
steamer  in  various  Peruvian  and  Chilian  ports. 

The  first  appearance  of  the  disease  in  man  occurred  on  April  28,  1903,  in  the  port  of 
Pisco;  almost  simultaneously,  on  April  29,  a  laborer  in  the  mill  of  Santa  Rosa  in  CaUao 
was  taken  sick. 

In  Pisco,  which  has  a  population  of  about  five  thousand,  there  was  no  epidemic;  only  4 
persons  were  attacked  who  had  come  in  contact  with  sick  or  dead  rats.  Of  these  4  persons 
3  died,  and  1  recovered.     The  last  case  died  on  May  3,  1903.     Since  that  time — that  is 


SECOND    INTERNATIONAL    SANITARY    (JON VKN'J'ION.  177 

to  say,  for  twenty-nine  months — there  have  been  no  cases  either  in  man  or  in  animals;  that 
port,  tlicrefore,  is  free. 

In  Callao,  the  population  of  which  is  31,0f){),  there  were  10  cases  between  April  20  and 
June  1,  1908;  since  that  timci  it  has  .not  b(H',n  iic,(;essary  to  o|)ci)  tlic  lazareLto  of  ttn;  port, 
because  the  few  cases  which  have  occurred  in  tiie  twenty-eigiit  months  since  said  date  has 
been  transferred  to  Lima  for  treatment,  which  city  is  only  twenty  minutes  distance  by 
train.  Notwithstanding  the  strenuous  campaign  undertak(!n  against  it,  tlie  disease  has 
not  disappeared  from  Callao,  because  from  time  to  time,  sometimes  at  intervals  of  three 
months,  there  appear  cases  of  plague  in  man  or  rodents  dead  from  the  disciase. 

The  total  number  of  cases  in  Callao  from  Api'il  29,  VMY.i,  to  June  30,  1905,  was  65,  with 
37  deaths,  giving  a  death  rate  for  bubonic  plague  In  Callao  of  .56.92  per  cent;  but  there 
must  be  taken  into  consideration  in  noting  this  mortality,  that  many  of  the  deaths  due 
to  plagué,  especially  during  the  iirst  days  of  its  appearance  in  Callao,  occurníd  because  the 
sick  did  not  subject  themselves  to  the  specific  treatment,  sometimes  through  ignorance, 
other  times  through  fear  of  isolation.  A  confirmation  of  this  statement  is  found  in  the  fact 
that  of  the  only  4  cases  which  occurred  in  Callao  in  the  first  six  months  of  19ÍJ5,  which 
were  treated  in  the  lazaretto  of  Lima,  1  died  only,  giving  a  death  rate  of  25  per  cent. 

In  Moliendo,  the  principal  i^outhern  port  of  the  Peruvian  coast,  with  a  little  over  4,000 
inhabitants,  the  plague  also  appeared  in  this  year.  The  first  case  in  man  occurred  on 
July  26,  and  the  epidemic  lasted  until  October  8,  during  which  time  there  were  51  cases 
and  20  deaths,  that  is  to  say,  an  absolute  mortality  of  39.60  per  cent.  After  seventeen 
months  of  freedom  therefrom,  in  March,  1905,  there  was  a  now  epidemic  which  lasted  until 
the  14th  of  June,  last;  during  this  epidemic  there  occurred  125  cases  with  49  deaths,  giving 
a  mortality  of  39.28  per  cent.  Of  the  125  cases,  115  were  treated  by  the  antiplague  serum 
of  the  Pasteur  Institute  of  Paris,  at  various  stages  of  the  disease,  resulting  in  40  deaths,  or 
a  mortality  of  34.78  per  cent,  and  10  did  not  receive  this  treatment,  of  which  9  died — that 
is,  a  mortality  of  90  per  cent.  Adding  these  figures  to  those  of  the  previous  epidemic,  we 
have  for  Moliendo  a  total  of  176  cases,  with  69  deaths,  giving  a  mortality  of  39.20  per  cent. 
Of  these  149  were  treated  with  serum,  with  49  deaths,  giving  a  mortahty  of  33.10  per  cent; 
and  28  did  not  receive  this  treatment,  with  20  deaths,  or  a  mortality  of  71.42' per  cent. 

After  Moliendo,  the  disease  invaded  the  province  of  Pacasmayo,  beginning  in  the  port  of 
the  same  name,  and  extending  afterwards  to  San  Pedro,  the  capital  of  the  province,  to  the 
suburbs  of  the  same,  and  to  the  districts  of  Jequetepeque,  Guadalupe,  and  Cliopén.  In 
this  province  the  disease  assumed  more  of  an  endemic  character  than  in  any  other,  as 
between  August,  1903,  to  April  5  of  the  present  year,  there  were  always,  with  some  small 
intervals,  cases  of  plague  in  some  of  the  towns  composing  it.  Since  April  5  this  province 
has  been  free  from  the  disease.  The  total  number  of  cases  which  occuiTed  in  these  20 
months  was  366,  with  211  deaths,  representing  an  absolute  mortality  of  57.65  per  cent;  of 
this  total  number  of  cases,  234  received  the  serum  treatment,  of  which  nimaber  117  died — 
that  is  to  say,  a  mortality  of  50  per  cent — and  132  cases  did  not  receive  the  specific  treat- 
ment, resulting  in  94  deaths,  giving  a  mortality  of  71.21  per  cent. 

The  figures  for  the  different  sections  of  the  province  were  distributed  as  follows: 

Pacasirimjo. — From  August,  1903,  to  October,  1904  (with  short  intei-vals  of  freedom): 
Cases  65,  deaths  35,  absolute  mortality  53.84  per  cent;  treated  44,  deaths  20,  mortality 
45.45  per  cent;  not  treated  21,  deaths  15,  mortality  71.33  percent.  In  January,  1905:  Cases 
3,  deaths  3,  mortality  100  per  cent;  treated  1,  deaths,  1,  mortality  100  per  cent;  not  treated 
2,  deaths  2,  mortality  100  per  cent.  Total  for  Pacasmayo:  Cases  68,  deaths  38,  absolute 
mortaUty  55.88  per  cent;  treated  45,  deaths  21,  mortality  46.66  per  cent;  not  treated  23, 
deaths  17,  mortahty  73.91  per  cent. 

San  Pedro  and  suburls. — From  October,  1903,  to  February  1,  1905:  cases  135,  deaths  92, 
absolute  mortality  68.14  per  cent;  treated  61,  deaths  45,  mortality  73.77  per  cent;  not 
treated  74,  deaths  47,  mortality  63.51  per  cent. 

Jequetepeque. — From  September  1  to  November  8,  1904:  cases  48,  deaths  28,  absolute 
mortahty  58.50  per  cent;  treated  24,  deaths  7,  mortality  29.16  per  cent;  not  treated  24, 
deaths  21,  mortality  86.66  per  cent. 

Guadalupe. — From  November  13,  1904,  to  March  12,  1905:  cases  105,  deaths  45.  abso- 
lute mortality  42.85  per  cent;  treated  97,  deaths  39,  mortality  40.20  per  cent:  not  treated 
8,  deaths  6,  mortality  75  per  cent. 

Ohepén. — ^From' January  23,  1905,  to  April  5,  1905:  cases  10,  deaths  8,  absolute  mor- 
tality 80  per  cent;  treated  7,  deaths  5,  mortality  71.42  per  cent. 

In  Lima,  the  first  case  of  plague  occurred  on  October  6,  1903,  in  the  vicinity  of  the  ware- 
house of  one  of  the  railroads  which  connect  Lima  with  Callao,  and  the  following  days,  nine 
cases  occurred  in  the  same  section;  this  leads  to  the  belief  that  the  disease  was  imported 
from  Callao  to  Lima  by  infected  rats  which  came  in  the  merchandise  brought  from  CaUao, 
which  rats  in  their  turn  infected  the  other  rats  of  the  town,  beginning,  as  was  natural, 
with  those  of  the  district  in  which  the  railway  warehouse  is  situated,  which  district  is  also 
one  of  the  least  sanitary  of  Lima  and  in  which  dead  rats  were  first  found.     Since  that  time 

5610—06 12 


178  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

cases  of  plague  have  not  failed  to  appear,  although  on  some  occasions  at  intervals  of  ten, 
fifteen,  twentj",  and  even  twenty-five  days  between  them.  The  worst  months  of  the  year, 
1904,  were  March  and  April,  which  months  correspond  to  the  beginning  of  autumn. 

The  total  number  of  cases  in  the  province  of  Lima — that  is  to  say  in  the  city  and  its  sub- 
urbs, which  may  be  estimated  as  having  a  population  of  200,000  (the  census  of  1903  giving 
the  city  alone  130.289  inhabitants)  was  to  June  30,  1905 — that  is  to  say,  in  twenty-one 
months — 463,  of  which  222  were  fatal,  corresponding  to  an  absolute  mortahty  of  47.94 
per  cent.  Of  the  463  cases,  415  were  treated  with  seiTim  and  48  did  not  receive  this  treat- 
ment, the  former  resulting  in  174  deaths,  equivalent  to  a  mortality  of  41.93,  and  the  latter 
in  48  deaths,  or  ai  mortahty  of  100  per  cent. 

In  Paita,  a  port  situated  on  the  northern  section  of  the  Peruvian  coast,  which  has  a  popu- 
lation of  3,500  inhabitants,  epidemics  of  plague  have  occurred.  The  first  occurred  in  the 
month  of  April,  1904,  and  lasted  to  September  9  of  the  same  year,  during  which  time  there 
were  174  cases,  with  73  deaths,  giving  an  absolute  mortality  of  41.95  per  cent.  These  cases 
are  distributed  as  follows:  Treated  with  serum,  132,  with  40  deaths;  not  treated  Nvith 
serum,  42,  with  33  deaths:  which  gives  a  mortality  of  30.30  per  cent  for  the  former  and  of 
78.57  for  the  latter.  From  September,  1904,  to  May,  1905 — that  is  to  say,  for  eight  months — 
the  plague  disappeared  from  Paita,  there  being  no  cases  e;thcr  in  man  or  in  rodents;  it 
reappeared  in  May  of  the  current  year,  and  continued  until  June  30,  causing  6  deaths  in 
10  cases  (absolute  mortality  60  per  cent),  of  which  8  treated  with  serum,  resulted  in  4 
deaths,  and  2  not  treated,  2  deaths,  or  a  mortality  of  50  per  cent  for  the  former  and  of  100 
per  cent  for  the  latter.  .  The  total  number  of  cases,  adding  those  in  the  two  epidemics, 
on  June  30,  reached  the  sum  of  184,  with  79 deaths,  equivalent  to  a  mortality  of  44.02  per 
cent:  of  these  140  were  treated  with  serum,  with  44  deaths,  and  44  not  treated,  with  35 
deaths,  equivalent  to  a  mortality  of  31.42  per  cent  and  79.54  per  cent,  respectively.  At 
the  time  of  my  departure  from  Lima  the  epidemic  had  not  disappeared  from  said  port, 
there  being  some  patients  in  the  lazaretto  when  I  passed  through  the  port. 

The  port  of  Salaverry,  which  has  a  population  of  about  1,000  inhabitants,  was  invaded 
after  that  of  Paita,  the  fii'st  case  in  man  appearing  on  June  27,  1904,  and  the  last  on  Septem- 
ber 4  of  the  same  year,  and  in  the  sixty-eight  days  between  these  two  dates  36  cases  occurred, 
vrith  20  deaths,  giving  an  absolute  mortality  of  55.55  per  cent.  Of  the  36  cases,  27  were 
treated  with  serum,  resulting  in  11  deaths,  and  9  not  treated,  with  9  deaths,  giving  a  mor- 
tality for  the  former  of  40.74  per  cent  and  of  100  per  cent  for  the  latter.  At  present  this  port 
is  free  from  the  disease. 

The  small  village  of  Huanchaco,  adjoining  that  of  Salaverry,  which  has  about  400  inhabi- 
tants, was  free  during  the  epidemic  in  Salaverry;  but  although  the  latter  had  concluded  the 
beginning  of  September,  1904,  as  has  been  said,  in  the  month  of  January,  1905 — that  is  to 
say,  four  months  afterwards — it  appeared  in  Huanchaco,  where  there  occurred  31  cases, 
with  13  deaths,  up  to  February  2  of  the  same  year,  when  the  last  case  occurred.  The  abso- 
lute mortality  was,  therefore,  41.93  per  cent.  The  31  cases  were  treated  with  serum,  so  that 
the  mortality  with  relation  to  the  specific  treatment  was  the  same  as  the  absolute  mortality. 

In  the  department  of  Lambayeque  the  plague  appeared  on  September  14  in  the  town  of 
Eten,  which  has  from  three  to  four  thousand  inhabitants.  ,  On  September  26  it  invaded  the 
city  of  Lambayeque,  and  on  February  2,  1905,  that  of  Chiclayo,  which  is  the  capital  of  the 
department.  The  epidemic  concluded  in  Eten  and  in  Lambayeque  in  the  month  of  April, 
and  in  Chiclayo  on  May  28  of  the  present  year,  since  which  date  the  department  has  been  free 
ft'om  the  disease. 

The  cases  which  occurred  were :  In  Eten,  103  with  67  deaths,  giving  an  absolute  mortality 
of  65.04  per  cent ;  treated  with  serum,  63,  with  29  deaths;  without  treatment,  40,  with  38 
deaths;  mortality  among  the  former  46.31  per  cent,  among  the  latter  95  per  cent.  In 
Lambayeque,  61,  with  28  deaths;  absolute  mortality  45.90  per  cent;  treated,  53,  with  20 
deaths,  mortality  37.73  per,  cent;  not  treated,  8,  with  8  deaths;  mortality  100  per  cent 
In  Chiclayo,  167,  with  122  deaths — that  is  to  say,  an  absolute  mortality  of  73.05  per  cent; 
treated,  82,  with  46  deaths;  mortahty  56.09  per  cent;  not  treated,  85,  with  76  deaths; 
mortahty  89.41  per  cent. 

Finally,  the  small  village  of  Yaminchad,  of  the  district  of  San  Pablo,  in  the  province  of 
Cajamarca,  was  invaded  by  the  plague,  coming  undoubtedly  from  the  province  of  Pacas- 
mayo,  which  it  adjoins,  on  March  2, 1905.  The  epidemic  was  extinguished  on  the  31st  of  the 
same  month,  after  having  caused  among  its  500  inhabitants  14  cases,  with  14  deaths,  of 
which  7  were  treated  with  serum  and  7  not,  all  of  them  succumbing  and  the  epidemic 
disappearing. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION:  179 

If  we  make  a  recapitulation  of  the  data  contained  above  on  the  bubonic  l^lague,  we  have: 


Locality. 


Pisco . . 
Callao . 


Moliendo . 


Pacasmayo  (province  of) . 
Lima  (province  of) 


Time  of  the  epidemic. 


Paita....'. 

Salavorry  and  Huancñaco. 


Lambayeque  (department  of). 
Yaminchad 


Total. 


Apr.  28to  Mays,  1903... 
Apr.  29,  1903,  to  June  30, 

1905. 
July  2(i,  1003,  to  Oct.   8, 

1903;   May  1,   1905,  to 

Juno  14,  1905. 
Aug.,  1903  to  Apr.  5, 1905. 
Oct.  0,  1903,  to  June  30, 

1905. 
Apr., 1904,  to  Sept.  9,1904; 

May,  1905,  to  June  30, 

1905. 
June  27,  1904,  to  Sept.  9, 

1904;    Jan.  15,  1905,  to 

Feb.  2,  1905. 
Sept.  14,  1904,  to  May  28, 

1905. 
Mar.  2  to  31,  1905 


Duration. 


6daya 

2  years  and  2  months. 

178  days 


20  months 

1  year  and  9  months. . 

7  months 


87  days. 


7J  months. 
29  days 


Popula- 
tion. 


6,000 
33,000 

4,000 


.50,000 
200,000 

3,500 


1,400 

50,000 
500 


Total  of 
cases. 


347,400 


4 
66 

176 

366 
463 

184 
67 

331 

14 


1,670 


Locality. 


Morbillty 
per  1,000 
inhabi- 
tants. 


Restored 
to  health. 


Dead. 


Absolute 

morbility, 

per  cent  of 

pest 

stricken. 


T^^ated     Restored 


Pisco •. 

Callao 

Moliendo 

Pacasmayo  (province  of) 

Lima  (province  of) 

Paita 

Salaverry  and  Huanchaco 

Lambayeque  (department  of)  . 
Yaminchad 

Total 


0.80 
1.87 

44.00 
7.32 
2.31 

52.57 

47.85 
6.62 

28.00 


4.80 


1 
28 
107 
155 
241 
105 
34 
114 
0 


3 

37 

69 

211 

222 

79 

33 

217 

14 


Per  cent. 
75.00 
56.92 
39.20 
67.65 
47.94 
44.02 
49.25 
65. 55 
100.00 


(a) 


148 
234 
415 
140 
58 
198 
7 


(°) 


785 


52.99 


a  1,201 


117 

241 

96 

34 

198 

0 


0  690 


Locality. 


Pisco 

Callao 

Moliendo 

Pacasmayo  (province  of) . . . 

Lima  (province  of) 

Paita 

Salaverry  and  Huanchaco . . 
Lambayeque  (department  of)  . 
Yaminchad 

Total 


Patients 
that  died. 


(a) 


49 
117 
174 
44 
24 
95 
7 


MorbiUty 
per  100 
dead. 


Per  cent. 
100. 00 

(a) 
23.10 
50.00 
41.93 
3L42 
41.37 
48.02 

100. 00 


Treated 
without 
serum. 


(a) 


28 

132 

48 

44 

9 

133 

7 


42.52 


a  404 


Restored 
to  health. 


(o) 


Dead. 


(») 


20 
94 

48 
35 
9 

122 

7 


Morbility 

per  100  not 

treated. 


Per  cent. 
66.66 

(») 

71.42 

71.21 
100.00 

79.54 
100.00 

91.72 
100.00 


a  67 


83.41 


a  The  numbers  corresponding  to  the  items  of  "Treated  \vith  serum"  and  "Without  serum"  in  Callao 
are  lacking,  because  many  of  them  were  before  the  organization  of  the  bureau  of  health 

It  should  be  noted  that  in  the  figure  1,201,  which  is  the  number  of  those  who  received  the 
serum  treatment,  and  in  that  of  42.54  per  cent,  which  is  that  of  the  mortality  among  them, 
are  included  aU  who  received  inoculations  of  this  specific  at  any  stage  of  the  disease,  some  of 
them  a  few  hours  before  their  death.  The  death  rate  would  be  much  lower,  it  might  be 
reduced  to  25  per  cent  or  30  per  cent,  if  there  were  taken  into  consideration  only  those  who 
received  the  inoculations  during  the  first  twenty-four  or  forty-eight  hours  of  their  sickness. 
Logically,  those  who  received  inoculations  during  their  last  moments,  when  their  organism 
had  already  succumbed  to  the  infecton  and  the  poison  of  the  plague  bacilli,  can  not  be  con- 
sidered as  having  received  the  serum  treatment. 

Of  the  other  infectious  diseases  there  is  little  to  be  said  in  so  far  as  Peru  is  concerned. 

Typhoid  fever  is  prevalent  in  many  sections  of  the  Republic,  but  the  average  general  death 
rate  is  low;  it  is  higher  in  the  very  populated  sections  of  the  coast,  such  as  Lima,  the  capital ;  it 
is  less  prevalent  in  the  mountain  districts.    In  1903  the  number  of  deaths  due  to  enteric  fever 


180  .SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

in  Lima  amounted  to  142,  which  vrith  reference  to  130,289  inhabitants,  which  is  the  figure 
given  by  the  census  of  that  year,  represents  a  mortahty  of  1.08  per  1,000  inhabitants.  In 
1904  this  figure  fell  to  O.SS  per  1 ,000,  as,  with  a  populat  ion  of  131 ,499,  which  may  be  accepted 
as  the  population  of  Lima,  there  Mere  117  deaths  in  the  jear.  It  is  as  yet  impossible  to  give 
exact  figures  for  the  lest  of  the  Repubhc. 

The  liydric  origin  of  tliis  disease,  which  is  one  of  the  easiest  to  prevent,  being  known,  the 
municipahties  and  the  Government  are  installing  or  improving  potable  waterworks  of  many 
towns  of  the  country,  especially  in  those  where  this  disease  is  of  most  frequent  occurence. 
Lima  is  supplied  with  works  furnishing  potable  water  of  very  good  quality,  but  at  certain 
seasons  of  the  year  it  is  necessary  to  use  liver  water  in  order  to  increase  the  supply  of  the 
city,  and  at  the  present  time  the  municipal  board  of  the  capital  is  seeking  some  means  to 
correct  this  defect.  In  Callao,  a  service  of  potable  water  lo  houses  has  been  established  for 
some  years.  In  the  principal  towns  of  the  coast  and  of  the  mountain  district  the  same  is 
true,  and  at  the  present  time  this  service  is  being  installed  in  El  Cuzco,  in  Puno,  and  other 
towns,  and  plans  arc  under  consideration  for  its  establishment  n  Moquegua  and  Iquitos. 

Examthematic  typhus  does  not  exist  on  the  coast,  but  it  is  frequenth"  found  in  the  towns 
of  the  mountain  district,  where  it  is  known  by  the  name  of  "tabardillo."  It  is  not  as  yet 
possible  to  give  figures  respecting  its  morbidity  and  mortalitj-,  because  up  to  the  time  of 
the  creation  of  the  bureau  of  health  there  was  no  central  office  whose  duty  it  was  to  gather 
the  respective  data,  which  were  fii-st  received  from  the  provinces  a  short  time  since.  It 
appears  in  some  towns  of  the  mountain  section  from  time  to  time  in  the  form  of  small  epi- 
demics, but  causing  a  high  death  rate.  The  general  sanitation  of  the  towns  of  Peru  which 
was  undertaken  in  connection  with  the  bubonic  plague,  which  will  improve  the  sanitary 
conditions  of  the  country,  will  cause  this  disease  to  diminish,  if  not  to  disappear  altogether. 

Smallpox,  in  spite  of  the  large  number  of  vaccinations  in  past  j^ears,  has  not  as  yet  dis- 
appeared from  the  countiy.  From  time  to  time  in  different  places  small  epidemics  appear 
which  are  limited  by  themselves  on  account  of  an  absence  of  susceptible  subjects.  Vac- 
cination is  made  obligatory  by  the  law  of  January  3,  1886,  during  the  fii'st  six  months 
after  birth,  and  at  the  ages  of  11  and  21,  and  revaccination  every  time  the  sanitary  officials 
believe  it  necessary.  In  the  month  of  March  of  the  present  year,  in  view  of  the  epidemic 
of  smallpox  which  existed  on  the  coast  of  Chile,  a  supreme  resolution  was  issued  ordering 
a  general  revaccination  throughout  the  Republic  and  creating,  vñih  this  end  in  view,  a 
corps  of  official  vaccinators,  who,  together  with  the  physicians  who  ordinarily  perform 
this  work,  will  render  the  extraordinary  sei-vice  which  is  still  being  conducted. 

Measles  appears  also  in  small  epidemics  periodically  in  Lima  and  other  cities  of  the 
Republic.  It  does  not,  excepting  on  very  rare  occasions,  assume  a  grave  form.  It  attacks 
children  almost  exclusively. 

Scarlet  fever  and  diphtheria  are  diseases  which  are  extremely  rare  in  Peru.  The  former 
produced  in  Lima  in  1903  only  3  deaths  and  5  in  1804,  there  being  some  years,  as  1902, 
1900,  etc.,  when  there  was  not  a  single  death  from  this  disease.  Diphtheria  was  respon- 
sible for  12  deaths  in  1903  and  8  in  1904. 

Influenza  was  imknown  in  the  country  until  1890.  Since  that  year  it  has  not  failed  to 
appear,  there  having  been  a  serious  epidemic  in  1892,  which  in  Lima  alone  caused  354 
deaths;  in  1900  there  was  another  which  caused  195  deaths,  and  in  1904,  the  last,  which 
caused  103. 

Tuberculosis  of  the  lungs  is  a  disease  which  causes  the  gi-eatest  ravages  on  the  coast  of 
Peru.  In  Lima  it  may  be  estimated  that  the  mortality  due  to  tuberculosis  is  25  per  cent 
of  the  general  mortality.  The  number  of  deaths  due  to  tuberculosis  of  the  lungs  in  Lima 
in  the  years  1903  and  1904  were  288  and  228,  respectively.  It  is  to  be  hoped  that  by 
means  of  the  works  of  sanitation  already  executed  or  in  course  of  execution  this  figure  mil 
be  considerably  reduced,  as  may  already  be  noted  by  comparing  the  figures  for  the  last  two 
years.  In  the  mountain  district  tuberculosis  is  an  exceedingly  rare  disease,  which  is 
explained  by  the  altitude  at  which  the  towns  are  situated,  and  especiall}^  on  account  of  the 
outdoor  life  and  the  small  population. 

Uta  is  a  disease  peculiar  to  certain  hot  regions  of  the  mountainous  section  of  Peru.  It 
has  been  confused  by  many  obsei^vers  with  lupus  or  tuberculosis  of  the  skin,  but  there  are 
certain  small  differences  between  them,  which  perhaps  give  sufficient  reason  to  separate 
them.  Its  form  is  that  of  ulcerations,  with  a  tendency  to  phagedena,  which,  if  not  treated 
in  time,  mutilates  the  organs  attacked,  producing  irreparable  lesions  and  deformities  of  a 
repulsive  aspect,  as  they  most  commonly  affect  the  face  or  uncovered  portions  of  the  body. 
The  investigations  made  by  the  observers  of  the  country  have  not  all  been  concluded  as 
yet,  but  the  majority  of  them  consider,  as  has  been  said,  that  "uta"  is  a  cutaneous  tuber- 
culosis, or  lupus. 

Cholera  has  never  invaded  the  national  territory,  notwithstanding  the  fact  that  it  has 
prevailed  in  Chile  and  other  countries  of  South  America. 

Beriberi  is  unknown  in  Peru,  at  least  on  the  coast  and  in  the  mountainous  section.  It  is 
probable  that  it  exists  in  the  forest  section,  as  it  exists  in  the  adjoining  provinces  of  the 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  181 

Republic  of  Brazil.  With  the  Japanese  immigration,  which  has  been  occurring  on  a  small 
scale  recently  in  Peru,  this  disease,  which  was  formerly  known  by  name  only,  became 
practically  known  in  our  Lima  hospitals,  and  the  cases  observed  in  Japanese  immigrants 
have  shown  that  the  disease  is  either  not  contagious  or  that  the  coast  of  Peru  does  not  pre- 
sent a  propitious  medium  for  its  propagation,  because,  notwithstanding  no  precautions  of 
any  kind  having  been  taken,  it  has  never  on  any  occasion  spread  to  the  nurses  or  other 
patients.  ' 

Leprosy  is  also  a  disease  entirely  unknown  in  the  country,  notwithstanding  its  prevalence 
in  Colombia  and  Ecuador.  In  the  department  of  Piura,  which  adjoins  Ecuaclor,  and  in 
that  of  Loreto,  adjoining  Brazil,  occasionally  lícuadorian  or  Brazilian  lepers  are  seen,  who 
come  there  seeking  a  good  climate  for  their  disease.  In  Lima  some  Cninese  lepers  have 
also  beeu  seen.  As  the  disease  does  not  exist  among  the  Pemvians  and  as  it  is  easy  for  it 
to  develop  by  the  immigration  of  foreign  lepers,  in  view  of  the  contagious  character  of 
leprosy,  recognized  by  most  writers  on  the  subject,  the  Government  of  the  Republic  recently 
issued  a  resolution  prohibiting  the  entry  into  the  national  teriitory  of  lepers  and  ordering 
the  isolation  of  those  in  the  department  of  Loreto,  which,  as  has  been  said,  are  imported 
cases,  in  a  leper  hospital,  which  has  been  ordered  built. 

Years  ago  there  occurred  in  various  sections  of  Peru  epidemics  of  dysentery.  At  the 
present  time  this  disease  is  neither  endemic  nor  epidemic  in  any  section  of  Peruvian  terri- 
tory. On  some  occasions  cases  of  sporadic  dysentery  may  be  observed  in  our  hospitals, 
but  in  most  cases  the  so-called  dysenteries  are  nothing  but  ulcerous  colitis  or  membraneous 
ulcers,  which  easily  respond  to  the  proper  dietary  and  medicinal  regimen  without  ever 
assuming  a  contagious  character. 

Anchylostoma  doudenalis  exists  in  Peru  in  the  so-called  trans-Andine  or  forest  section 
and  is  almost  always  acquired  by  the  drinking  of  bad  unfiltered  water  or  by  eating  uncooked 
vegetables,  which,  having  been  irrigated  vñth  such  water,  may,  like  it,  become  the  vehicle 
of  introduction  of  the  eggs  of  this  parasite  into  the  digestive  canal.  Its  persistence  and 
reproduction  in  the  human  intestine  produce  pathological  effects  known  among  us  under 
the  name  of  "mountain  anemia"  and  by  that  of  anchylostomiasis  or  anchylostomacia  in 
other  countl-ies.  It  consists,  essentially,  in  a  profound  anemia,  with  aortic  sjnnptoms, 
oedema,  fatigue,  palpitations,  serous  discharges,  diarrhea,  and  consuptive  phenomena, 
which  lead  to  a  fatal  termination  if  a  rational  treatment  be  not  begun  in  time.  In  our 
hospitals  thymol  has  been  found  to  give  very  good  results  as  a  parasiticide  in  the  special 
case  of  anchylostomiasis.  Its  prophylaxis  consists  specially  in  drinking  only  filtered 
water  (Pasteur-Chamberland  filters)  or  boiled  water  and  in  eating  cooked  vegetables  in 
places  where  the  parasite  is  frequently  found. 

Rabies  does  not  exist  in  Peru.  "Carbón  humano,"  which  was  relative  frequent  in  past 
times,  has  diminished  considerably.     Tetanus  is  present,  but  rare. 


(b)  summary  of  the  sanitary  and  quarantine  laws  enacted  after  the  first 

convention. 

(c)  all  special  sanitary  works  in  course  of  construction  or  "whose  construction 

is  proposed. 

Even  though  the  scientific  programme,  published  by  the  internal  sanitary-  bureau  for  the 
reports  of  the  delegates  at  this  second  conference,  prescribes  that  there  be  indicated  only  the 
sanitary  and  quarantine  laws  enacted  after  the  first  one,  which  took  place  in  December,  1902, 
Peru  not  having  had  a  representative  thereat  and  being  desirous  of  giving  as  fuU  an  idea  as 
possible  of  the  sanitary  organization  of  my  country,  some  of  whose  institutions  and  laws  are 
of  a  date  prior  thereto,  I  will  deviate  somewhat  in  this  point  fxom  the  said  programme,  beg- 
ging the  conference  to  pardon  me  for  this  as  also  for  treating  in  the  report  together  the  sub- 
jects (b)  and  (c),  which  I  am  forced  to  do  because  in  Peru  sanitary  work  both  with  regard  to 
legislation  and  the  actual  work  of  sanitation  is  at  present  in  course  of  execution,  making 
it  difficult  to  separate  the  laws,  regulations,  or  resolutions  of  sanitation  from  the  works 
and  installations  of  the  same  character  which  supi)lement  them. 

1.  Sanitary  organization. — The  sanitary  service  may  be  considered  as  divided  into  two 
classes — general  and  local. 

The  former,  consisting  in  the  issue  of  marine  and  land  sanitary  regulations,  measures  to 
enforce  the  observance  of  the  same  and  of  the  existing  laws,  the  study  and  execution  of  the 
reforms  and  works  necessary  to  improve  the  sanitary  conditions  of  the  country,  the  prophy- 
laxis of  exotic  diseases  and  the  struggle  against  the  endemic  and  epidemic  diseases  existing 
in  the  country,  the  organization  of  the  demographic  medical  statistics  and  the  classifica- 
tion of  diseases  for  the  purposes  of  the  registration  of  mortality  in  the  national  territory, 
etc.,  are  under  the  charge  of  the  bureau  of  health,  which  is  one  of  the  three  branches  of  the 
ministiT  of  fomento. 


182  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

The  latter,  tl)at  is  to  saj-  the  local  service,  is  under  the  charge  of  the  municipalities. 

The  bureau  of  health,  created  by  the  law  of  November  G,  in03,  which  conmienced  to 
operate  in  February,  1904,  consists  ol  two  divisions — that  of  hygiene  and  that  of  demog- 
raphy. The  chief  of  the  bureau  is  Dr.  Julian  Arco,  a  man  well  known  in  the  country  by 
reason  of  his  works  on  sanitary  subjects.  Tiic  director  of  liealth  is  under  the  direct  juris- 
diction of  the  niiuistcr  of  fomento  and,  through  his  intermediar}',  of  the  President  of  the 
Republic. 

The  division  of  h^-giene  and  that  of  demogi-aphy  each  have  a  technical  chief  and  the  neces- 
sary employees  for  the  service;  the  undersigned  is  the  chief  of  the  division  of  hygiene; 
Dr.  Rómulo  Eizaguirre  is  the  chief  of  the  division  of  demograpliy.  In  addition,  a  special 
division  is  in  course  of  formation  for  the  direction  and  execution  of  all  the  potable  water- 
works in  the  country,  which  division  is  in  charge  of  Dr.  xibel  S.  Olaechea,  a  physician  belong- 
ing to  the  bureau  of  health. 

As  a  consulting  board  of  the  bureau,  we  have  the  supreme  board  of  health,  the  president 
of  which  is  the  naiuister  of  fomento,  and  whose  members  are  the  professors  of  the  faculty  of 
medicine,  members  of  the  National  Academy  of  Medicine,  the  director  of  the  Public  Charity 
Association,  the  director  of  the  navy,  the  chief  of  the  consular  division,  a  State  engineer,  the 
president  of  the  chamber  of  commerce  and  the  maj^^or  of  Lima. 

As  may  be  seen,  the  bureau  of  health,  advised  when  necessary  by  the  supremo  board  of 
health,  forms  the  central  office,  under  whose  jurisdiction  come  all  the  general  hygienic  and 
demographic  services  of  the  country'.  Its  recent  establishment  and  the  special  conditions 
present  in  the  country  by  reason  of  the  existence  of  bubonic  plague,  have  not  as  yet  per- 
mitted of  their  developing  their  activity  to  the  full  extent  of  the  sphere  of  action  assigned 
them  by  the  law,  but  it  is  the  intention  of  the  Government  of  the  Republic  and  the  personnel 
of  the  bureau  to  broaden  the  radius  of  its  powers,  by  creating  special  divisions  for  the  different 
branches  under  its  jurisdiction,  in  order  to  specialize  its  personnel  in  each  of  such  branches 
and  thus  secure  the  greatest  efBciency.  The  first  step  with  this  end  in  view  has  already  been 
taken  by  the  creation  of  the  office  of  physician  to  the  division  of  hygiene,  charged  with  the 
study  of  questions  pertaining  to  potable  water  exclusively.  With  the  same  end  in  view,  the 
bureau  of  health,  by  virtue  of  a  special  law  and  regulations,  sends  annually  to  Europe  or  to 
the  United  States,  at  the  option  of  the  persons  interested,  two  young  physicians,  and  sup- 
ports them  for  two  years  in  the  study  of  a  special  subject,  and  maintains  in  Europe  a  sanitary 
agent  to  keep  it  informed  of  any  matters  which  may  be  of  interest.  With  the  same  pur- 
pose in  view,  it  requested  and  procured  through  the  kindness  of  the  American  Government 
permission  to  send  to  Panama  and  form  a  part  of  the  sanitary  commission  of  the  canal  a 
Peruvian  physician  and  an  engineer,  to  learn  from  their  American  colleagues  the  methods 
and  procedure  employed  in  the  work  of  civilization  and  humanity  which  the  Government  of 
that  great  country  is  executing  on  the  Isthmus. 

The  bureau  of  health  has  charge  of  and  devotes  special  attention  t9  the  study  of  all  ques- 
tions pertaining  to  potable  waterworks  and  the  drainage  of  the  towns  of  Peru.  This  branch 
of  public  hygiene,  one  of  the  most  important,  calls  for  a  specially  qualified  personnel,  which 
it  does  not  as  yet  have,  but  which  it  intends  to  acquire  shortly,  engaging  in  Europe  or  in  the 
United  States  sanitary  engineers  whose  services  are  to  be  used  until  the  national  engineers 
are  qualified.  Notwithstanding  this  lack  of  personnel,  plans  for  and  works  of  this  character 
are  being  made,  with  the  assistance  of  foreign  engineers  and  even  with  some  few  natives 
who  have  studied  this  branch  in  other  countries.  Thus  at  the  present  time  plans  are  in 
course  of  preparation  for  the  potable  water  service,  and  drainage  of  Iquitos,  Moquegua, 
Cuzco,  Puno,  etc. 

The  division  of  hygiene  has  charge  both  of  the  marine  and  land  sanitary  service.  For  the 
former  it  has: 

A.  The  sanitary  stations  of  Callao,  Paita,  and  lio. 

B.  The  sanitary  services  of  the  other  ports. 
C  The  sanitary  and  municipal  physicians. 
D.  The  sanitary  pohce. 

For  the  land  service  of  sanitation,  it  has: 

A.  The  departmental  and  provincial  boards  of  health. 

B.  The  municipal  and  sanitary  physicians. 
C  The  lazarettos. 

D.  The  service  of  vaccination  and  serotherapy. 

E.  The  sanitary  police. 

Shortly  it  will  also  have,  as  has  been  said,  a  force  of  sanitary  engineers. 

MARINE   SERVICE. 

A.  The  sanitary  stations  of  Paita,  Callao,  and  lio,  that  is  to  say,  of  one  of  the  southernmost 
ports  of  the  Peruvian  coast,  of  one  of  the  northernmost  and  of  the  principal  and  central  port, 
were  created  by  a  law  of  November  20,  but  did  not  begin  to  be  installed  until  the  buieau  of 
health  had  been  established,  when  the  funds  necessary  therefor  were  appropriated  in  the 


SECOND    INTERNATIONAL    SANITARY    (.'ON  V  EN'I'ION.  183 

budget  of  the  Republic.  These  statioas,  the  fjurpose  of  which  is  to  serve  as  a  filter  agaiast 
the  irnpoftation  into  the  country  of  exotic  pestilential  diseases  by  water,  are  not  as  yet  fully 
etiuippcd,  in  the  sense  that  they  do  not  as  yet  comprise  all  the  services  or  divisions  of  whicn 
they  should  consist. 

(a)  The  sanitary  station  of  Callao. — It  comi)rises: 

1.  Service  of  sanitary  inspedion  of  vessels  on  arrival.— Bakuv.  beiii^  entered,  ves.sels  arriv- 
ing at  Callao,  as  in  any  jjort  of  the  Peruvian  coast,  aie  subjected  to  a  sanitary  inspection, 
which,  in  Callao,  is  made  by  the  pr<jvincial  physician.  The  latter,  after  examination  of  the 
bills  of  health  and  other  sanitary  documents,  and  observing  tlu;  passengers  and  members  of 
the  crow,  as  to  tlie  state  of  their  lusalth,  visits  each  of  Úw,  compartments  of  the  vessel  to 
examine  its  state  of  hygiene  and  to  determine  what,  if  any,  precautionary  measures  should 
be  adopted  and  their  character. 

If  the  vessel  comes  from  a  clean  poi't  and  has  no  sick  on  board  or  no  suspicious  cargo,  the 
only  measure  adopted  is  that  of  vaccinating  the  passengeis  or  members  of  the  crew  who  have 
not  recently  been  vaccinated.  When  the  vessel  carries  immigrants,  they  ai-e  also  examined 
for  leprosy,  for  the  reason  that  the  cntzy  of  lepers  into  the  territory  of  the  Republic  was 
forbidden  by  a  supreme  resolution  of  March  17  of  the  present  year. 

2.  Service  of  disinfection  of  vessels  and  their  cargo. — If  the  vessel  comes  from  a  port  which 
is  infected  or  suspected  of  being  infected  with  yellow  fever,  bubonic  plague,  cholera,  or  small- 
pox, or  has  on  board  persons  sick  or  suspected  as  being  sick  of  one  of  these  diseases,  or  has  a 
cargo  from  a  place  in  which  one  of  these  diseases  exists  in  an  epidemic  form,  which  is  estab- 
lished by  the  sanitary  inspection  and  the  examination  of  the  ship's  papers,  such  vessel  is 
subjected  to  precautionary  measures  which  varj''  according  to  the  cases,  but  which,  in  so  far 
as  the  vessel  herself  and  her  cargo  are  concerned,  consist  in  the  disinfection  of  the  compart- 
ments of  the  vessel  which  do  not  inspire  confidence. 

For  this  work  the  sanitary  stations  of  Calloa  has  two  "Clayton"  apparatus,  type  B,  which 
each  produce  23  cubic  meters  of  gas  per  minute,  mounted  on  special  vessels,  one  of  them 
steam,  and  managed  by  the  necessary  technical  force.  These  are  used  for  the  disinfection 
of  the  holds  of  the  vessel  and  of  the  merchandise  therein,  as  well  as  the  storerooms  of  the 
vessel,  when  it  is  desired  to  destroy  the  rats  on  board,  the  quarters  of  the  crew,  and  in 
general  all  compartments  of  the  vessel  which  can  be  closed  to  avoid  the  escape  of  the  gas. 

The  disinfection  by  Clayton  gas  (a  mixture  of  air,  sulphurous  anhydrid,  and  small  amounts 
of  sulphuric  anhydrid)  is  effected  by  filling  the  compartments  to  be  disinfected  with  gas,  at 
the  same  time  that  the  air  therein  is  extracted,  and  then  closing  them,  leaving  the  merchan- 
dise in  contact  with  the  gas  for  five  or  six  hours.  The  total  duration  of  this  operation  varies 
naturally  with  the  size  of  the  vessel,  but  in  the  largest  which  come  to  Callao,  it  never  exceeds 
«ight  or  nine  hours,  being  reduced  to  six  or  seven  for  those  of  average  tonnage.  This  disin- 
fection takes  place  simultaneously  with  the  other  sanitary  measures  on  the  vessel,  so  that 
the  duration  thereof  is  the  maximum  delay  which  the  sanitary  precautions  cause  a  vessel  in 
Callao  before  she  is  permitted  to  unload. 

For  the  disinfection  of  the  other  departments  of  the  vessels,  such  as  the  cabins,  staterooms, 
saloons,  etc.,  when  necessary,  formaldehyde  apparatus  under  pressure  are  used;  the  sani- 
tary station  of  CaUao  has  foiu-  of  these  apparatus  of  the  largest  size,  manufactm-ed  by  the 
fijm  of  Kny-Scheerer  Company,  of  New  York.  The  disinfection  of  the  baggage,  clothing, 
of  the  crew,  etc.,  is  effected  in  the  steam  box  of  the  vessel,  or  on  shore  if  the  suspicious  bag- 
gage has  been  landed,  formaldehyde  or  sulphurous  anhydrid  being  used  for  goods  which 
could  not  stand  disinfection  by  steam  under  pressure.  ' 

In  cases  of  vessels  manifestly  infected,  the  ñoors,  walls,  ceilings,  furniture,  etc.,  are  also 
washed  with  disinfecting  solutions  (chloride  of  lime,  bichloride  of  mercury,  lysol,  creolin, 
carbolic  acid,  etc.)  applied  by  means  of  pumps  under  pressure. 

All  these  operations  are  under  the  direction  of  a  sanitary  physician  and  executed  by  the 
technical  force  which  the  service  requires.  The  force  in  charge  of  this  service  when  I  left 
Callao  was  the  following: 

Physician  in  chief,  Dr.  Fabio  M.  Reynoso. 

One  assistant. 

A  machinist  to  run  the  steam  launch  and  one  of  the  Clayton  apparatus  moimted  thereon. 

One  assistant  for  the  same. 

One  helmsman  for  the  vessel. 

One  fireman. 

One  watchman. 

Two  sailors. 

Two  laborers. 

One  machinist  to  run  the  other  apparatus. 

One  assistant. 

One  watchman. 

The  cost  of  the  disinfections  is  charged  to  the  companies  owning'the  vessels,  but  this  price 
is  a  low  one,  as  the  value  of  the  material  used  oidy  is  charged.  The  disinfection  of  the  large 


184  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

passenger  and  freight  steamers  which  touch  regularly  at  Peruvian  ports — the  Pacific  Steam 
Navigation  Company,  Compañía  Sud- Americana  de  Vapores,  Kosmos  Line,  Lamport  &  Holt, 
Merchant  Line,  etc.,  entails  an  expense  of  35  to  100  silver  soles,  or  $17  to  $50  each.  Vessels 
of  small  tonnage  get  the  service  free. 

The  disinfection  of  the  vessels  and  of  their  cargo  is  made,  according  to  the  cases,  either  on 
their  arrival,  to  prevent  the  importation  of  exotic  diseases,  or  on  their  departure,  when  it  is 
a  question  of  a  Peruvian  port  being  infected,  to  prevent  other  Peruvian  or  foreign  ports  at 
which  the  vessel  touches  from  becoming  infected  in  theh  turn.  At  the  time  of  mydeparture 
from  Callao  vessels  were  being  disinfected  on  their  departure  from  the  port,  which  adjoins 
Lima,  where  there  were  some  cases  of  bubonic  plague,  and  in  that  of  Paita,  where  there  were 
also  some,  if  dangerous  cargo  had  been  received. 

3.  Scrmce  of  disÍ77f€ciion  of  baggage. — This  service,  at  the  sanitary  station  of  Callao,  is 
effected  on  land,  in  provisional  apparatus,  consisting  of  a  steamer  of  German  manufacture 
and  appliances  for  lilie  generation  of  gaseous  formaldehyde.  Together  Mnth  the  material 
for  the  building  of  the  sanitary  station  at  Callao,  six  more  boilers  have  been  ordered  from 
Europe,  of  large  size,  two  of  which  will  be  assigned  to  this  port,  in  order  to  expedite  the 
disinfection  which  now  takes  place  with  one  boiler  only. 

The  baggage  is  disinfected  with  steam  or  formaldehj^de,  according  to  its  character,  when 
this  is  necessarj^;  but  all  baggage  is  examined  by  the  sanitary  officer  in  charge  of  this  service 
before  being  permitted  to  be  placed  on  board  in  CaUao  in  order  to  prevent  its  carrying  pes- 
tiferous germs  to  other  parts  of  the  country  or  abroad. 

The  force  engaged  in  this  service  at  the  sanitary  station  of  Callao  is  composed  of : 

One  physician  in  chief,  Dr.  Justo  L.  Castro  Gutierrez. 

One  assistant,  a  medical  student. 

One  machinist  for  the  boiler. 

One  employee  for  the  formaldehyde  apparatus. 

One  watchman. 

Two  laborers. 

This  force  will  be  increased  on  the  arrival  and  installation  of  the  new  boilei"s.  The  service 
is  free.  Its  efficiency,  both  as  to  the  disinfection  by  steam,  as  by  formaldehyde,  has  been 
experimentally  proved  on  several  occasions. 

4.  Service  of  treatment  of  contagious  diseases.- — Among  the  buildings  ordered  of  the'fh-m  of 
Humphreys,  of  London,  England,  for  the  sanitarj^  station  of  Callao,  are  included  two  pavil- 
ions of  twelve  beds  each  for  the  treatment  of  two  different  diseases  simultaneously,  and  one 
pavilion  with  two  beds  for  patients  under  observation.  These  buildings  of  iron  and  wood 
will  come  ready  to  be  put  up  and  equipped  immediately.  They  should  reach  Callao  in  the 
month  of  December  or  January  next,  and  the  equipment  will  have  all  the  appliances  neces- 
sary for  this  service. 

At  the  present  time  there  is  in  provisional  use  for  this  purpose  a  floating  lazaretto ;  that 
is  to  say,  a  national  vessel  has  been  set  aside  for  the  pvupose,  equipped  with  the  most  mdis- 
pensable  elements  for  the  purpose.  Smallpox  patients  arriving  in  Callao  on  vessels  coming 
from  the  Chilean  coast  during  the  late  epidemic  in  that  country  have  been  receiving  attend- 
ance on  the  same.  There  are  also  on  land  in  the  zone  which  will  be  occupied  by  the  pavilions 
of  the  sanitary  station  wooden  barracks,  which  were  built  in  the  year  1903,  when  the  bubonic 
plague  appeared  in  Callao,  which  are  now  closed  but  which  are  ready  to  be  opened  again  if 
any  vessels  carrying  persons  suffering  from  this  complaint  should  arrive  in  Callao. 

The  floating  lazaretto  has,  in  addition  to  the  marine  force  necessary  for  the  maintenance 
and  care  of  the  vessel,  one  physician,  one  pharmaceutic  nurse,  and  one  assistant.  The  bar- 
racks or  lazaretto  on  land,  being  closed  as  they  are,  have  at  the  present  time  no  force  in 
attendance,  but  if  they  should  ever  be  opened  they  would  come  under  the  technical  direction 
of  the  city  physician  of  Callao,  as  prescribed  by  the  sanitary  regulations.  The  attendance 
of  patients  suffering  from  contagious  diseases  is  free. 

5.  Service  of  isolation  of  and  surveillance  against  contacts. — The  sanitary  station  of  Callao 
wiU  include  among  its  buildings  a  pavilion  for  the  quarantine  of  healthy  passengers,  com- 
posed of  40  separate  rooms,  for  one  or  two  persons  (passengers  of  the  first  class),  one  dining 
room,  one  sitting  room,  kitchen,  servants'  rooms,  water-closets,  baths,  etc.,  independent  of 
aU  the  other  services  of  the  sanitary  station,  and  with  a  similar  equipment,  but  not  as 
comfortable,  for  third-class  passengers.  At  the  present  time  there  are  no  conveniences  for 
this  service,  and  the  Government  is  endeavoring,  with  this  end  in  view,  to  purchase  a 
pontoon  which,  after  the  installation  of  the  service  in  its  own  building,  will  be  used  for  the 
sanitary  observation  of  immigrants. 

There  being  at  the  present  time  no  building  for  the  observation  of  passengers  in  Callao, 
recourse  is  had,  according  to  the  cases,  either  to  observation  on  board  the  vessel  which 
carries  them,  until  the  dangerous  period  has  passed  (which  is  done  at  the  present  time  with 
passengers  coming  ft-om  Panama  and  Guayaquil  who  arrive  in  CaUao  after  five  or  six  days 
from  the  date  of  their  departure  from  said  ports,  who  are  forbidden  to  land  for  one  or  two 
days,  in  order  to  make  up  seven  days,  which  is  considered  as  the  average  period  of  incubation 


SP]COND    INTERNATIONAL    HANITARY    CONVENTION.  185 

of  yellow  fever),  or  to  a  sanitary  passport,  which  permits  passenf^ors  to  land,  witli  the  oVjli- 
gation  of  leaving  their  address,  in  order  that  they  may  be  visitfid  daily  by  the  sanitary 
doctors  until  their  dangerous  period  shall  tiavf!  f)ii,.s.s(!d  (which  is  done  at  tlie  present  timo 
with  passengers  coining  from  ports  in  which  Ijubonic  plague  is  susfjected  to  exist). 

The  service  of  medical  surveillance  of  the  passengcirs,  wiien  quarantined  on  board,  is  unrler 
the  charge  of  the  city  physician  of  Callao;  on  land,  tiie  service  is  under  the  charge  of  the 
sanitary  physicians  of  the  cities. 

6.  Sermce  of  inspection  of  passengers  on  departure. — Although  Callao  can  not  be  con- 
sidered as  a  port  infected  with  bubonic  plague,  as  there  is  no  epidemic  there,  cases  appearing 
only  from  time  to  time,  whoso  source  can  not  be  exactly  determined,  many  of  whicri  prol>- 
ably  originated  in  Lima,  this  circumstance,  and  its  sliort  distance  from  the  capital  (14 
kilometer's),  with  wliich  it  maintains  a  continual  traffic  and  in  which,  although  few  in  num- 
ber, cases  have  not  been  absent  since  1903,  cause  it  to  be  considered  a  suspicious  port  and 
make  it  necessary  to  examine  passengers  on  their  departure,  as  a  means  of  avoiding  any  of 
them  taking  the  germs  of  this  disease  to  other  Peruvian  or  foreign  ports.  Persons  having 
febrile  or  suspicious  symptoms,  from  the  standpoint  of  the  plague  or  an}'  other  grave  epi- 
demic disease,  and  persons  not  vaccinated  or  not  recently  vaccinated,  are  not  permitted  to 
continue  their  trip.  This  precaution,  together  with  the  inspection  and  disinfection  of  bag- 
gage going  from  Callao,  which  are  done  as  strictly  as  possible,  constitute  a  guaranty  against 
the  infection  of  the  vessel  and  is  adopted,  not  only  in  Callao,  but  in  all  other  ports  which 
may  be  considered  in  any  way  suspicious. 

The  service  is  under  the  charge  of  a  sanitary  physician,  who  gives  the  vessel  on  her 
departure  from  Callao  a  list  or  roll  of  the  passengers  and  crew  examined  by  him  and  whose 
baggage  has  been  disinfected,  in  order  that  the  physician  of  the  port  of  destination  of  the 
vessel  may  know  what  passengers  may  be  freely  allowed  to  land  and  which  ones  should  be 
placed  under  surveillance  before  being  permitted  to  do  so. 

7.  Other  services  of  the  sanitary  station. — At  the  present  time,  the  services  appurtenant  to 
those  mentioned,  such  as  laboratory,  ambulance,  mortuary,  washing,  administration,  etc., 
are  effected,  provisionally,  in  loaned  buildings.  The  sanitary  station  ordered  from  Europe 
will  comprise  a  pavilion  for  the  medical  force  and  their  assistants,  an  office,  pharmacy, 
laundry,  disinfection,  ambulance,  laboratory,  and  mortuary. 

8.  The  sanitary  police. — This  is  a  body  organized  in  the  form  of  the  police  force  of  cities. 
At  the  sanitary  station  of  Callao  it  enforces  the  observance  on  land  or  on  board  of  the 
vessels  of  the  sanitary  measures  adopted.  For  the  service  of  this  station  twelve  inspectors 
are  usually  detailed  under  the  command  of  an  officer  and  under  the  jurisdiction  of  the 
sanitary  physicians. 

(b)  Sanitary  station  of  Paita. — ^With  the  differences  due  to  the  smaller  traffic  at  this  port, 
the  sanitary  station  is  organized  in  the  same  maimer  as  that  of  Callao  and  comprises  almost 
the  same  services  as  the  latter.     In  that  of  Paita  the  following  services  are  in  operation: 

That  of  sanitary  inspection  of  vessels  and  passengers,  vaccination,  etc. 

That  of  disinfection  of  vessels  and  cargo  by  means  of  a  "Clayton"  apparatus,  type  B, 
similar  to  those  of  Callao,  mounted  on  a  special  vessel. 

That  of  disinfection  of  baggage  by  "Clayton"  gas  and  by  formaldehyde,  in  special 
chambers  and  by  means  of  Kny-Scheerer  Company  pressure  apparatus. 

That  of  attendance  on  patients  having  contagious  diseases,  in  a  lazaretto  recently  built 
on  land  and  which,  when  I  passed  through  said  port,  was  in  use  for  the  plague  patients  in 
Paita. 

That  of  inspection  of  passengers  on  departure,  by  reason  of  there  being  bubonic  plague 
in  said  town. 

That  of  sanitary  police. 

Within  a  short  time  there  will  also  be  in  operation  the  quarantine  isolation  of  passen- 
gers, the  construction  of  the  building  for  which  was  to  have  begun  at  the  time  I  left  Lima, 
on  a  plan  similar  to  that  of  Callao;  that  is  to  say,  having  separate  rooms  for  passengers  of 
the  first  class  and  wards  for  those  of  the  second,  dining  rooms,  baths,  etc. 

That  of  disinfection  by  steam  ovens.  One  of  the  large  ovens  ordered  from  Europe,  which 
will  arrive  shortly,  is  destined  to  Paita. 

The  force  in  charge  of  the  sanitary  station  of  Paita  consists  of  a  sanitary  physician,  the 
chief  of  the  station,  a  titular  physician  in  charge  of  the  attendance  of  the  sick  in  the  laza- 
retto, a  mechanician,  a  ffi-eman  and  a  watcliman  for  the  service  of  the  "  Clavton"  apparatus, 
an  emploj^ee  in  charge  of  the  formaldehyde  apparatus,  niirses  and  attendants  in  the  laza- 
retto, the  number  of  which  varies  with  the  number  of  patients,  laborers  for  the  work  of 
disinfection,  and  four  sanitary  police  inspectors.. 

The  purpose  of  the  measures  adopted  with  vessels  arriving  m.  Paita  from  the  north  is, 
principally,  to  prevent  the  importation  of  yellow  fever  from  Panama  or  Guayaquil.  Paita 
being  the  largest  northernmost  port  of  the  Peruvian  coast,  and  the  principal  object  is  to 
destroy  the  mosquitoes.  The  measures  adopted  on  departure  from  Paita  have  for  their 
principal  purpose  the  avoidance  of  the  propagation  to  other  ports  of  the  bubonic  plague, 
which  exists  there  at  the  present  time,  and  consist  in  the  destruction  of  the  rodents. 


186  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

The  prices  charged  for  the  disinfection  of  large  vessels  ai'e  the  same  as  in  Callao;  that  i<3 
to  say,  charge  is  made  only  for  the  cost  thereof.  The  fii'st  disinfections  made  in  Paita  were 
effected  by  the  undersigned  in  person  in  the  month  of  June,  1904. 

(c)  The  sanitary  station  of  Ilo,  which  is  one  of  the  southernmost  ports  of  the  Peruvian 
coast,  is  destined,  principally,  to  prevent  the  importation  into  Peru  of  any  epidemic  diseases 
existing  in  the  countries  to  the  south.  It  is  to  have  the  same  services  as  those  of  Paita  and 
Callao,  but  on  a  smaller  scale  than  the  latter,  as  its  commerce  is  smaller.  At  the  present 
time,  with  a  force  consisting  of  a  sanitary  phj'sician,  the  chief  of  the  station,  an  assistant 
specially  in  charge  of  vaccination,  a  mechanician,  a  fireman,  a  watchman,  and  the  necessary 
laborers,  the  following  services  are  in  operation: 

The  medical  inspection  of  vessels,  vaccination,  etc. 

The  disinfection  of  vessels  and  of  their  cargo  by  means  of  a  "  Claj^ton  "  apparatus,  type  B. 

The  disinfection  of  baggage  by  "Claj'ton"  gas  or  formaldehyde  (Kny-Scheerer  appa- 
ratus) .  i 

Soon  there  will  be  added: 

Disinfection  by  a  steam  oven. 

Attendance  of  sick  in  a  lazaretto. 

Quarantine  isolation  of  passengers  healthy  but  suspicious.  The  building  for  this  service 
must  be  in  course  of  construction  at  the  present  time. 

The  port  of  Ilo  having  a  small  trade,  a  majorit}'^  of  the  vessels  arriving  there  touch  only 
for  the  puipose  of  being  disinfected  in  order  to  prevent  their  being  subjected  to  any  unnec- 
essaiy  delay,  at  the  port  of  Moliendo — which  is  the  next  port  noi'tli  of  Ilo — four  or  five 
hours  from  the  latter,  vessels  are  permitted,  upon  their  holds  being  fiUed  with  gas,  to  con- 
tinue northward  without  awaiting  the  five  hours  necessary  for  the  contact  of  the  gas  with 
the  merchandise,  but  leaving  with  their  holds  closed  and  sealed,  to  be  opened  at  Moliendo 
in  the  presence  of  the  sanitary  physician  of  that  port. 

The  price  for  the  disinfection  is  the  same  as  that  in  Callao  and  Paita. 

B.  Sanitary  services  in  other  ports. — In  addition  to  the  sanitary  stations  of  Paita,  Callao, 
and  Ho,  there  are  sanitary  maritime  services  in  other  poits  of  the  Peiiivian  coast.  Going 
from  north  to  south  we  have: 

Eten. — Here  there  is  a  sanitary  physician  in  charge  of  the  maritime  service,  and  the  disin- 
fection of  the  cargo  and  baggage  of  vessles  is  efi'ected  in  special  chambers  built  on  shore 
and  by  means  of  a  "Clayton"  apparatus,  type  H,  and  formaldehyde  apparatus  built  by 
Kny-Scheerer. 

A  few  kilometere  from  the  port,  connected  by  railroad,  is  situated  the  town  of  the  same 
name,  where  there  is  a  lazaretto  recently  built,  which  may  be  used  in  case  of  necessity  for 
the  treatment  of  contagious-disease  patients  found  on  a  vessel  anchored  in  the  port. 

Pacasmayo. — There  is  here  a  sanitary  physician  for  the  maritime  service,  a  lazaretto  for 
contagious  cases  in  charge  of  a  district  physician,  and  the  service  of  disinfection  of  baggage 
by  formaldehyde. 

Salaverry. — There  is  a  sanitary  physician  here  for  the  maritime  service,  a  lazaretto  for 
the  attendance  of  the  contagious  diseases,  service  for  the  disinfection  of  cargo  by  means  of 
a  "Clayton"  apparatus,  type  H,  and  of  baggage  by  means  of  formaldehyde  and  special 
chambers  for  this  purpose. 

Huacho. — There  is  here  a  sanitary  physician  in  charge  of  the  maritime  service  and  a 
chamber  and  formaldehyde  apparatus  for  the  disinfection  of  baggage. 

Moliendo. — There  is  a  sanitary  physician  for  the  port  here  and  a  lazaretto  for  the  treat- 
ment of  contagious  diseases  and  the  service  of  disinfection  of  baggage  by  formaldehyde. 
At  present  an  observation  building  for  passengers  in  quarantine  is  being  constructed,  and 
one  of  the   steam  ovens  ordered  from  Europe  will  be  installed  here. 

Iquitos. — Even  though  this  is  not  a  maritime  port,  it  must  be  stated  here  that  this  river 
port,  situated  on  the  Peruvian  Amazon,  has  also  a  sanitary  service  with  a  "Clayton"  appa- 
ratus, type  B,  for  the  disinfection  of  vessels  arriving  there  and  their  cargo  and  baggage. 

C.  The  sanitary  and  titular  physicians. — In  addition  to  those  already  mentioned,  there 
are  sanitaiy  or  titular  physicians  in  the  following  ports:  Casma,  Ancon,  Cerro  Azul,  Tambo 
de  Mora,  and  Pisco,  all  under  the  direction  of  the  bureau  of  health.  In  such  of  these  ports 
as  means  of  disinfection  are  lacking  the  sanitary  inspection  of  the  vessels  only  is  made. 

D.  The  sanitary  police. — By  virtue  of  the  supreme  resolution  of  June  10  of  the  present 
year  a  corps  of  sanitary  police  has  been  organized,  under  the  jurisdiction  of  the  bureau  of 
health,  which  renders  service  both  in  maritime  and  in  land  sanitation.  It  is  an  armed  force, 
the  purpose  of  which  is  to  assure  the  execution  of  the  sanitary  measures  which  may  be 
adopted. 

The  service  of  land  sanitation  is  much  more  difficult  to  organize  and  much  more  expensive 
than  the  maritime  sei-\ice.  It  is  relatively  easy  to  prevent  the  seed  reaching  the  land  by 
closing  the  doors  of  entry  or  placing  therein  more  or  less  narrow  filters,  but  it  is  very  diffi- 
cult to  prevent  that  seed  after  having  been  planted  from  germinating  or  to  make  matters 
so  hostile  thereto  that  even  if  planted  it  does  not  vegetate. 


SECOND    INTERNATIONAL    Í5ANITAKY    CONVENTION.  187 

Furthermore,  as  has  already  boon  said,  tlie  creation  of  tlie  bureau  of  health  in  Peru  is  of 
so  recent  a  date  that  it  has  not  as  yet  been  possible  for  it  to  undertake  works  on  a  large 
scale  in  this  sense,  such  as  are  requiiod  by  the  sanitation  of  the  towns  of  so  backward  a 
country,  of  a  country  so  lacking  in  elements  whicJi  may  be  used  for  the  purpose,  and  in 
which  nothing  or  almost  nothing  had  been  done  heretofore  for  hygiene.  Nevertheless,  a 
beginning  has  boon  made,  and  in  tlie  course  of  the  year  1904  and  the  past  months  of  190o 
a  prophylactic  work  has  been  undertaken  which  has  produced  greater  results  than  could 
have  Ixion  expected  in  the  period  of  organization  thiough  which  the  sanitation  of  Vera  is 
passing,  due  to  which  it  has  been  possible  to  confine  to  restrif;ted  limits  the  terrible 
«pidemic  of  bubonic  plague  which  the  bureau  of  health  found  diifused  throughout  the 
country,  causing  it  to  disappear  from  some  sections  and  reducing  it  in  others  to  insignificant 
proportions. 

For  the  service  of  land  sanitation  the  bureau  of  health  has: 

.A.  21ie  departmental  and  provincial  hoards  of  health,  which  the  antiquated  health  regula- 
tions, in  force  in  part,  provide  for,  which  will  probably  be  kept  in  the  modem  sanitary 
regidations  with  which  the  country  may  be  provided,  either  under  the  same  name  or  under 
a  diit'eront  name,  because  practice  has  shown  that  if  proper  use  be  made  thereof  they  can 
render  important  services. 

The  depai'tmental  boards  of  health  in  the  departments  and  the  provincial  boards  in  the 
provinces  have  the  same  powers  and  duties — to  watch  over  the  health  of  the  territorial 
districts  under  their  jurisdiction,  the  former  being  under  the  direct  jurisdiction  of  the 
bureau  of  health  and  the  latter  under  the  jurisdiction  of  the  departmental  boards  of  health. 
They  are  composed  of  the  political  and  municipal  authorities  of  the  respective  places,  the 
directors  of  tlie  charitable  associations,  the  district  physicians,  and  two  or  more  prominent 
persons  of  the  department  or  province,  and  it  is  their  duty  to  enforce  the  observance  of 
the  sanitary  measures  adopted  for  the  entire  Republic,  enact  those  of  a  local  character,  pro- 
pose changes  or  improvements  in  the  sanitaiy  services,  etc.  Duiúng  the  campaign  under- 
taken against  the  bubonic  plague  the  local  boards  of  health  have  played  an  important  role, 
assuming  the  direction  of  the  prophylactic  measures  in  each  territorial  division  and  the 
administration  of  the  funds  appropriated  for  the  purpose,  and,  with  rare  exceptions,  they 
have  corresponded  to  the  pui-poses  of  their  institution. 

B.  The  distñct  and  sanitary  physicians. — There  is  a  district  physician  in  each  province, 
who  is  intrusted  wdth  the  gratuitous  attendance  of  the  poor  classes  in  the  local  hospitals, 
the  antivariolic  vaccination,  the  prohylaxis  of  infectious  diseases,  the  sanitary  inspection 
of  railroads,  and  the  technical  direction  of  all  the  local  sanitary  measures  adopted  in  normal 
times.  When  epidemics  appear  sanitary  physicians  are  sent  to  the  provinces  in  which  they 
occur  charged  vsdth  the  duty  of  combating  them,  with  the  assistance  of  the  boards  of  health 
and  in  accordance  with  the  instructions  of  the  bureau  of  health. 

C.  The  lazarettos. — During  the  years  1904  and  1905  some  have  been  built  and  equipped 
with  all  the  elements  necessary  to  the  extent  of  the  resources  of  the  country.  Among 
others,  that  of  Lima,  used  at  the  present  time  for  the  treatment  of  plague  patients,  has  an 
administrative  pavilion,  a  kitchen,  a  laundry,  a  disinfecting  plant,  a  pa\'ilion  for  autop- 
sies and  a  laboratory,  a  pavilion  for  attendants,  one  for  the  transportation  of  patients,  and 
stable,  a  pharmacy,  one  with  separate  rooms  for  pay  patients  (12  beds)  and  eight  for  free 
patients,  the  capacity  of  which  varies  between  16  and  24  beds  each,  with  baths,  water-closets, 
etc.;  that  of  Trujillo,  which  is  not  as  yet  concluded  (the  pavilion  of  administration,  of  dis- 
infection, the  mortuary  pavilion,  and  a  part  of  that  for  the  pay  paitents  being  still  lack- 
ing) ;  that  of  Moliendo,  partly  built  in  1903 :  that  of  Paita,  that  of  Salaverry,  that  of  Eten, 
that  of  Arequipa  (just  begun),  and  some  others  of  less  importance. 

D.  The  service  of  antivariolic  vaccination  and  serotherapy. — This  has  been  estabhshed  for 
some  years,  animal  vaccine  prepared  in  the  country  only  being  used,  which  gives  very  good 
results.  The  Institute  of  Vaccine  and  Serotherapy  is  established  in  its  own  building,  which 
was  recently  built  and  comprises  stables  for  vaccinated  animals,  for  animals  under  observa- 
tion, and  for  experimental  animals,  a  section  for  the  vaccination  of  calves,  a  section  for  the 
gathering  of  the  lymph,  a  section  for  the  preparation  of  the  glycerin  emulsion,  a  bacteiio- 
logical  laboratory,  offices,  and  rooms  for  the  vaccination  of  the  public.  The  institute  is  in 
charge  of  a  competent  technical  personnel;  and  one  of  its  chiefs.  Dr.  Ramon  Ribeiro,  is  at  the 
present  time  in  Europe,  having  been  sent  there  by  the  Govermnent  to  study  the  best  vaccine 
institutions  of  said  Continent  and  the  changea  which  should  be  made  in  that  of  Lima. 

For  the  practice  of  vaccination,  which  is  obligatory  in  Peru  by  the  law  of  January  3,  1896, 
the  Vaccine  Institute  sends  continuously  and  periodically  to  the  provinces  the  amounts  of 
fresh  animal  vaccine  emulsion  which  may  be  necessaiy,  and  the  latter  is  inoculated  by  the 
district  or  sanitary  physicians,  by  vaccinating  phj'sicians  supported  by  some  municipalities, 
and  by  a  corps  of  40  vaccinators,  prepared  in  the  institute,  of  recent  creation,  and  which, 
up  to  the  time  of  my  departure  from  the  countrv,  were  going  through  the  southern  depart- 
ments, which  at  that  time  were  the  most  seriously  threatened  by  smallpox  by  reason  of  the 
presence  of  an  epidemic  of  this  disease  in  Chile.  _  . 


188  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Although  by  its  creation  the  Nationd  Vaccine  Institute  is  also  one  of  serotherapy,  serum 
is  not  yet  manufactured  in  Peiii.  Upon  the  return  from  Europe  of  the  chief  of  the  labora- 
tory' of  said  institute,  who,  as  has  been  said,  was  sent  to  study  the  manufacture  of  vaccine 
and  serum,  which  will  be  in  January  of  next  year,  laboratories  for  the  manufacture  of  spe- 
cific semms  \\ill  probably  be  established.  In  the  meantime  the  institute,  by  a  contract 
entered  into  with  similar  "institutes  of  Europe,  is  always  provided  with  the  serums  which  it 
can  not  manufacture  to  meet  tlie  needs  of  the  Republic.  Said  serams,  in  accordance  with 
the  supreme  resolution  of  January  20,  1905,  are  furnished  by  the  institute  free  of  charge  to 
poor  persons  provided  wth  a  physician's  prescription. 

E.  The  saivitaTij  police. — As  has  already  been  said,  this  corps  is  intrusted  with  the  enforce- 
ment of  sanitary  measures,  both  in  the  land  and  marine  services. 

The  division  of  demography  is  charged  by  the  law  which  created  the  bureau  of  health 
with  the  special  duty  of  preparing  the  sanitary  demography  of  the  country;  but  it  has  also 
occupied  itself  -niththe  general  demography,  using  for  this  purpose  the  data  furnished  it 
by  the  hundred  municipalities  of  the  provinces  of  the  Repubhc,  which,  by  a  law  of  1873, 
must  keep  registers  of  civil  status  and  the  statistics  of  their  respective  jurisdictions. 

Notwithstanding  this  law  of  1873,  only  a  portion  of  the  provinces  of  the  Republic  have 
begim  statistical  work,  and  in  most  of  the  provinces  the  offices  for  the  registration  of  the 
civil  status  have  been  very  defective  in  the  formation  thereof,  especially  mth  regard  to 
births  and  deaths,  which  defects,  thanks  to  the  forms  furnished  by  the  division  of  demog- 
raphy, are  being  corrected,  while  the  data  collected  are  being  made  uniform  and  centralized. 
The  work  of  the  division  of  demography  not  having  been  begun  until  the  beginning  of 
last  year,  and  almost  the  entire  year  having  passed  in  preparatory  work  or  in  organization, 
it  was  not  until  1905  that  the  data  requested  of  the  municipalities  of  the  provinces  began 
to  be  received,  so  that  at  the  end  of  this  year  it  will  be  possible  to  have  information  of  the 
demographic  movement  of  the  provinces  of  Peru,  although  they  will  probably  not  be  com- 
plete as  yet. 

At  the  present  time  the  division  of  demogi-aphy,  in  addition  to  the  statistics  concerning 
births,  marriages,  and  deaths,  of  infectious  diseases,  of  vaccinations,  etc.,  is  preparing  the 
demography  of  Lima  from  1884  to  the  present  time,  which  will  decide  many  demographic, 
sanitary,  and  social  points  which  have  been  the  subject  of  discussion  heretofore,  due  to  the 
absence  of  scientifically  established  figures. 

In  June  of  the  present  year  the  bureau  of  health  took  a  census  of  the  population  of  Callao, 
which  work  is  not  as  yet  concluded,  but  which  gave  34,436  inhabitants.  With  the  docu- 
ments of  this  census,  and  mth  those  of  that  taken  by  the  municipahty  of  Liina  in  1903,  the 
division  of  demography  will  be  able  to  form  the  sanitary  statistics  of  the  inhabitants  of 
Lima  and  Callao. 

The  local  health  services  in  Peru,  as  has  already  been  said,  are  under  the  charge  of  the 
municipaUties  of  the  provinces  and  those  of  the  districts.  They  direct  and  execute  the 
potable  waterworks,  works  of  drainage,  canaUzation,  paving,  sewer  cleaning,  constmction 
of  dwellings,  markets,  public  estabhshments,  .schools,  etc.,  even  though  they  are  all  under 
the  vigilance  of  and  must  be  approved  by  the  Government,  and,  from 'a  sanitary  point  of 
view,  by  the  bureau  of  health. 

Among  them,  as  is  natural,  is  the  municipality  of  Lima,  which  has  done  niore  than  any 
other  up  to  the  present  time  to  improve  the  saiutary  conditions  of  its  jurisdiction;  and  in 
the  course  of  the  years  1904  and  1905  it  has  established  a  municipal  institute  of  hj^giene, 
consisting  of  a  division  of  chemistry,  a  division  of  bacteriology,  of  a  hbrary,  and  a  small 
hygienic  museum,  in  which  important  chemical  and  bacteriological  work  is  being  con- 
ducted, referring  to  the  local  services.  This  institute,  although  of  modern  proportions,  is 
equipped  with  all  modern  apphances,  and  here  examination  is  made,  free  of  charge  for  the 
poor  and  at  moderate  charge  for  the  well-to-do,  of  sputum,  of  physiological  or  pathological 
products,  of  secretion  or  excretion,  of  anatomical  sections,  of  samples  of  water,  beverages, 
food  products,  medicines,  etc.,  in  addition  to  the  work  the  institute  does  on  its  own  account 
or  by  direction  of  the  municipality  of  Lima  or  of  the  bureau  of  health  pertaining  to  the 
local  health  service  or  that  of  other  locahties. 

The  municipality  of  Lima  has  also  established  during  the  present  year  a  public  disinfect- 
ing plant  equipped  with,  the  principal  apphances  an  institution  of  this  character  requires, 
and  which  meets  the  requirements  of  the  town  of  Lima.  It  has  also  built  a  central  market, 
the  lower  part  of  which  has  already  been  inaugurated  and  which,  from  a  hygienic  stand- 
point, leaves  nothing  to  be  desired. 

By  virtue  of  these  and  other  works  of  importance,  such  as  the  extension  of  the  sewer 
system  to  streets  which  did  not  have  it,  the  paving  of  the  city  with  compressed  asphalt 
or  stone  blocks,  etc.,  the  sanitary  conditions  of  Lima  have  notably  improved. 

The  municipalities  of  the  other  provinces  of  the  Republic  are  doing  similar  work  within 
the  limits  of  their  means  and  the  funds  appropriated  to  this  end  by  the  National  Govern- 
ment. That  of  Callao  is  at  present  constructing  ditches  for  drainage,  which  it  lacked,  and 
is  concluding  the  potable  waterworks. 


SECOND    INTERNATIONAL    SANITARY    iJON VKNTKjN.  18'J 

2.  Sanitary  legislation.— 'No  fundamental  «anilary  law  lias  as  yet  bc(;n  adojjtcd  in  Peru. 
Its  formation  is  at  the  present  time  in  the  hands  of  a  commission  appointed  for  the  purpose, 
and  the  plan  thereof,  the  basis  of  which  was  pnipared  by  tfie  bureau  ol  healtb,  will  f)roijably 
be  submitted  for  the  approval  of  the  national  Congress  at  the  next  legislatuie.  'Jlie  only 
sanitary  law  in  force  in  the  llepublic  at  the  present  time  is  that  of  January  3,  189fj,  making 
vaccination  obligatory. 

The  sanitary  regulations  issued  in  1887,  which  was  the  first  efl'ort  made  in  the  country 
in  the  matter  of  sanitary  legislation,  were  in  force  until  the  bureau  of  health  was  created; 
and,  although  it  has  not  been  expressly  repealed  by  any  resolution,  it  is  no  longer  taken 
as  a  standard,  at  least  partially,  since  this  institution  began  to  operate,  beeau.s(!  the  prin- 
ciples of  public  hygiene  on  which  it  was  bastid  are  in  hai'mony  with  the  dominating  ideas  at 
the  time  it  was  issued,  a  majority  of  which  are  at  the  present  time  inadmissible.  These 
regulatiohs  provide,  among  other  things,  for  the  quarantine  of  infected  oi'  suspicious  ves- 
sels, a  quarantine  which  the  bureau  of  health  has  abolished  since  it  has  the  means  of 
disinl'ecting  the  vessel  and  her  caigo  as  soon  as  she  arrives  at  the  Peruvian  coast. 

This  absence  of  regulations  and  legislation  of  a  sanitary  character  is  supplied  for  the 
present,  until  the  proposed  laws  and  regulations  are  enacted,  by  general  resolutions  issued 
by  the  National  Government  or  by  transitory  provisions  issued  for  special  cases  by  the 
bureau  of  health,  within  the  scope  of  the  law  creating  it.  Among  the  resolutions  issued  in 
recent  years  relating  to  sanitary  matters,  the  following  may  be  mentioned: 

The  supreme  resolution  of  October  2,  «1903,  which  appropriates  funds  for  the  study  of 
serotherapy  and  vaccine  against  Peruvian  "verruga." 

The  law  of  November  6,  1903,  creating  the  bureau  of  public  health  and  defining  its 
duties. 

The  supreme  resolution  of  November  20,  1903,  directing  that  there  be  sent  to  Eiu-ope, 
at  the  cost  of  the  State,  the  chief  of  the  laboratory  of  the  Institute  of  Vaccine  and  Sero- 
therapy, Dr.  Ramon  F.  Ribeiro,  to  study  there  the  manufacture  of  serums  and  vaccines. 

The  law  of  November  20,  1903,  creating  the  three  sanitary  stations  of  Paita,  Callao, 
and  lio. 

The  supreme  resolution  of  March  8,  1904,  imposing  upon  the  steamship  companies 
engaged  in  trade  with  Peruvian  ports  the  obligation  of  having  disinfecting  apparatus  on 
board. 

The  supreme  resolution  of  April  4,  1904,  providing  for  the  disinfection  of  the  baggage  of 
passengers  embarking  at  Callao  and  their  medical  inspection,  in  order  to  prevent  that  the 
germs  of  bubonic  plague  be  taken  from  this  port  or  from  Lima  to  other  ports  of  the  Repubhc 
or  of  other  countries.  (Even  though  this  resolution  was  issued  at  a  time  when  the  constant 
existence  of  the  plague  in  Callao  made  it  indispensable  and  the  sanitary  conditions  of  this 
port  have  changed  since,  it  continues  m  force.) 

The  supreme  resolution  of  April  4,  1904,  ordering  that  similar  preca.utions  be  taken  as 
to  passengers  leaving  Lima  for  the  interior  of  the  country  by  railroad,  also  as  a  n->eans  of 
preventing  the  spread  of  the  plague.     (It  continues  in  force.) 

The  supreme  resolution  of  April  15,  1904,  appointing  a  board  for  the  management  of  the 
campaign  against  the  bubonic  plague  in  the  province  of  Lima.  The  director  of  health  is 
the  president  of  this  board,  which  has  directed  the  work  of  sanitation  in  Lima  during  recent 
times. 

The  supreme  resolution  of  May  27,  1904,  which  directs  the  formation  of  the  general 
census  of  the  Republic  and  prescribes  that  the  bureau  of  health  shall  formulate  the  plan 
and  estimate  of  the  expenses  of  the  work. 

The  supreme  resolution  of  July  1,  1904,  directing  the  ministry  of  foreign  affairs  to 
request  the  Government  of  the  United  States  to  permit  the  incorporation  of  a  Peruvian 
physician  in  the  sanitary  corps  which  may  be  sent  to  Panama  to  undertake  the  sanitation 
of  the  Isthmus,  supplemented  by  that  of  the  8th  of  the  same  month  and  year,  to  the  effect 
that  the  petition  for  incorporation  be  for  one  physician  and  one  engineer. 

The  supreme  resolution  of  July  2,  1904,  providing  that  the  municipal  councils  forward 
demogi'aphic  statistics  to  the  bureau  of  health  at  regular  intervals. 

The  supreme  resolution  of  July  2, 1904,  comixiissioning  the  chief  of  the  division  of  hygiene, 
Dr.  D.  E.  Lavereria,  to  study  the  report  on  the  installation  of  the  sanitary  station  of  Paita. 

The  supreme  resolution  of  the  same  date,  creating  a  sanitary  agent  of  Peru  in  Eui'ope, 
charged  with  the  duty  of  forwarding  such  reports  and  acquiring  such  elements  as  may  be 
required  by  the  bureau  of  health. 

The  supreme  resolution  of  the  same  date,  creating  a  commission  intrusted  with  the  study 
and  recommendation  of  a  plan  for  the  construction  of  dwellings  for  renting  purposes. 

The  supreme  decree  of  September  16,  1904,  issuing  the  railroad  sanitary  regulations. 

The  supreme  resolution  of  December  9,  1904,  ordering  the  disinfection  of  vessels  coming 
from  the  south  at  the  sanitary  station  of  Ilo. 


190  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

The  supreme  resolution  of  December  22, 1904,  providing  that  Peru  be  ofllcially  represented 
at  the  Medical  Pan-,\merican  Congress  of  Panama,  and  appointing  as  the  delegate  of  Peru, 
Dr.  Ugo  Biffi. 

The  supreme  resolution  of  December  23,  1904,  providing  regulations  goverping  the  send- 
ing every  year  to  Europe  of  young  physicians  who  specialty  distinguished  themselves  in  their 
school  career  to  perfect  their  knowledge. 

The  supreme  resolution  of  December  30,  1904,  providing  that  Peru  take  part  in  the  con- 
stitution of  the  International  Sanitary  Bureau  of  Washington  and  contribute  the  proper 
sum  to  its  support. 

The  supreme  resolution  of  January  20,  1905,  directing  that  the  Institute  of  Vaccine  and 
Serotlierapy  furnish  poor  persons  requesting  it  by  a  medical  prescription,  specific  serums 
(antidiptheritic,  antitetanic,  antistrepthecoccic,  etc.).  . 

That  of  the  same  date,  providing  for  the  establishment  of  a  service  of  disinfection  of  ves- 
sels in  the  port  of  Iquitos. 

That  of  March  1,  1905,  creating  the  office  of  physician  under  the  bureau  of  health  for  the 
study  of  questions  pertaining  to  potable  water. 

That  of  March  10,  1905,  ordering  the  taking  of  the  census  of  the  province  of  Callao. 

That  of  ^iarch  17,  1905,  creating  a  corps  of  vaccinators  to  go  through  the  provinces  and 
districts  of  the  Republic,  to  assist  the  district  and  sanitary  physicians  and  the  municipal 
vaccinators  in  the  work  of  vaccination. 

That  of  the  same  date,  prohibiting  the  entr\'*into  the  national  territory  of  lepers  and 
ordering  the  creation  of  a  leper  hospital  in  the  department  of  Loreto  for  the  isolation  of 
the  lepers  in  that  department  adjoining  other  countries  in  which  leprosy  is  present. 

That  of  March  24,  1905,  approving  the  plans  for  the  drainage  of  Callao  and  ordering  the 
preparation  of  plans  for  the  drying  of  the  subsoil  of  said  port. 

That  of  March  31,  1905,  appointing  a  commission  to  prepare  the  draft  of  a  sanitary  law 
for  submission  for  the  approval  of  Congress. 

That  of  April  7, 1905,  directing  that  the  consuls  of  the  Republic  abroad  inform  the  bureau 
of  health,  by  cable  or  by  mail,  according  to  the  cases,  of  the  appearance  in  their  consular 
jurisdiction  of  grave  contagious  diseases,  transmissible  by  commercial  traíBc. 

That  of  May  19,  1S05,  ordering  the  construction  of  potable  waterworks  in  El  Cuzco. 

That  of  the  same  date  approving  the  plan  of  tlie  firm  of  Humphreys,  of  London,  for  the 
buildings  of  the  sanitary  station  of  Callao,  and  ordering  their  purchase. 

That  of  June  10,  1905,  organizing  the  sanitary  police. 

That  of  July  21,  1905,  ordering  the  study  of  water  supplj^,  and  drainage  of  the  port  of 
Iquitos. 

That  of  August  7,  1905,  establishing  the  precautions  to  which  passengers  coming  from 
Panama  or  Guayaquil  are  to  be  subjected,  during  the  existence  of  yellow  fever  in  said  ports 
in  an  epidemic  form. 

That  of  August  11,  1905,  directing  the  study  and  execution  on  the  coast  of  Peru  of  the 
works  necessary  for  the  destruction  of  the  Stegomyia  species  of  mosquitoes,  beginning  with 
Callao  and  Lima. 

That  of  September  1, 1905,  prescribing  the  conditions  under  which  fraits  capable  of  carry- 
ing mosquitoes  is  to  be  brought  from  Panama  or  Guayaquil  to  Peru,  while  the  sanitary  con- 
ditions in  those  ports  last;  and  many  others  which  it  would  take  too  long  to  enumerate. 

The  report  which  I  am  called  upon  to  make  to  the  conference  in  accordance  with  the 
progranmie  published  by  the  Sanitary  Bureau  of  the  American  Repubhcs,  being  concluded, 
on  behalf  of  the  country,  it  only  remains  for  me  to  say  that  Peru,  making  all  possible  efforts 
on  her  part  to  improve  the  hygienic  conditions  of  her  ports,  having  established  sanitary 
services  and  stations  along  her  extensive  coast  line,  and  adopting  measures  which  will 
guarantee,  as  far  as  possible,  not  only  her  own  ports  but  those  of  neighboring  countries,  and 
publishing  systematically  the  appearance  of  cases  of  contagious  diseases,  in  order  that  such 
defensive  measures  as  may  be  deemed  proper  may  be  adopted,  observes  in  the  matter  of 
international  hygiene,  a  policy  of  frankness  and  good  faith,  and  considering  the  delays  and 
loss  caused  to  her  own  commerce  and  that  of  neighboring  countries  by  the  sanitary  measures 
in  force  at  the  present  time  in  Panama,  in  Ecuador,  in  Peru  and  in  Chile,  I  would  be  glad  to 
see  this  conference,  among  other  beneficial  measures,  take  steps  for  the  formation  of  an 
international  agreement  between  the  countries  which  have  frequent  traffic  with  Peru,  in 
order  that  the  sanitary  measures  adopted  in  each  of  them  may  be  uniform  and  have  some 
value  in  the  other  countries,  and  in  order  that  the  common  action  of  all  will  result  in 
what  the  isolated  work  of  each  of  them  renders  difficult  of  realization,  that  is  to  say,  the 
extirpation  from  the  western  coast  of  South  America  of  the  diseases  transmissible  by  water 
communication. 


SECOND    ÍNTEKNATIONAJ.    SANITARY:    CONVKNTK^X.  ilii 

REPORT  FROM  THE  DELEGATE  FROM  THE  DOMINICAN  REPUBLIC, 
MR.  EMILIO  C.  JOUBERT. 

The  Dominican  Republic  contributes  to  this  convention  only  its  good  wishes  in  favor  of 
the  cause  of  public  health,  which  is  a  noblo  one  worthy  of  the  attention  of  governments 
and  individuals  with  liigh  aspirations.  It  docs  not  contiiljiite  any  scientific  «liscoverics,  nor 
experiences,  nor  data  toward  the  progress  of  suiiitary  science  or  its  applieation  to  the 
necessities  of  nations.  This  is  not  due  to  no  importance  being  there  given  to  these  matters, 
as,  from  their  nature,  they  are  of  the  greatest  transcendency,  as  they  aifect  tlic  public 
health,  not  only  of  one  region,  but  of  humanity  in  general,  but  is  due  to  the  fact  that  the 
country  is  endowed  with  exceptionally  favorable  conditions  for  the  prcscnation  of  a 
satisfactory  sanitary  condition  and  has  therefore  not  found  any  urgent  need  of  devoting 
special  study  to  these  matters. 

Considering  the  sanitary  question  of  the  Dominican  Republic  from  the  point  of  view  of 
its  legislation,  it  may  be  observed  that  there  exist  in  the  country  only  municipal  legulations, 
laws  of  a  purely  local  character,  which  tend  to  protect  public  health  by  placing  restrictions 
and  imposing  penalties  within  the  jurisdiction  of  the  judicial  authorities.  The  absence  of 
other  laws  of  a  broader  character  and  of  greater  importance  is  an  evidence  of  the  fact  that 
the  country  has  not  found  any  greater  protection  than  that  afforded  thereby  to  be  necessary. 
As  a  matter  of  fact,  although  in  former  times,  not  very  far  back,  there  existed  foci  of  yellow 
fever  near  the  coast  of  Santo  Domingo,  this  country  has  always  been  free  from  this  epidemic. 
There  has  been  a  case  now  and  then  at  an  interval  of  ten  or  twelve  years,  but  never  to  such 
an  extent  as  to  permit  this  disease  to  be  considered  more  to  be  feared  than  any  other  non- 
epidemic  disease.  I  do  not  refer  to  the  time  when  the  Spanish  army  imported  the  fever 
and  propagated  it  among  its  members  on  account  of  an  absence  of  sanitary  precautions. 

We  have  also  had  smallpox  in  an  endemic  form  near  our  coasts,  but  our  police  laws  and 
the  measures  adopted  by  the  boards  of  health  of  the  Republic  were  sufficient  to  keep  our 
towns  free  from  its  ravages.  The  prophylactic  service  of  vaccination,  which  was  organized 
from  time  to  time,  has  greatly  contributed,  as  there  was  no  opposition  thereto  among  the 
people,  to  prevent  the  invasion  and  propagation  of  this  disease.  It  is  now  more  than  a 
quarter  of  a  century  since  a  case  of  smallpox  has  occurred  in  the  country. 

Forty  years  have  elapsed  since  the  last  invasion  of  cholera,  which  disease,  if  it  was  propa- 
gated and  caused  a  large  number  of  deaths,  was  due  also  to  the  causes  which  made  yellow 
fever  cases  of  frecjuent  occurrence  at  the  same  time. 

As  may  be  seen,  the  sanitary  condition  of  the  country  has  not  called  for  more  than  what 
has  been  done  to  keep  the  country  free  from  the  ravaging  action  of  epidemics.  The  tem- 
porary quarantine  measures  have  also  contributed  efficiently  to  the  result  I  take  pleasure  in 
calling  attention  to ;  but  however  satisfactory  the  past  may  have  been,  it  is  also  necessary 
to  look  into  the  future,  in  order  that  our  retrospective  glances  may  not  predispose  us  to  a 
criminal  indolence. 

Upon  the  termination  of  the  Panama  Canal,  Santo  Domingo  will  be  on  the  route  of  the 
vessels  of  all  nations  coming  from  or  going  to  all  ports  of  the  world.  Then  many  vessels 
will  touch  at  her  coasts;  commercial  traffic  will  increase,  and  therewith  the  danger  of  con- 
tagion and  the  spread  of  all  infectious  diseases.  Foresight  advises  preparation  to  meet 
the  exigences  these  new  conditions  will  present. 

An  easy  means  at  hand  to  prevent  the  importation  of  epidemics  was  that  of  closing  the 
the  ports  to  vessels  coming  from  infected  places;  but  a  covmtry  situated  in  the  midst  of  an 
active  and  powerful  commercial  current,  can  not  have  recourse  to  such  primitive  measures 
which  are  to  a  certain  extent  nugatory  and  therefore  unjustifiable,  without  provoking  the 
anger  of  nations.  Since  the  Vienna  congress  up  to  this  convention  in  Washington  which 
will  work  on  the  same  basis,  every  sanitary  conference  has  adopted  in  principle  the  ideas 
which  prevailed  in  England  prior  to  the  date  of  said  congress;  because  these  ideas,  properly 
applied,  protect  the  interests  of  universal  commerce  while  at  the  same  time  protecting  the 
lives  and  interests  of  natives. 

Our  Government  is  convinced  of  the  advisability  of  preparing  itself  by  the  enactment  of 
sanitary  laws  and  measures  adequately  to  meet  the  necessities  which  the  new  order  of  things 
will  create  in  the  relations  of  the  Republic,  and  has  already  appointed  a  commission  of 
experts  to  study  the  sanitary  laws  of  the  most  advanced  coimtries  in  this  matter  and  to 
prepare  a  body  of  laws,  as  well  as  projects  for  the  organization  of  the  service  of  inspection 
and  quarantine. 

The  work  of  this  body  will  greatly  facilitate  the  labors  of  said  commission,  because  the 
questions  of  sanitary  science  concerning  the  preventive  measures  which  it  would  be  advisa- 
ble to  adopt,  with  an  international  character,  to  prevent  the  importation  and  propagation 
of  contagious  diseases,  will  here  be  intelligently  discussed. 


iy2  SECOND    INTERNATIONAL    SANITARY    CONVIJNTION. 

REMARKS  MADE  AT  THE  CLOSING  OF  THE  CONVENTION  BY 
MR.  EMILIO  C.  JOUBERT,  DELEGATE  FROM  THE  DOMINICAN 
REPUBLIC. 

Gentlemen:  I  have  very  little  to  say  at  this  moment  when  this  convention  is  about  to 
adjom-n,  not  having  had  much  to  do  during  its  most  important  labors,  they  being,  by 
their  character,  very  dilTereut  from  those  within  my  scope  by  virtue  of  the  studies  I  have 
made  and  my  habitual  occupation  heretofore. 

But  I  can  express,  as  I  do  with  pleasure,  the  great  satisfaction  I  have  felt  in  coming  into 
contact  with  gentlemen  who  are  so  notable  and  eminent  by  reason  of  their  vast  knowledge, 
gentlemen  who  have  placed  their  talent  and  their  heart  at  the  service  of  their  country 
and  of  humanity. 

I  can  also  state  here  that  I  expect  to  feel  satisfaction  of  a  like  character  when  the  labors 
of  this  convention  will  be  received  in  the  Dominican  Republic  with  the  favor  they  deserve 
anil  when  the  sanitary  provisions  contained  in  the  convention  we  have  just  concluded  are 
put  in  practice. 

Santo  Domingo,  when  the  Panamn  Canal  is  concluded,  will  be  on  the  route  of  all  nations; 
their  vessels  will  touch  at  her  ports,  and  it  is  necessary  that  these  ports  be  prepared  to 
receive  them  and  not  closed  on  account  of  misimderstood  sanitary  precautions. 

With  these  sentiments  and  with  this  hope,  I  am  glad  to  have  had  the  honor  to  attend 
this  convention  on  behalf  of  the  Dominican  Republic. 

I  have  concluded. 


REPORT  BY  DR.  H.  D.  GEDDINGS,  ASSISTANT  SURGEON-GENERAL, 
UNITED  STATES  PUBLIC  HEALTH  AND  MARINE;- HOSPITAL 
SERVICE,  DELEGATE  FOR  THE  UNITED  STATES. 

Mr.  Chairman  and  Gentlemen  :  The  provisional  scientific  programme  includes  a  report 
upon  plague,  yellow  fever,  and  malaria.  It  is  with  gratification  that  we  are  able  to  report 
for  the  United  States  that  the  last  case  of  plague  occurred  in  the  city  of  San  Francisco  neai'ly 
eighteen  mouths  ago.  The  number  of  cases  has  been  published  from  time  to  time  in  the 
public  health  reports  by  the  Public  Health  and  Marine-Iiospital  Service,  and  the  measures 
which  were  taken  in  the  eradication  of  the  disease,  with  the  careful  inspection  of  that  part 
of  the  city  of  San  Francisco  infected  with  the  disease,  and  an  account  of  the  observations 
of  all  the  dead  and  dying  of  any  race  whatever,  the  supervision  of  corpses  at  the  various 
undertaking  establishments  of  the  city,  and  as  a  special  sanitary  measure,  the  destruction 
of  rats  and  mice,  and  the  careful  observation  of  rats  and  mice  both  trapped  and  found  dead 
in  various  sections  of  the  city.  It  is  a  matter  of  congratulation  that  the  disease  was  con- 
fined not  OTÚJ  to  one  quarter  of  the  city  of  San  Francisco,  but  there  has  been  no  spread  to 
other  sections  of  the  city,  and  absolutely  none  to  other  sections  beyond  the  boundaries  of 
California,  which  shows  the  effectiveness  of  the  measures  taken,  and  the  possibility  of  sup- 
pressing a  disease  of  this  nature  without  panic  and  without  serious  detriment  to  the  com- 
mercial interests  of  the  city  in  which  it  prevails;  and,  above  all,  the  signal  triumph  of  mod- 
eiTi  sanitary  science  in  its  conflict  with  one  of  the  most  dreaded  diseases  of  which  we  have 
knowledge. 

It  is  unnecessary  to  state  to  you  gentlemen  about  yellow  fever  that  yellow  fever  now 
prevails  in  the  city  of  New  Orleans,  in  various  portions  of  the  State  of  Louisiana,  and  in 
certain  sections  of  the  adjoining  State  of  Mississippi.  To  date  there  have  been  in  the  city 
of  New  Orleans  3,214  cases  of  the  disease,  with  409  deaths.  In  the  various  parishes  of  the 
State  of  Louisiana  outside  of  New  Orleans  there  have  been  2,778  cases,  with  232  deaths, 
and  in  Mississippi,  from  the  various  reports  received  up  to  September  27,  there  have  been 
332  cases  and  13  deaths.  How  the  disease  was  introduced  into  New  Orleans — for  intro- 
duced it  was — is  a  matter  that  is  yet  under  investigation,  and  the  method  of  its  introduction 
and  the  time  of  the  first  appearance  of  the  disease  is  as  yet  subjudice,  and  it  would  be 
indelicate  and  improper  on  this  occasion  for  me  to  express  a  positive  opinion ;  but  it  is  to  be 
distinctly  understood  that  in  all  of  the  other  places  in  the  United  States  where  yellow  fever 
now  prevails  it  is  believed  that  its  prevalence  can  be  traced  to  certain  railroad  excursions 
which  carried  people  from  various  adjoining  States — Mssissippi,  Alabama,  and  Florida — 
into  New  Orleans  after  the  disease  prevailed  there  but  before  it  had  been  recognized  or 
aimounced.  The  measures  taken  for  the  eradication  of  the  disease  in  New  Orleans  are  those 
so  signally  exemplified  in  the  city  of  Habana,  Cuba,  by  the  American  commission,  whose 
good  work  has  been  so  ably  continued  by  gentlemen  now  on  the  floor  of  this  convention. 
The  measures  taken  for  the  eradication  of  the  disease  have  been  directed  simply  and  solely 
against  the  mosquito  Stegomyia  fasciata  as  the  sole  recognized  means  of  transmission  of 
the  disease.  A  campaign  has  been  directed  against  that  mosquito.  The  measures  taken 
have  been  the  fumigation,  either  by  sulphur  or  by  other  agents,  and  the  isolation  of  persons 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  193 

either  sick  witli  tho  disease  or  suspected  in  tlioiouglily  screened  hospitals  or  in  a  thoroughly 
screened  room  in  the  house  where  they  W(!re  taken  sick.  Measures  havr;  also  hrsen  taken 
in  regard  to  cisterns  and  in  regard  to  stagnant  water  from  time  to  time,  atid  water  that  it 
was  impossible  to  drain  in  certain  places  luxs  been  gotten  out  of  tin;  way  l>y  iiiling  up;  and 
the  measure  has  been  used  of  introducing  salt  into  the  running  water  in  tin;  gutters  of  New 
Orleans,  this  measure  being  based  upon  the  fact  that  the  ova  of  the  stegomyia  mosquito 
will  not  mature  in  water  that  contains  so  much  as  one-sixth  part  of  sea  water. 

To  say  that  the  experiments  have  be(;n  altogether  crowned  with  success  would  be  to 
anticipate  results  which  we  believe  to  be  inevitable  in  the  next  two  wcseks.  They  have  been 
crowned  with  a  certain  measure  of  success,  gratifying  because  original.  The  disípase  has  not 
spread  with  the  rapidity  and  to  the  extent  that  has  been  observed  in  epidemics  heretofore 

Erevailing,  and  it  is  believed  by  the  Chief  of  tlie  Service  which  I  have  tlie  honor  to  represent 
ere,  andall  the  officers  whom  he  has  d'elegated  to  the  charge  of  the  epidemic  measures  in 
New  Orleans,  that  the  results  to  be  obtained  within  a  reasonably  short  time  will  be  an 
abundant  vindication  of  the  correctness  of  the  mosquito  doctrine. 

In  regard  to  malaria,  as  you  know,  this  is  a  wide  and  a  large  country.  Malaria  is  some- 
thing that  is  with  us  perennially,  and  prevaihng  under  many  types,  and  under  many  mani- 
festations. It  is  impossible  to  say  what  measures  have  been  taken  for  the  eradication  of 
malaria,  but  it  is  perfectly  fair  to  say  that  the  matter  is  one  with  which  the  boards  of  health 
of  various  States  of  the  Union  have  occupied  themselves,  and  the  correctness  of  the  mos- 
quito doctrine  of  the  transmission  of  malaria  has  impressed  itself  upon  and  has  been  vin- 
dicated in  the  minds  of  State  health  authorities.  The  matter  has  excited  the  keenest 
interest  in  every  State  of  the  Union  almost.  A  campaign  is  at  present  being  waged  against 
the  anopheles  mosquito  as  a  transmitter  of  malaria,  and  large  State  organizations,  and  in 
one  case  a  national  organization,  have  busied  themselves  with  a  campaign  for  the  total  eradi- 
cation of  all  mosquitoes,  so  far  as  possible.  This  body,  the  American  Mosquito  Extermina- 
tion Society,  held  its  second  meeting  at  New  Orleans  about  a  year  ago,  and  gratifying  reports 
were  received  from  various  communities  and  States  interested,  showing  the  spirit  of  emula- 
tion which  existed  between  various  communities  in  the  same  States  and  between  cities 
themselves  for  the  suppression  of  this  pest,  and  in  the  eradication  of  this  fruitful  source 
of  the  spread  of  a  disease,  which,  when  everything  is  said,  causes  more  morbidity,  if  not 
more  mortality,  than  yellow  fever,  whose  advent  we,  as  sanitarians,  so  much  dread. 

I  regret,  Mr.  President,  that  at  the  present  time  I  have  been  unable  to  put  my  remarks  in 
writing,  but  with  your  permission  the  full  report  will  be  submitted  either  before  the  adjourn- 
ment of  the  convention  or  in  time  for  publication  in  the  transactions. 


BEPOBT    OF   DR.  J.    S.  FULTON,  DELEGATE    FOR    THE   UNITED 

STATES. 

Mr.  Chairman  and  Gentlemen:  In  accordance  with  the  suggestion  made  me  within 
a  few  days,  I  appear  before  this  convention  to  give  you  as  briefly  and  clearly  as  I  can  some 
account  of  the  modes  of  organization  which  prevail  in  the  United  States  in  the  govern- 
mental units  under  our  system,  namely,  the  methods  of  organization  of  the  States  for  the 
purpose  of  sanitary  government.  There  are  something  like  half  a  dozen  different  plans  to 
be  found  in  our  Union,  not  all  good  and  none  of  them  wholly  bad.  To  begin  with  the 
most  primitive  idea  of  a  State  sanitary  government,  one  would  begin  at  the  most  extreme 
southern  State  of  the  Union.  There  we  get  the  idea  of  the  sanitary  government  of  a  State 
by  one  man.  The  State  of  Texas  has  no  board  of  health.  It  has  no  State  sanitary  organ- 
ization on  any  other  than  a  quarantine  basis.  This  to  my  mind  characterizes  the  sanitaiy 
government  of  the  State  of  Texas  as  the  most  primitive  type  to  be  found  in  our  country. 
The  quarantine  officer  of  Texas  unites  in  his  own  person  aU  the  sanitary  authority  which 
the  State  of  Texas  takes  to  herself  at  all,  and  up  to  the  present  time  that  power  has  been 
exercised  against  but  one  disease,  and  that  not  a  disease  always  present  in  Texas.  The 
quarantine  officer  of  Texas  is  charged  with  the  duty  of  excluding  yellow  fever.  He  has 
similar  powers  with  respect  to  the  bubonic  plague;  but  he  has  no  internal  powers,  or  at 
least  he  exercises  none,  with  regard  to  the  diseases  which  every  locality  must  furnish.  In 
that  way  the  sanitary  organization  of  Texas  belongs  strictly  to  the  class  of  emergency 
agencies,  and  has  practically  no  routine  duties  aside  from  those  of  the  maritime  quarantine, 
and  on  an  emergency.     This  is  the  most  primitive  form  of  sanitary  organization. 

The  next  in  that  order  would  probably  be  the  idea  of  a  government  for  the  exclusion 
only  of  exotic  diseases,  but  the  government  not  being  kept  in  the  hands  of  one  man.  The 
State  of  Louisiana  has  a  board  of  health  which  is  essentially  a  quarantine  board;  that  is, 
it  has  no  duties  except  with  regard  to  diseases  that  are  not  present  in  the  country.  It  has 
no  duty  in  connection  with  the  diseases  which  are  always  present  among  the  inhabitants 

5610—06 13 


194  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

of  Louisiana.  It  is  strictly  a  quarantine  board,  maintains  a  large  and  expensive  equip- 
ment, and  has  this  rather  primitive  idea,  not  ot  growing  skillful  on  any  routine  hygienic 
work,  but  simply  to  keep  out  diseases  not  normally  found  among  the  population.  Several 
of  the  States  along  the  Gulf  coast  belong  to  this  class.  Formerly  Georgia  and  Mississippi 
and  .yabama  had  their  boards  of  health  organized  somewhat  on  the  same  plan.  The 
State  of  Florida,  one  is  happy  to  say,  has  emerged  from  tltat  condition,  and  b}'  disposing 
finally  of  her  quarantine  power  has  become  a  real  board  of  healtii;  that  is,  a  board  of  health 
with  modern  ideas  which  looks  aftci'  the  needs  of  the  people  under  ordinaiy  circumstances 
and  at  all  times.  Georgia  also  has  a  board  of  health  designed  on  modern  principles,  and 
in  fact  is  soon  to  become  a  large  factor  in  the  progress  of  sanitation  in  the  United  States. 
These  two  illustrations  show  the  two  simplest  types  of  sanitary  organization  to  be  found 
in  this  countiy. 

Next  above"^  them  one  comes  to  the  idea  of  a  board  of  health  truly  representative  of  the 
people  of  the  State,  and  engaged  at  all  times  on  the  problems  which  they  provide.  For 
illustration  of  that  type  of  board  of  health  one  must  mention  the  boards  of  health  of 
Massachusetts  and  of  the  States  of  Michigan  and  of  Iowa.  These  boards  consist  of  either 
five  or  seven  members.  The  members  are  appointed  by  the  governor  of  the  State  for  a 
definite  term.  They  include  a  number  of  plij'sicians,  but  are  not  composed  exclusively 
of  ph3-sicians.  The}-  themselves  do  no  executive  work.  They  elect  or  appoint  a  secretar}^ 
who  is  their  executive  officer,  and  by  virtue  of  his  election  he  becomes  merely  their  execu- 
tive, and  nothing  more.  This  puts  the  executive  officer  of  the  board  of  health  of  that  type, 
of  these  States  which  are  exemplified  by  Massachusetts,  Michigan,  and  Iowa,  in  the  class 
of  wage-earners  rather  than  in  the  class  of  salaried  officers,  which  is  an  advantage.  They 
are  not  bound  to  appoint  a  bitizen  of  the  State,  and  they. disregard  political  boundaries 
and  are  not  tied  down  by  constitutional  limitations  in  the  matter  of  salary.  The  executive 
officer  of  boards  of  this  type  can  be  an  expert  sanitarian.  He  will  have  a  fair  chance  for  real 
work  in  the  line  of  sanitation,  and  some  of  the  best  work  that  has  been  done  in  this  country 
has  been  done  by  boards  of  that  type.     There  are,  however,  very  few  boards  of  this  sort. 

Next  after  this  comes  the  class  of  boards  of  health  in  which  are  the  great  majority  of  the 
boards  of  health  of  this  country.  These  are  the  boards  which  include  a  majority  of  physi- 
cians, and  which  are  appointed  by  the  governors  of  the  States  for  a  definite  period  of  service, 
and  which  elect  a  secretary  or  executive  officer,  who  becomes  a  member  of  the  board.  In 
other  words,  in  the  largest  class  of  boards  of  health  in  the  United  States,  the  secretar}^  is 
not  an  employee  of  the  board  but  is  a  member  of  the  board.  His  functions  are  usually 
pretty  well  circumscribed  bj^  law.  As  this  is  numerically  the  largest  class  among  different 
types  of  boards  of  health,  it  of  course  includes  a  good  many  excellent  examples  of  very 
good  working  bodies  and  perhaps  for  the  same  reason,  that  it  is  the  largest  class  numerically, 
it  also  illustrates  better  than  the  others  the  abuses  that  are  possible  under  that  system. 
As  I  say,  in  this  class  of  boards  it  is  not  possible  to  go  outside  of  the  political  units  of  the 
States  to  find  an  expert  sanitarian  or  a  trained  sanitarian.  The  executive  officer  becomes 
a  member  of  the  board  of  health,  and  he  must  have  been  elected  ft-om  among  the  citizens 
of  the  State.  One  of  the  abuses  possible  under  this  class  I  will  mention.  The  worst  one 
is  that  the  members  of  the  board,  from  the  time  of  their  appointment,  can  agree  to  divide 
the  emoluments  during  their  service  in  such  a  way  that  everj^body  will  share  alike.  In  this 
country  none  of  the  boards  of  health  receive  salaries;  the  executive  members  of  the  board 
do  not  receive  salaries,  I  think,  anywhere,  in  either  of  these  two  classes.  So  that  it  happens 
that  at  least  one  board  of  health  that  I  know  of  manages  to  divide  the  emoluments  of  the 
offices  for  a  period  of  six  years  by  agreeing  that  each  of  them  shall  fill  the  position  of  the 
executive  for  a  year  and  receive  all  the  emoluments  for  one  year,  at  the  end  of  which 
year  he  passes  on  his  executive  position  to  the  next  member.  In  that  way  the  board  of 
health  that  formerly  did  good  work  every  j  ear  now  changes  its  secretary  every  year  and 
changes  its  executive  officer  every  3'ear  and  of  course  does  no  good  work.  That  is  one  of 
the  worst  features  that  can  come  in  under  this  scheme  of  ours  which  includes  the  largest 
number  of  boards  of  health. 

Next  after  this  in  point  of  time  we  come  back,  curiously  enough,  to  the  very  first  scheme  of 
all,  which  has  the  most  reason  in  its  favor,  and  that  is  the  scheme  of  one-man  sanitary  gov- 
ernment in  a  State.  Since  Texas  started  and  is  now  about  to  outgrow  that  idea,  two  States 
in  our  Union  have  revived  that  notion — New  York  and  Pennsylvania.  There  is  no  board  of 
health  in  the  State  of  New  York,  but  it  has  a  very  large  and  quite  strong  sanitary  organiza- 
tion. Its  head  is  a  commissioner  of  health,  appointed  by  the  governor  of  the  State,  and  his 
term  of  ofiice  is  equal  to  that  of  the  governor  who  appoints  him.  This  has  made  the  execu- 
tive position  in  the  board  of  health  of  New  York  rather  desirable.  It  is  a  political  plum, 
and  experience  shows  so  far  that  the  heads  of  the  board  of  health  will  change  about  as  often 
as  the  chief  executive  is  changed  in  the  State  of  New  York.  That  is  a  one-man  board,  and 
all  the  responsibilities  for  its  government  of  the  State  are  centered  in  him,  with  power  to 
remove  his  subordinates,  most  of  them. 


SECOND    INTERNATIONAL    HANITARY    CONVENTION.  195 

The  State  of  Pennsylvania  has  within  a  year  concluded  to  (irnf)ark  on  the  same  plan,  hav- 
ing had  the  experience  of  some  tweiity-iiv(!  or  tliirty  years  in  tin;  i)lan  of  an  apfjoinli  ve  board 
of  health,  havinji  power  to  elect  its  own  s(!cretary.  It  is  perliaps  too  eaily  to  nay  that  this 
last  plan  is  ccsrtain  to  be  a  bad  i)ian.  It  is  eonocival)le  that  a,  one-man  .sanitary  arl^iter  of  the 
State's  destinies  might  be  a  strong  enough  man  to  put  tliat  State  on  a  very  higli  plane  iridfMjd; 
but  it  does  not  quite  consoit  witii  our  r(![)ublican  ideas  in  the  Unittul  States,  and  personally  Í 
am  inclined  to  doubt  whether  that  was  a  wise  move.  1  think  it  is  rather  a  curious  circum- 
stance that  the  two  latest  States  to  make  changes  in  their  laws  should  have  come  back  to  the 
one-man  idea  which  Texas  up  to  that  time,  alone  illustrated,  and  I  am  quite  sure  that  Texas 
is  nearly  or  quite  persuaded  now  to  abandon  that  idea. 

I  have  given  you  this  as  a  brief  story  of  the  modes  of  organization  in  the  United  States 
simply  for  your  information.  1  would  conccdve  it  to  be  rather  impropc'r  for  me  to  express  my 
personal  views  about  the  probabilities  of  ultimately  developing  in  this  country  a  ftrst-class 
sanitary  organization  on  any  of  these  plans,  although  I  have  such  views,  which,  as  1  say,  1 
retain  at  this  time. 


ABSTRACT  OF  THE  REPORT  PRESENTED  BY  SENOR  REQUENA 
BERMUDEZ,  CHARGE  D'AFFAIRES  OF  URUGUAY,  IN  WASHING- 
TON. 

(Although  the  Republic  of  Uruguay  did  not  sign  the  Convention  agreed  upon  by  the 
conference,  it  was  represented  in  the  sessions  thereof  by  Señor  P.  E,equena  Bci'mudez,  P'irst 
Secretary  and  Charge  d'Aifaires  of  Uruguay  in  Washington,  who,  in  the  name  of  his  country, 
submitted  to  the  conference  an  extensive  report,  of  which  the  following  is  an  extract.) 

The  sanitary  measures  adopted  in  Uruguay  have  amended  certain  laws  relating  to  land 
and  maritime  sanitation,  some  of  them  being  of  such  importance  that  we  do  not  doubt  will 
present  our  country  as  inspired  in  the  most  advanced  ideas  respecting  the  manner  in  which 
prophylaxis  against  exotic  and  infectious  diseases,  should  be  applied. 

The  protection  against  the  importation  into  our  country  of  contagious  and  infectious 
diseases,  the  provisions  contained  in  sections  33  and  50  of  the  IMaritime  Health  Regulations, 
the  struggle  against  tuberculosis,  and  the  sanitary  inspection  of  prostitution  have  originated 
new  laws  and  ordinances  prescribing  prophylactic  measures  more  in  accordance  with  the 
modern  theory  m  regard  to  the  manner  of  propagation  and  the  means  to  suppress  infectious 
and  contagious  diseases. 

All  measures  adopted  by  the  national  council  of  hygiene  are  of  high  importance,  but  the 
one  which  will  cause  a  total  revolution  in  those  existing  at  present,  which  will  afford  greater 
benefits  to  the  public,  commerce  and  our  international  relations,  is  that  relating  to  the 
method  in  which  prophylaxis  should  be  carried  out  against  the  importation  by  sea  of 
exotic  diseases  of  an  iiofectious  character,  such  as  bubonic  plague,  yellow  fever,  and  Asiatic 
cholera. 

The  bases  of  this  prophylaxis  have  been  prescribed  in  the  International  Sanitarj-  Conven- 
tion held  at  Rio  Janeiro,  June  5, 1904,  and  in  which  the  Republics  of  Uruguay,  Argentina, 
Brazil,  and  Paraguay  participated,  which  bases. were  duly  ratified  by  the  respective  Govern- 
ments. Laws  enforcing  the  provisions  of  said  convention  have  been  passed  by  these 
Governments. 

By  the  provisions  of  the  treaty  in  reference,  long  quarantines,  nonadmission  of  infected 
vessels,  and  the  old  measures  which  obstructed  commerce,  rendered  foreign  intercourse  diffi- 
cult, and  annoyed  passengers,  have  been  suppressed,  all  of  which  benefits  have  been  obtained 
with  provisions  which  do  not  impair  the  efficiency  of  the  prophylactic  measures  necessary  to 
preserve  the  country  free  from  exotic  infectious  diseases.  Our  nation  may  be  proud  of 
having  taken  the  initiative  of  said  convention. 

In  order  to  carry  out  the  prescriptions  of  the  Rio  Janeiro  convention,  the  National 
Council  of  Hygiene  has  ordered  the  construction  of  a  disinfection  plant  in  one  of  the  landing 
places.  While  this  plant  is  being  constructed,  the  station  and  disinfecting  apparatus  in  the 
Island  of  Flores  shall  continue  to  be  used  for  the  treatment  of  clothing  and  baggage. 

The  passengers  shall  be  free  to  go  to  their  residences,  where  they  shall  be  under  the  obser- 
vation of  medical  inspectors  for  a  period  equal  to  that  of  the  incubation  of  the  suspected 
disease. 

Vessels  and  merchandise  shall  be  disinfected  by  means  of  the  Clayton  system,  which  ves- 
sels and  merchandise,  after  undergoing  this  rapid  operation,  remain  perfectly  free  for  traffic. 

Passengers  affected  with  exotic  diseases,  and  third-class  passengers,  shall  be  sent  for  their 
attendance  or  observation  to  the  Island  of  Flores,  which  is  the  only  sanitary  station  that 
we  have. 

The  National  Council  of  Plygiene  has  under  consideration  the  manner  of  transforming  into 
a  land  sanitary  station  the  present  isolation  house,  in  order  that  passengers  who  arrive 
suffering  from  a  contagious  or  infectious  disease  may  be  attended  therein. 


196  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Certain  amendments  have  been  made  to  sections  33  and  50  of  the  Maritime  Health  Regula- 
tions. Said  amendments  deal  with  the  method  which  must  be  followed  in  treating  vessels 
infected  with  exotic  contagious  diseases;  they  specify  with  more  accuracy  the  classification 
of  infected  and  suspected  vessels,  and  prescribe  the  process  to  be  observed  in  the  sanitary 
treatment  of  vessels  infected  with  exanthematous  typhus,  measles,  and  diphtheria. 

In  relation  to  land  sanitation,  the  Council  has  prescribed  new  measures  in  order  to  estab- 
lish a  more  cflicient  prophylactic  treatment  in  the  residences  of  pauper  consumptives.  It 
has  also  taken  into  consideration   the  regulation  of  the  sanitary  inspection  of  prostitution. 

Paupers  atilicted  with  tuberculosis,  a  disease  which,  on  account  of  its  frequency,  extent, 
and  serious  consequences  has  become  a  dreadful  universal  scourge,  have  adopted  in  Monte- 
video a  policy  which  will  help  us  to  accomplish  the  desired  end,  which  is  the  suppression  or 
diminution  of  the  spread  of  tuberculosis  among  the  inhabitants  of  said  city. 

Thanks  to  the  humanitary  services  rendered  bj^  the  association  against  tuberculosis, 
pauper  consumptives  are  given  attendance  in  the  dispensaries  of  the  association,  and  the 
physicians  attending  them  report  every  case  immediately.  All  new  or  old  cases  of  tuber- 
culosis attended  to  in  said  dispensaries  are  reported.  Many  other  cases  attended  to  in 
private  houses  are  also  reported,  as  all  physicians  have  taken  the  policy  to  report  all  such 
cases  attended  by  them. 

For  this  reason  the  last  statistics,  especially  those  for  1904,  show  a  comparatively  increased 
number  of  reported  tuloerculosis  cases.  In  fact,  many  of  them  are  not  new,  but  of  previous 
years,  which  were  not  reported  until  recently. 

The  sanitary  condition  of  the  Republic  during  1904  and  the  past  months  of  the  current 
year,  1905,  has  been  satisfactory.  Áüld  smallpox  epidemics  have  appeared  once  in  a  while, 
but  they  were  easily  extinguished  by  means  of  vaccination  and  other  ordinary  prophylactic 
measures.  Several  cases  of  scarlet  fever,  diphtheria,  and  typhoid  fever  have  also  been 
recorded  during  said  period. 

As  regards  yellow  fever,  bubonic  plague,  and  Asiatic  cholera,  we  would  say  that  they 
are  unknown  in  our  country,  being  exotic  therein. 

Malaria  is  a  disease  that  likewise  does  not  exist  in  Uruguay,  at  least  under  its  character- 
istic forms,  and  we  can  not  say  with  certainty  whether  there  are  no  larvate  cases  in  some 
country  places. 


REPORT  FROM  THE  DELEGATE  OF  VENEZUELA,  MR.  N.  VELOZ- 

GOITICOA. 

Dr.  Walter  Wyman, 

President  of  the  Second  General  International  Sanitary  Convention 

of  the  American  Repullics: 

As  the  delegate  of  the  United  States  of  Venezuela  to  this  international  convention  I  have 
the  honor  to  submit  herewith  the  report  called  for  by  the  scientific  programme  on  the  dis- 
eases prevailing  in  my  country  and  the  sanitary  and  quarantine  laws  at  present  in  force. 

With  regard  to  the  first  point,  I  call  attention  to  the  exhibit  herewith  marked  "A,"  con- 
taining a  report  of  the  director  of  hygiene  and  statistics  of  the  western  section  of  the  Federal 
District,  entitled  "Demographic  Sanitary  Report,"  comprising  the  entire  section  of  said  dis- 
trict, and  constituting  an  important  comparative  study  on  mortaUty,  nativity,  marriage 
statistics,  and  the  causes  of  death  and  their  comparisons,  and  including  the  work  done  by  the 
inspectors  of  city  cleaning  and  municipal  works. 

The  exhibit  marked  "B"  contains  the  general  tables  of  mortahty  statistics  for  the  second 
six  months  of  the  year  1904  in  the  states  of  the  Venezuelan  Federation  and  its  Federal  Dis- 
trict, which  mortality  is  classified  according  to  the  Bcrtillon  system  by  diseases  and  causes 
of  death,  closing  with  a  graphic  demonstration  of  the  proportion  of  total  deaths.  These 
data  were  taken  from  those  published  by  the  general  direction  of  statistics  in  the  report 
of  the  department  of  fomento  for  the  year  1905. 

The  following  is  a  sunmaary  of  the  sanitary  and  quarantine  laws  in  force  in  Venezuela: 

DISEASES   CALLING   FOR   QUARANTINE   AND   SANITARY   PRECAUTIONS. 

Asiatic  cholera,  yellow  fever,  bubonic  plague,  smallpox,  and  typhus  are  the  diseases  which 
call  for  quarantine  and  other  special  sanitary  measures. 

Vessels  coming  or  suspected  as  coming  from  some  port  infected  with  one  of  these  dis- 
eases, are  subjected  to  a  quarantine  of  observation  of  three  days  for  persons;  but  if  there  is 
absolute  certainty  that  there  has  been  no  case  of  the  disease  on  the  trip,  the  said  quarantine 
may  be  reduced  to  a  shorter  period,  after  a  scrupulous  examination. 

The  quarantine  of  observation  is  enforced  in  lazarettos,  and,  in  the  absence  thereof,  on 
lighters  (pontones)  assigned  for  the  purpose. 

Any  vessel  that  has  had  during  the  trip  any  cases  of  the  said  diseases  on  board  shall  be 
subjected  to  compulsory  quarantine.     This  shall  be  for  Asiatic  cholera  "from  one  to  two 


SECOND    INTERNATIONAL    SANITARY    CONVENTION.  107 

days,  for  yellow  fever  from  three  to  six  days,  and  for  buVionic  plaf^ue  twelve  days.  The  sick 
shall  be  confined  in  a  lazaretto,  and  the  healtíiy  persons  on  hoard,  to(¿;ether  with  the  haí<{íage, 
merchandise,  and  other  effects,  shall  nsmain  on  the  vessel  or  be  transfernsd  to  another  laza- 
retto for  the  time  of  the  quarantine,  the  vessel  being  disinfected  when  the  persons  on  board 
are  landed.  The  persons  on  board  shall  be  subjected  to  the  quarantine  p;  escribed  by  the 
respective  sanitary  physician  and  board,  in  view  of  the  circumstances  of  the  ca.yc. 

INSPECTION   OF    VESSEL   AND   QUAKANllNE. 

On  the  arrival  of  a  suspected  or  infected  vessel  at  one  of  the  ports  of  Venezuela  communi- 
cation with  her  shall  in  no  case  be  permitted,  and  neither  pensons,  baggage,  merchandi.se,  or 
other  effects  shall  be  permitted  to  land. 

Vessels  arriving  with  a  clean  bill  of  health,  but  on  wiiich  cases  of  Asiatic  cholera,  yellow 
fever,  bubonic  plague,  etc.,  shall  have  occurred,  shall  be  subjected  to  a  strict  quarantine  for 
such  time  as  may  be  fixed. 

If  the  vessel  shall  have  had  direct  communication  with  ports  where  an  epidemic  is  present, 
or  if  she  comes  from  a  port  where  there  was  one  recently,  .she  shall  also  be  subjected  to  quar- 
antine for  observation. 

Every  vessel  subjected  to  quarantine  for  observation  shall  be  made  to  anchor  to  leeward, 
shall  be  carefully  watched,  and  shall  have  a  physician  placed  on  board.  If  during  the  quar- 
antine of  observation  any  case  of  an  infectious  disease  should  occur,  strict  quarantine  shall  at 
once  begin.  If  tlie  vessel  subjected  to  quarantine  should  be  desirous  of  continuing  her  trip, 
her  state  of  health  must  be  stated  on  her  bill  when  she  is  cleared.  The  board  of  health  and 
the  police  authorities  shall  adopt  all  necessary  hygienic  precautions  to  prevent  the  develop- 
ment of  any  deleterious  source  in  the  locality,  destroying  every  focus  of  infection,  maintain- 
ing the  greatest  cleanliness  possible,  and  sterilizing  anything  which  might  affect  or  vitiate  the 
atmosphere  in  any  manner  whatever. 

DISINFECTION. 

This  is  done  before  the  health  officer  and  includes  the  disinfection  of  baggage,  merchan- 
dise, and  of  the  vessel  herself,  in  a  strict  and  general  manner. 

Animal  substances,  such  as  hides,  wool,  horsehair,  and  organic  substances,  are  disinfected 
more  carefully,  and  when  this  can  not  be  done,  they  are  cremated. 

The  disinfection  is  always  done  in  accordance  with  the  nature  of  the  object,  and  is  stricter 
with  regard  to  the  substances  hable  to  preserve  the  malignant  germ,  and  less  strict  with  those 
not  so  liable  to  preserve  it. 

The  disinfection  is  done  after  the  vessel  has  anchored  and  unloaded,  being  fumigated  with 
chlorine,  sulphur  and  jets  of  steam. 

LAZARETTOS. 

The  lazarettos  shall  be  located  on  the  most  suitable  places  leeward  of  the  port,  preference 
being  given  to  uninhabited  islands  having  good  drinking  water. 

BILLS   OF   HEALTH. 

Every  vessel  arriving  at  any  port  of  Venezuela,  is  required  to  have  a  bul  of  health,  showing 
her  port  of  departure,  her  ports  of  destination,  her  true  sanitary  condition,  and  the  cases  of 
any  disease  she  may  have  had  on  board  during  the  trip.  If  she  has  a  suspicious  biU  of 
health,  she  shall  be  placed  under  quarantine  of  observation,  and  if  a  foul  bul  of  health 
under  strict  quarantine. 

HEALTH   AUTHOEITIES. 

There  are  health  authorities  in  every  port  to  watch  and  provide  for  the  local  needs  and  to 
take  the  proper  precautions  to  prevent  the  importation  of  epidemic  diseases,  as  also  to 
enforce  the  provisions  of  the  sanitary  regulations,  specially  concerning  quarantine  and 
sanitary  measures. 

The  chief  sanitary  officer  is  a  physician,  appointed  for  the  puipose,  who  has  under  his 
orders  aU  the  agents  of  the  health  service. 

The  boards  of  health  shall  be  composed  of  the  physician  appointed  for  the  purpose  by  the 
highest  civil  authority  of  the  place,  of  the  collector  of  customs  representing  the  pubhc 
treasury  and  in  his  capacity  of  captain  of  the  port,  of  two  merchants,  residents  of  the  place, 
and  of  one  engineer.  The  president  of  this  board  of  health  shall  be  the  health  officer,  and 
the  foreign  consuls  residing  in  the  port  shall  also  be  members  of  the  said  board,  with  con- 
sulting voice  and  vote,  to  guarantee  the  interests  whose  protection  is  intrusted  to  them. 

The  boards  of  health  shaU  meet  when  the  director  of  health  shall  consider  it  advisable, 
and  wül  consider  everything  connected  with  the  administration  of  the  lazarettos  and 


198  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

lighters  (pontones)  already  established  or  wliich  may  hereafter  be  established,  and  will 
have  charge  of  the  strict  supervision  and  of  everything  contributing  to  the  health  of  the 
locality. 

The  civil  and  niihtary  authorities  and  the  officials  of  the  revenue  and  poHtical  branch 
are  compelled  to  cooperate  with  the  boards  of  health  to  this  end  and  to  render  them  efficient 
and  opportune  assistance  to  enforce  their  decisions. 

In  this  manner  I  comply  with  the  directions  given  me  to  present  to  this  convention,  as  the 
delegate  of  my  country,  a  report  on  the  diseases  prevailing  therein  and  on  her  sanitary  and 
quarantine  laws.. 


Exhibit  A. 


Sanitary  and  demogtapMc  report  of  Caracas,  El  Valle,  Antimano,  La  Vega,  Macarao,  E 
Recreo,  La  Guaira,  2IaiquMía,  Macuto,  Carahalleda,  Naiguatá,  Carayaca,  Caruao,  Los 
Teques,  MiquiUn,  Carrizal,  San  Pedro,  San  Antonio,  San  Diego,  Tacata,  Paracotos,  Petare, 
Baruta,  El  Hatillo,  and  Chacao,for  tJie  year  1904. 

KEPOKT   SUBMITTED   TO   THE    CITIZEN   GOVERNOR   BY  DR.    A.   HERRERA   VEGAS,   DIRECTOR   OF 

THE    OFFICE. 

Citben  governor  of  the  western  section  of  the  Federal  District,  Caracas: 

It  is  with  the  greatest  satisfaction  that  I  place  in  your  hands  herewith  the  "Sanitary  and 
demographic  report"  for  the  vast  territory  of  your  jurisdiction,  corresponding  to  the  year 
1904.  This  is  the  fourth  report  which  I  have  had  occasion  to  subscribe,  because,  although 
the  office  of  hygiene  and  statistics  under  my  charge  has  been  in  existence  for  two  years  only, 
I  devoted  myself  for  some  time  before  to  studies  of  this  character,  and  by  gathering  data 
and  material  was  able  to  issue  a  sanitary  report  for  Caracas  and  neighboring  towns  in  the 
years  1901  and  1902. 

At  the  present  time  the  office  of  hygiene  and  statistics  having  been  assisted  by  the  civil 
and  military  authorities,  its  labor  has  been,  if  not  easy,  at  least  fuller,  and  hence  I  am 
enabled  to  submit  to  you  a  particular  and  comparative  study  of  the  movement  of  the 
population  and  sanitary  conditions  of  Caracas,  El  Valle,  Antlmano,  La  Vega,  Macarao,  and 
El  Recreo,  which  form  the  Libertador  Department;  of  La  Guaira,  Maiquetía,  Macuto,  Cara- 
halleda, Naiguatá,  Carayaca,  and  Caruao,  parishes  of  the  Vargas  Department ;  of  Los  Teques, 
Miquilén,  Carrizal,  San  Pedro,  San  Antonio,  San  Diego,  Tacata,  and  Paracotos,  composing 
the  Department  of  Guaicaipuro;  and,  finally,  of  Petare,  Bamta,  El  Hatülo,  and  Chacao,  parts 
of  the  Department  of  Sucre — a  total  of  25  towns,  with  a  population  of  184,500,  distributed 
as  follows:  Caracas,  85 ,000 souls;  district  parishes,  18,500;  Department  of  Vargas,  32,000; 
Department  of  Guaicaipuro,  30  000,  and  Sucre,  19,000. 

The  vast  area,  the  great  population,  and  the  many  interests  to  be  found  in  this  section  of 
Venezuela,  make  it  necessary  to  give  serious  attention  to  all  the  details  which  a  study  of 
this  report  will  show,  to  which  I  take  the  hberty  of  very  earnestly  caUing  your  attention. 

Summary, 
work  of  the  office  of  hygiene  in  the  year  1904. 

Caracas:  Comparative  study  of  its  mortahty,  births,  and  marriages;  movement  of  the 
population  in  1904;  causes  of  death;  age  of  the  deceased;  nationaHty;  prevailing  diseases 
during  the  year;  typhoid  fever;  tuberculosis;  diseases  of  the  digestive  apparatus;  climate 
of  Caracas:  parallel  between  deaths  and  the  seasons  of  the  year;  co  efficient  of  mortahty; 
general  and  comparative  nativity;  legitimate  and  illegitimate  children;  annual  variations  in 
birth  rate  since  1900 ;  marriage  statistics — total  number  of  marriages,  ages  of  the  contracting 
parties,  marriages  per  month,  by  parishes;  comparative  statistics;  coefficient  of  marriages; 
conclusions. 

Department  of  Vargas,  Department  of  Guaicaipuro,  Department  of  Sucre:  Study  of  their 
population. 

WORK    OF   THE   DIVISION    OF   HYGIENE   IN   THE   YEAR    1904. 

Before  entering  upon  a  sanitary  and  demographic  study  of  the  division,  permit  me  to  show 
you  a  detailed  report  of  the  large  number  of  works  executed  by  the  office  of  hygiene  and  by 
the  departments  of  street  cleaning  and  municipal  pubhc  works,  for  although  the  latter  are 
not  under  the  jurisdiction  of  the  former  their  work  redound  directly  to  the  benefit  of  general 
health,  for  which  reason  I  include  them. 


8ECONJJ    INI'KKNATIONAL    SANITARY    CONVKNTION. 


I'jy 


Nothing  like  what  is  stated  in  tliis  report  has  ever  htil'ore  be(!n  done  in  Caracas.  Something 
is  being  done,  but  tiiere  is  much,  vary  much,  tliat  still  remains  to  b(;  done  in  order  that  the 
hygiene  and  consequently  the  health  of  our  capital  may  I'each  the  proper  devtilopment. 

I  have  the  best  reasons  to  believe,  and  all  o!  Caracas  do(;s  Uk(!wis(!,  that  this  year  will  be 
one  marked  La  letters  of  gold  in  tlie  annals  of  the  history  of  Venezuela  by  reason  of  its  prog- 
ress, and  there  is  no  doubt  that  the  National  Governnuint,  presided  over  by  so  ardent  a 
patriot  as  General  Castro,  will  extend  a  helping  hand  to  the  work  of  making  the  capital  of 
the  Kepublic  hygienic,  already  begun. 

To  you,  as  the  faithful  interpreter  of  the  high  sentiments  of  the  former,  will  pertain  the 
glorious  task,  assisted  by  j^our  subordinates,  to  extirpate  the  high  tribute  we  now  pay,  due  to 
the  insufñciency  of  our  means  of  defense  against  it. 

'  WORK   DONE   BY   THE    OFFICE   OF   HYGIENE   IN   THE   YEAR    1904. 

Division  of  street  cleaning. 

Daily  cleaning  of  the  market,  slaughterhouse,  squares,  avenues,  and  a  large  number  of 
streets;  constant  repair  of  sewers  and  street  pavements. 

Foci  of  infection  denounced 378 

Inspections  made 421 

Orders  to  clean 215 


Total 1,014 


Division  of  hromatology. 

Denunciations  of  food  stuffs  of  bad  quality 257 

Samples  of  food  stuffs  received 137 

35 

26 

18 

89 

28 

56 


Requests  for  analyses. 

Inspections  in  the  market 

Inspections  in  the  slaughterhouse. 
Inspections  in  dairies 

Inspections  in  vegetable  gardens. . 
Inspections  in  butcher  shops. 


Inspections  in  grocery  stores 178 


Total. 


Food  stuffs  condemned  by  the  office  of  hygiene  and  by  the  market  management : 


824 


Pounds. 

Fresh  fish 4,  967 

Salt  fish 2, 706 

Fresh  meat 443 

Salt  meat 573 

Beans 4,  701 

Chick  peas 882 

Potatoes 4,  048 

Other  vegetables 325 


Cheese 

Black  pudding. 

Butter 

Ham 

Italian  pastes. . 


Pounds. 
180 
214 
139 
173 
190 


Total 19,541 

Canned  goods cans..         261 


Division  of  prophylaxis  of  contagious  diseases. 


Informations  received 

Inspections 

Requests  for  disinfection 

Disinfections  made  in  rooms. 

Total 


32 

32 

26 

152 


242 


Division  of  vaccination. 


Vaccine  inoculations. 
Certificates  issued 


212 
37 


Total. 


249 


200 


SECOND    INTERNATIONAL    SANITARY    CONVENTION. 


Division  of  vital  statistics. 

Data  requested  was  furnished  to  Drs.  L.  Razetti  and  Ayala  and  Bachelors  Clemente, 
Smith,  De  Armas,  and  Gonzalez  Montano,  and  to  the  otfico  of  hj^gicne  of  Sao  Paulo,  Brazil. 

The  report  of  the  western  section  of  the  Federal  District  was  published  monthly. 

From  all  points  of  view  the  principal  place  corresponds  to  Caracas,  for  which  reason  we 
will  begin  with  said  city. 

The  year  1904  may  be  qualified  as  a  most  favorable  one  for  our  capital,  from  a  san- 
itarj-  demographic  view  point,  as  may  clearly  be  seen  from  the  table  marked  No.  1. 

A  comparison  of  this  table  with  a  similar  one  for  1903  shows  the  improvement  at  once, 
and  it  is  still  more  evident  if  the  figures  for  previous  years  are  also  examined,  as  follows: 

Mortality  for  Caracas. 


Year. 

Number  oí 
deaths. 

Annual 
coefficient. 

1901 

2,838 
3,233 
3,199 
2,516 

33.00 

1902 

38.03 

1903 

37.99 

1904 

29.06 

MORTALITY    STATISTICS. 


BeatJis,  hy  cause,  age,  sex,  and  nationality,  in  Caracas  in  1904- 
[Population  of  Caracas,  85,000.] 


Epidemic  diseases: 

Typhoid  fever 86 

Erysipelas 2 

Measles 1 

Diphtheria 4 

Whooping  cough 4 

Grippe 7 

Other  epidemic  diseases 5 

Total 109 

General  diseases: 

Tuberculosis  of  lungs 415 

Tuberculosis  of  meninges 13 

Tuberculosis  of  other  organs 80 

General  tuberculosis 13 

Scrofula 11 

Pott's  disease 2 

SyphUis 8 

jUcoholism 21 

Cancer  and  other  tumors 56 

Septicemia 1 

Anemia,  chlorosis 21 

Malarial  fevers 31 

Rheumatism 1 

Chronic  alcoholism 2 


Total. 


675 


Diseases  of  the  nervous  system: 

Encephalitis 16 

Simple  meningitis 44 

Locomotor  ataxia 3 

Softening  of  the  brain 13 

Cerebral  congestion 12 

Cerebral  hemorrhage 23 

Epilepsy 2 

General  paralysis 11 


Diseases  of  the  nervous  system — Con. 

Nonpuerperal  eclampsia 26 

Infantile  convulsions 46 

Other  diseases  of  the  brain 23 

Other  diseases  of  the  medulla . 10 

Tetanus 17 

Total 246 

Circulatory  system: 

Endocarditis 10 

Pericarditis 2 

Organic  diseases  of  the  heart 80 

Angina  pectoris 16 

Valvular  diseases 84 

Arterial  diseases 60 

Aneurisms 67 

Embolism 2 

Other  diseases 14 


Total. 


335 


Respiratory  system: 

Diseases  of  the  larynx 2 

Acute  bronchitis 25 

Chronic  bronchitis 3 

Pneumonia 59 

Pleurisy 18 

Congestion  of  the  lungs 12 

Apoplexy  of  lungs 11 

Gangrene  of  lungs 1 

Asthma 3 

Broncho-pneumonia. 41 

Other  diseases 22 

Total 194 


SECOND    INTERNATIONA  I.    HANITAKY    CONVENTION. 


201 


Digestive  system : 

Pliarynx  and  esophagus 2 

Ulcer  of  the  stomach 9 

Other  diseases  of  the  stomach ....  34 

Diarrhea  in  infants  under  2  years .  133 

Enteritis 159 

Hernia  and  intestinal  obstructions .  1 1 

Intestinal  parasites 17 

Other  diseases  of  the  intestines ...  6 

Dysentery 181 

Cirrhosis 23 

Jaundice 11 

Biliary  calculi 40 

Peritonitis 6 

Appendicitis 26 

Other  diseases 7 

Cholera  morbus 13 

16 

Total 694 

Genito-urinary  system: 

Acute  nephritis ^ .  25 

Bright's  disease 19 

Calculi  of  urinary  tract 1 

Diseases  of  the  bladder 6 

Diseases  of  the  prostate 2 

Uterine  hemorrhage 5 

•     Hemorrhage  of  the  annexes 5 

Cysts    and   other   tumors   of   the 

uterus  and  ovaries 11 

Total 74 


Puerperal  diseases: 

Convulsions 1 

Other  accidents 1 

Pueiperal  septicemia 18 


Total. 


Diseases  of  the  skin : 

Anthrax 

Other  diseases. , 


Total. 


20 


Old  age: 

Congenital  debility 89 

Senile  debility 27 

Total 116 

Violent  deaths: 

Firearms.*. 12 

Fractures 3 

Burns  and  scalds. : 7 

Suicides 1 

Poison 4 

Other  violent  deaths 8 

Sudden  deaths 2 

Total 37 

Til-defined  diseases 4 


KEOAPITULATION . 


Nervous  system 246 

Circulatory  system 335 

Respiratory  system 197 

Digestive  system 694 

Genito-urinary  system 74 

Epidemic  diseases 109 

General  diseases 675 

Puerperal  diseases 20 


Congenital  debility 

Senile  debility 

Violent  deaths 

Skin  and  cellular  tissue. 
Ill-defined  diseases 


89 

27 

37 

9 

4 


Total 2,516 


The  following  table  shows  a  comparison  between  the  causes  of  death  in  1903  and  1904: 


1903. 

1904. 

Differ- 
ence in 
favor  of 
1904. 

Nervous  system 

283 

446 

153 

855 

71 

172 

869 

15 

52 

23 

41 

14 

68 

15 

246 
335 
197 
694 

37 

Circulatory  system 

111 

Respiratory  system 

Digestive  svstem 

Ifil 

Genito-urinary  system 

74 

Epidemic  diseases 

109                  63 

General  diseases 

675                194 

Puerperal  diseases 

20 

Congenital  debility 

89 
27 
37 
9 
4 

Senile  debility 

Violent  deaths 

4 

Skin  and  cellular  tissue 

5 

Pott's  disease 

64 

Unknown 

10 

Total 

3,077 

2,616 

202 


SECOND    INTEENATIONAL    SANITARY    CONVENTION. 


The  table  shows  the  progress  of  mortality  in  each  month  of  the  year,  and  there  should 
be  noted  the  decrease  thereof  from  January  to  December,  the  low  rate  being  constantly 
maintained  in  the  past  months  of  this  year.  This  table  also  shows  the  movement  of 
deaths  in  the  eight  parishes,  it  being  notable  that  the  most  health}^  is  Santa  Rosalia  and 
the  least  healthy  San  José.  The  former  has  a  population  of  10,000  and  the  latter  6,000. 
Next  in  point  of  health  comes  Santa  Teresa,  with  9,000  inliabitants  and  22-1  deaths;  then 
La  Pastora,  with  Q,000  inhabitants  and  241  deaths;  and  finally  Candelaria,  San  Juan, 
Altagracia,  and  Catedral,  with  a  mortality  quite  large  for  their  population. 

The  same  table  permits  a  study  of  the  mortahty  compared  with  that  in  1903. 

Mortality,  hy  months,  in  1904- 


Parishes. 

3 

a 

l-j 

3 
0) 

ft 

^ 

s 

a 

>-> 

3 

a 

a 

i 

ft 
& 

Ü 

,§ 
o 

o 
O 

Oí 

o 

1 

8 

Total. 

1903. 

34 
34 
22 
27 
35 
24 
12 
50 

29 
31 

i 
'¿ 

22 
40 

25 
34 
21 
25 
23 
19 
20 
56 

30 
31 
23 
28 
31 
11 
15 
31 

21 
25 
19 
39 
29 
18 
19 
46 

31 
20 

24 
27 
34 
21 
25 
56 

24 
21 
11 
28 
29 
14 
20 
43 

28 
32 
23 
31 
18 
18 
19 
54 

20 
23 

17 
19 
34 
22 
14 
36 

23 
37 
25 
28 
15 
19 
34 
30 

27 
34 
16 
25 
23 
13 
11 
44 

23 
38 
18 
33 
17 
12 
13 
36 

315 
360 
241 
334 
'    307 
213 
224 
522 

330 

,'\itagi'acia 

423 

344 

San  Juan       

386 

Candelaria 

424 

Santa  Rosalia         

276 

Santa  Teresa 

258 

758 

Total 

238 

209 

223 

200 

216 

238 

190 

223 

185 

211 

193 

190 

2,510 

3,191 

The  preceding  table  permits  even  a  close  analysis  and  more  favorable  deductions  if  a 
comparison  be  made  of  the  figures  of  the  diseases  which  have  alwaj^s  caused  the  greatest 
ravages  in  the  health  of  our  capital.     Let  us  begin  with  tuberculosis. 

In  1903  this  terrible  social  plague  was  responsible  for  a  total  of  563  victims  of  all  ages, 
especially  between  15  and  40  years  of  age,  of  both  sexes.  In  1904  this  figure  was  reduced 
to  521 — still  a  very  high  figure,  a  figure  due  in  great  part  to  our  inertia.  As  often  as  I 
have  heretofore  endeavored  to  establish  a  "Venezuelan  league  against  tuberculosis,"  my 
efl'orts  have  come  to  naught,  but  I  am  not  yet  conquered.  I  still  feel  that  I  have  strength 
for  the  struggle  and  enthusiasm  for  the  work.  It  will  never  be  too  late  if  we  attain  the 
object  we  pursue. 

Another  of  the  chapters  which  deserves  serious  attention  is  typhoid  fever. 

Much,  very  much,  has  been  said  and  written,  but  not  yet  enough,  during  the  first  months 
of  1905  and  the  last  months  of  1904  on  this  disease,  which  is  daily  becoming  more  prevalent 
and  which  threatens  to  become  permanently  established  among  us. 

As  the  causes  which  produce,  maintain,  and  distribute  the  disease  are  still  in  existence — 
namely,  sewers,  which  are  deficient  on  account  of  their  primitive  character,  which  will 
fortunately  be  modified  in  a  very  short  time,  as  the  governor,  who  is  so  zealous  in  secur- 
ing the  salubrity  of  Caracas,  has  destined  the  sums  that  Mr.  Felipe  Cavallini  will  pay 
under  his  contract  for  the  installation  of  a  new  system  which  will  constitute  a  sanitary 
improvement  of  the  highest  order,  and  in  the  meantime  repairs  to  the  existing  sewers  will 
be  done  with  a  constancy  which  is  a  certain  pledge  of  the  good  intention  to  protect  the 
lives  of  the  inhabitants  of  Caracas;  a  defective  water  service  in  the  houses,  neglect  of 
hj^gienic  measures  in  regard  thereto — it  is  evident  that  it  has  continued  its  nefarious  work, 
but  fortunately  not  attaining  the  character  of  an  epidemic,  although  it  has  produced  a 
number  of.  deaths,  which  forces  us  to  adopt  all  the  precautions  that  science  prescribes  and 
that  experience  advises. 

In  1903  the  disease  caused  88  deaths  and  this  year  86. 


DIGESTIVE    SYSTEM. 

Next  in  turn  come  the  diseases  of  the  digestive  system,  the  number  of  deaths  from  which 
has  been  relatively  smaller  this  year,  but  still  representing  so  high  a  rate  that  they  are 
worthy  of  a  serious  analysis. 

In  the  3'ear  under  consideration  diseases  of  this  character  were  responsible  for  694  deaths, 
as  against  855  in  1903,  showing  a  balance  in  favor  of  1904  of  161. 

I  have  said  it  more  than  enough  times  to  be  well  understood,  but  once  more  will  not 
be  superfluous:  The  water  in  the  first  place,  not  the  water  of  Macarao,  but  the  water  of 
Caracas,  which  produces  dysentery,  enteritis,  the  vehicle  of  intestinal  parasites,  is  the 
most  immediate  cause  of  the  large  number  of  diseases  of  this  kind.  I  will  sustain  this 
opinion  until  the  contrary  be  proved. 


SEOOND    INTEKNATIONAL    SANITARY    CONVENTION. 


203 


Notwithstanding  the  continued  well-directed  efforts  of  the  very  competent  supervisor 
of  the  market  of  this  city,  who  daily  visits  tlie  various  departments  of  tfie  [juihílníí  and 
condemns  evoiything  not  up  to  tlio  necesHary  staiulaid  of  liealtli,  and  in  spite  of  tlif,  inves- 
tigations conducted  by  th(!  office  of  hygiene,  the  amount  of  food  stnlfs  of  bail  fjuality  sold 
in  this  city  is  so  great  that  tliey  in  themselves  are  sufficient  to  pnKlucc  tlie  Imd  efi'ects 
daily  observed. 

I  call  your  attention,  Citizen  Governor,  to  the  urgent  necessity  of  providing  tfic  office 
of  hygiene  with  a  chemical  laboratory  for  the  analysis  of  all  substances  which  in  tiie  judg- 
ment of  the  director  of  the  office  do  not  fulfiil  tiic  required  conditions.  The  irrirncfliiito 
advantage  of  this  would  be  to  enable  an  exact  e.xamination  of  the  pi(;dijct  arid  pci-init 
of  the  punislunent  of  an  unscrupulous  mcrciiant  who  for  tlie  sake  of  a  few  cents  d(K;s  not 
hesitate  to  poison  the  entire  population  of  a  town.  Another  jemote  advantage  of  this 
would  bo  that  other  dealers,  on  seeing  one  of  their  colleagues  discjualified  to  engage  in  his 
industry,  would  think  a  long  time  before  giving  the  public  an  adulterated  or  decomposed 
product. 

Caracas  in  thankfulness  would  applaud  you  heartily. 

I  could  say  very  much  on  a  matter  of  so  great  interest  and  so  instructive,  but,  in  the 
first  place,  I  have  already  spoken  of  the  subject  in  earlier  reports  and  in  the  daily  press; 
and,  in  the  second,  the  necessarily  great  length  of  this  work  does  not  permit  me  to  continue. 

Table  No.  4  shows  us  a  transcendental  social  problem;  that  is,  the  age  at  death.  From 
0  to  10  years  of  age  729  persons  dies  in  Caracas,  a  little  under  one-third  of  the  total  num- 
ber of  deaths — 2,516. 

Many  are  called  to  live  and  few  selected  to  continue  living.  Unfortunately,  facts  of 
this  character  are  not  our  exclusive  patrimony.  The  same  thing  occurs  throughout 
Europe,  America,  and,  finally,  throughout  the  entire  world ;  but  in  other  nations  they  are 
not  satisfied  to  call  attention  to  the  evil,  but  they  remedy  it,  forming  societies  for  the 
protection  of  infants  against  infantile  convulsions,  etc. 

Here  defective  nourishment,  convulsions,  and  sometimes  epidemic  diseases  decimate  the 
infantile  population.  I  take  the  liberty  of  recommending  the  establishment  of  hygienic 
packages  against  infantile  convulsions  as  one  of  the  easiest  works  to  execute,  not  only  on 
account  of  the  small  cost  thereof,  but  the  ease  with  which  they  can  be  sent  to  their  desti- 
nation. Please  issue  your  orders,  as  I  possess  all  the  data  necessary  to  proceed  in  the 
matter  successfully. 

From  20  to  50  years — that  is,  during  the  age  of  sexual  vigor,  at  the  time  of  the  procrea- 
tion of  both  sexes — 1,259  persons  died,  most  of  them  victims  to  tuberculosis,  as  it  is  well 
known  that  this  is  the  age  when  its  ravages  are  greatest.  This  shows  how  important  it  is 
that  the  fight  against  this  disease  be  begun  as  soon  as  possible. 

Between  the  ages  of  50  and  100  the  deaths  numbered  528,  a  figure  which  is  not  very 
encouraging  regarding  the  duration  of  life  among  us. 


Table  No.  4. — Ages. 


0  to  1  year 413 

1  to  10  years 316 

11  to  20  years 241 

21  to^Oyears 447 

31  to  40  years 349 

41  to  50  years 222 


51  to  60  years 185 

61  to70years 169 

71  toSOyears 102 

81  and  over 72 


Total 2,516 


With  regard  to  conjugal  condition  and  nationality  the  statistics  for  1904  do  not  show 
very  notable  figures. 


Single 

Mairied. . . 
Widowed. 


1,940 
386 
190 


Total 2,516 

The  nationality  shows  only  the  small  number  of  foreigners  living  among  us : 


Venezuelans 2,  346 

Spaniards 107 

Italians 20 

French 10 

Germans 9 


Other  nations. 
Unknown 


20 
4 


Total 2,  516 


204 


SECOND    INTERNATIONAL    SANITARY    CONVENTION. 


BERTH   RATE. 

This  is  a  matter  of  the  highest  importance  in  a  country.  It  is  a  grave  problem  for  a 
nation,  especially  for  one  like  Venezuela,  which  has  suflered  since  remote  times  so  great  a 
death  rate. 

The  figures  corresponding  to  the  nativity  of  Caracas  for  the  years  1903  and  1904  are 
almost  identical — 2,382  and  2,387 — representing  a  rate  of  28,  which  is  certainly  very  pleasing. 

Now,  then,  if  our  mortality  were  not  so  high  the  population  would  rapidly  increase,  but 
the  contrary  is  the  qase,  to  the  extent  that  the  deficit  is  almost  constant.  In  1903  it  was 
817,  and  in  1904  there  was  also  a  deficit,  but  much  lower,  hardly  reaching  129.  Diil'erence 
in  favor  of  this  year,  688. 

It  would  be  exceedingly  tiresome  to  repeat  the  arguments  which  may  be  considered  as 
an  expression  of  the  truth  to  explain  the  deficit  of  population,  not,  as  has  already  been 
said,  on  account  of  a  scarcity  of  births,  but  on  account  of  an  excess  of  deaths. 

I  have  always  attributed  to  the  large  number  of  illegitimate  children  the  high  rate  of 
infant  mortaUty,  and  with  better  reason  than  ever,  I  repeat  it  now. 

I  take  the  liberty  to  submit  herewith.  Citizen  Governor,  a  table  showing  the  number  of 
births  in  the  eight  parishes  composing  our  capital,  and  at  the  end  a  statement  of  the  legiti- 
mate and  illegitimate  childi-en  in  the  years  1903  and  1904. 

The  number  of  males  and  females  was  practically  the  same — 1,207  and  1,183.  This  is  a 
factor  of  considerable  importance  from  a  social  standpoint  of  view,  if  we  reflect  at  the 
end  of  the  year  many  more  males  have  died  than  females,  and  that,  therefore,  it  is  necessary 
that  more  of  the  former  be  born  than  of  the  latter,  to  reestablish  the  balance  which  has  so 
direct  an  influence  on  the  constitution  of  the  five  forces  of  a  country  for  its  defense  and 
vitahty. 

Table  No.  5. — Nativity  in  Caracas  in  lOOJ/.,  iy  parishes  and  hy  monihs. 


>> 

OJ 

ú 

ü 

Parishes! 

3 

o3 

3 

O 

í 

P. 
< 

Ú 

s 

§ 

3 

3 

3 
< 

1 

03 
O 

O 

> 

o 

i 

o 

"3 

o 

Catedral 

29 
27 

28 
24 

26 
34 

43 
26 

39 
30 

41 
25 

37 
25 

21 
21 

47 
41 

35 
36 

28 
30 

43 
33 

397 

Altagracia 

352 

La  Pastora 

21 

16 

19 

30 

16 

29 

18 

22 

19 

20 

23 

35 

268 

27 
23 

21 
17 

23 
39 

29 
35 

36 
32 

23 
28 

39 
11 

38 
31 

21 
33 

43 
10 

34 
20 

34 
25 

368 

Candelaria 

304 

Santa  Teresa 

19 

14 

13 

24 

12 

23 

10 

30 

13 

19 

16 

26 

219 

Santa  Rosalia 

16 

15 

14 

17 

11 

19 

21 

15 

14 

23 

15 

28 

208 

San  Jose 

15 

11 

21 

27 

26 

26 

18 

28 

22 

20 

18 

39 

271 

Total 

177 

146 

189 

231 

202 

214 

179 

206 

190 

206 

184 

263 

2,387 

Legitimate  males 626 

Legitimate  females 603 


Total 1, 229 


Illegitimate  males 581 

Illegitimate  females 577 

Total 1, 158 


MARRIAGES. 

The  number  of  marriages  celebrated  in  the  city  of  Caracas  in  1904  was  405.  Considering 
this  figure  to  be  exact,  as  it  is  taken  ftom  the  civil  register,  and  estimating  the  population 
of  the  capital  at  85,000  inhabitants,  we  get  a  marriage  rate  of  4.70  per  thousand  inhabitants, 
which  is  in  itself  quite  satisfactory,  especially  if  compared  with  1903,  when  the  rate  was  3.60. 

The  financial  situation  of  our  country  having  improved  somewhat  in  the  past  year,  a 
large  number  of  persons  ha\'ing  the  capacity  to  contract  what  was  until  recently  an  indis- 
soluble tie,  found  means  to  satisfy  their  legitimate  desires,  and  thus  it  is  that  the  number 
of  marriages  increased  from  one  year  to  the  next  from  300  to  405.  There  is  no  doubt  that 
in  the  current  year  the  figure  will  increase  to  what  it  was  during  the  good  times  of  Caracas,  in 
the  shadow  of  the  peace  secured  on  the  field  of  battle  by  the  always  victorious  sword 
of  our  highest  magistrate,  and  consolidated  by  the  industry  which  has  since  been  observed 
in  the  field  of  labor. 

If  the  present  sovereign  National  Congress  would  deign  to  pass  a  law  which  would 
permit  the  most  humble  citizen  to  contract  marriage  without  the  series  of  obstacles  and 
requisites  which  leads  them  away  from  the  salutary  practice,  forcing  them  to  a  certain 
extent  to  Uve  observing  the  laws  of  nature  only,  it  would  perform  one  of  the  most  advan- 
tageous works,  which  in  a  few  years  would  be  evident  by  the  increase  of  population. 


SECOND    INTERNATIONAL    SANITARY    CONVENTION. 


205 


Table  No.  6  shows  the  number  of  marnages  by  parishes  and  by  montiis  in  Caracas, 
and  table  No.  7  the  previous  status  of  the  contracting  parties,  their  dogre(;s  of  education, 
and  their  nationahty. 

Of  the  parishes  composing  Caracas,  the  first  place  is  occupied  by  La  Pastora  on  account 
of  its  high  marriage  rate,  in  view  of  its  population,  which  is  much  smaller  than  that  of 
any  other  parish.  Eighty-two  marriages  were  celebrated.  Then  follows  Altagracia,  with 
68,  and  in  a  descending  scale  wo  reach  that  of  San  Jose,  where  only  28  were  celebrated. 

From  the  preceding  statement  of  the  contracting  parties  we  deduce  that  382  single  men 
and  widowers  contracted  marriage  with  390  single  women  and  15  widows,  with  a  total 
of  20  children. 

From  the  table  showing  the  nationality,  we  see  that  the  Spaniards  lead  in  the  number 
of  those  who  marry  our  women,  44  having  contracted  marriage;  then  come  the  Italians, 
the  French,  English,  and  other  nations. 

Table  No.  6. — Marriages  celebrated  in  Caracas  in  1904. 


Parishes. 

a 

i 

03 

ft 

^ 

3 

<-> 

3 
tUO 

3 

M 

a 

P. 

Ú 

o 

r, 

1 

Í 

■a 

^ 

pR 

a 

< 

a 

^ 

t-s 

< 

OT 

o 

;? 

f^ 

H 

4 
5 

3 
9 

5 

8 

3 
6 

5 
4 

1 

1 

2 

4 

3 
5 

3 

6 

5 
.5 

2 
6 

6 
10 

42 

Altagracia 

68 

La  Pastora 

3 

3 

6 

1 

7 

9 

4 

G 

13 

15 

15 

82 

San  Juan 

5 
3 

6 
4 

4 

1 

6 
3 

1 
9 

3 
4 

5 
1 

8 

7 

5 

4 

6 
2 

4 
3 

8 
11 

61 

Candelaria 

52 

Santa  Rosalia 

5 

1 

6 

4 

5 

3 

3 

1 

1 

3 

4 

3 

39 

Santa  Teresa 

4 

5 

1 

4 

2 

4 

2 

2 

6 

1 

2 

33 

5 

1 

3 

2 

1 

5 

2 

4 

5 

28 

Total 

34 

32 

28 

31 

29 

24 

31 

32 

25 

40 

39 

60 

405 

Table  No.  7. — Data  relating  to  the  contracting  parties. 


The  contracting  man: 

Number  of  marriages. 


405 


Uimiarried 283 

Widowers 23 

Know  how  to  read  and  write 382 

Are  related 4 

Have  children 91 

Nationality: 

Venezuelans 342 

Spaniards 44 

Italians 8 

English 2 

French 2 

Others 7 


The  contracting  woman: 

Unmarried  women 390 

Widows 15 

Know  how  to  read  and  write 377 

Are  related 4 

Have  children 90 

Nationality: 

Venezuelans 378 

Spaniards 16 

Italians 3 

French 1 

Other  nations 7 


STILLBIRTHS. 

By  morti-nativity  is  indicated  the  relation  existing  between  the  total  number  of  still- 
bii'ths  and  that  of  births  and  deaths  occurring  in  a  determinate  period. 

In  Caracas  this  number  was  109  in  1904,  as  against  142  in  1903,  the  former  being  classified 
as  64  males  and  45  females,  a  rate  which  is  almost  universal  thi-oughout  the  world,  and  in 
this  instance  corroborates  what  Bertillon,  an  authority  in  the  matter,  says,  to  the  effect 
that  the  male  morti-nativity  always  exceeds  the  female. 

This  is  a  matter  which  deserves  much  attention,  but  the  data  I  possess  up  to  the  present 
do  not  permit  me  to  ascertain  the  legitimacy  or  illegitimacy,  the  nationality  of  the  parents, 
and  often  even  the  sex.     The  civil  register  does  not  show  this  clearly. 

I  propose,  depending  in  advance  on  your  recognized  kindness,  to  take  steps  to  have 
this  data  transmitted  to  this  oflBce  with  fuller  and  more  exact  details. 

Having  concluded  this  lengthy  statement  regarding  Caracas,  we  now  have  to  consider 
the  district  parishes,  some  of  which  are  subm'bs  of  the  capital  and  places  of  recreation  for 
their  residents. 

Their  partial  tables  do  not  show  anything  worthy  of  note,  excepting  their  salubrity  and 
the  almost  total  absence  of  contagious  and  epidemic  diseases. 

The  population  increased  in  all  of  them  and  75  marriages  were  celebrated. 


206 


SECOND    INTERNATIONAL    SANITARY    CC^STVENTION. 


Department  of  Vargas. 

In  order  that  each  section  of  teriitoiy  called  a  department  may  figure  in  this  report 
with  its  own  features,  1  have  deemed  it  advisable  to  make  a  sufficiently  detaüed  study  of 
the  population  of  each.  Therefore,  there  may  be  seen  below  a  statement  of  the  movement 
of  the  population  and  the  causes  of  death  in  La  Guaira,  Maiquetia,  Caraballeda,  Naiguata, 
Carayaca,  and  C'aruao. 

From  a  stud}'  of  these  tables  we  deduce  that  in  La  Guaira  there  predominated  in  the 
year  1904  tuberculosis,  with  47  deaths,  malarial  fevers,  16,  and  diseases  of  the  gastro- 
intestinal sj'stem,  with  45  deaths. 

In  Maiquetia,  tuberculosis  in  the  first  place,  53,  diseases  of  the  digestive  system,  in  a 
higher  proportion  even  than  in  La  Guaira,  62,  for  a  lower  mortality. 

In  Macuto,  diseases  of  children,  convulsions,  eclaiupsia,  intestinal  parasites,  and  one  or 
two  cases  of  malarial  and  tj^jhoid  fever,  the  latter  having  undoubtedly  been  imported. 

In  Caraballeda  dysentery  caused  some  deaths,  11  out  of  36  being  due  thereto.  Tuber- 
culosis and  malarial  fevers,  together  with  convulsions,  caused  the  rest. 

There  is  nothing  worthy  of  note  in  Naiguata,  excepting  several  deaths  from  ophidian 
poisoning. 

Caraj^aca,  with  a  population  of  5,000  inhabitants,  incorporated  to  the  Department  of 
Vargas,  has  statistics  for  6  months  onh^.  Its  deaths  numbered  61.  Due  to  malaria, 
11,  and  9  to  infantile  convulsions. 

Finally,  Caruao,  with  30  deaths,  13  due  to  whooping  cough,  wliich  figure  is  quite  alanning 
enough  to  seek  a  corrective  measure  if  it  should  be  repeated. 

The  sanitary-demographic  movement  of  the  Department  of  Vargas  was  the  following: 

MORTALITY    STATISTICS. 


Deaths  hy  cause,  age,  sex,  and  nationality  in  the  Department  of  Vargas  in  1904-. 
[Population  of  the  Department  of  Vargas,  32,000.] 


Epidemic  diseases: 

Typhoid  lever 13 

Erysipelas 1 

Diphtheria 1 

Whooping  cough 16 

Grippe 2 

Scarlet  fever 1 

Other  epidemic  diseases 2 

Total 36 

General  diseases: 

Tuberculosis  of  the  lungs 122 

Pott's  disease 3 

Syphilis 5 

Alcoholism 2 

Cancer  and  other  tumors 10 

Malarial  fevers 42 

Rheumatism 1 

Chronic  poisonings 2 

Total 187 

Diseases  of  the  nervous  system  and  or- 
gans of  sense: 

Simple  meningitis 13 

Cerebral  congestion 11 

Cerebral  hemorrhage 5 

Epilepsy 1 

General  paralysis 5 

Convulsions,  nonpuerperal 16 

Infantile  convulsions 40 

Other  diseases  of  the  medulla  ....  3 

Tetanus 8 

Total 102 


Circulatory  system: 

Organic  diseases  of  the  heart 31 

Valvular  diseases 20 

Arterial  diseases 2 

Aneurisms 18 

Total 71 

Respiratory  system : 

Chronic  bronchitis 5 

Pneumonia 33 

Plem-isy 2 

Hemorrhage 2 

Asthma - 1 


Total. 


43 


Digestive  svstem: 

Enteritis 69 

Intestinal  parasites 11 

Dysenteiy 60 

Cirrhosis 8 

Jaundice 1 

Abscesses  of  the  liver 4 

Peritonitis 1 

Appendicitis 1 

Cholera  morbus 2 


Total. 


157 


Genito-urinary  system: 

Acute  nephritis 4 

Bright's  disease 3 

Diseases  of  the  bladder 2 


Total. 


9 


SECOND    INTERNATIONAL    SANITARY    CONVENTION. 


207 


Puerperal  diseases: 

Puerperal  septicemia 4 

Skin  and  cellular  tissue: 

Gangrene 5 

Old  ago: 

Congenital  debility 6 

Senile  debility 3 


Total. 


Violent  deaths: 

By  firearms 

Burns  and  scalds 

Suicides 

Other  violent  deaths. 
Sudden  deaths 


Total. 


1 
2 
3 
5 

4 

15 


Ill-defined  diseases .50 

Unknown  causes 2 


Total. 


52 


EEOAPITULATION. 


Nervous  system 102 

Circulatory  system 71 

Respiratory  system 43 

Digestive  system 157 

Genito-urinary  system 9 

Epidemic  diseases 36 

General  diseases ' 187 

Puerperal  diseases .■ .  5 


Congenital  debility 6 

Senile  debility 3 

Violent  deaths 15 

Skin  and  cellular  tissue 5 

Ill-defined  diseases 50 

Unknown  causes 2 


Grand  total 691 


Ages. 


From  0  to  1  year 144 

From  1  to  4  years 88 

From  5  to  19  years 75 

From  20  to  39  years 131 


From  40  to  59  years 136 

60  years  and  upward 117 


Total 691 


Nationality. 


Venezuelans 622 

Spaniards 52 

Italians 3 

French 3 


Germans 

Other  nations . 


Total 691 


Civil  status  of  the  deceased. 

Unmarried 532 

Married ' : 99 

Widowed 60 

Total 691 


Births. 

Legitimate  males 213 

Legitimate  females 210 

Illegitimate  males 236 

Illegitimate  females 190 


The  Department  of  Guaicaipuro,  composed  of  Los  Teques,  Mquilén,  Carrizal,  San  Pedro, 
San  Antonio,  San  Diego,  Tacata,  and  Paracotos,  constitutes  what  we  call  "Los  Altos  "  (The 
Heights),  and,  having  a  fine  climate  and  fertile  plantations,  they  form  a  magnificent  part  of 
the  country. 

Los  Teques,  a  pleasant  spot  for  recreation  on  account  of  its  admirable  topography  and 
healthy  climate,  with  a  population  of  4,000  inhabitants,  had,  in  the  second  semester  of  1904 
(having  been  annexed  in  May  to  the  Federal  district),  a  mortality  of  63,  which,  multiphed 
by  2  to  give  us  that  for  the  year,  gives  us  a  rate  per  thousand  of  15.74,  which  is  equal  to  or 
better  than  that  of  many  European  countries. 


208 


SECOND    INTERNATIONAL    SANITARY    CONVENTION. 


Dysentery  and  anemia,  which  diseases  are  endemic  and  responsible  for  many  deaths  in 
that' section  of  Venezuela,  as  will  be  seen  in  the  course  of  this  report,  produced  the  largest 
number  of  deaths,  the  diseases  of  the  respiratory  organs,  tuberculosis  of  the  lungs,  bron- 
chitis, etc.,  coming  next  in  importance. 

Miquilén,  a  large  district  of  the  town  of  Los  Teques,  also  with  4,000  inhabitants,  had  60 
deaths.  Ten,  or  one-sixth,  were  due  to  tuberculosis.  This  is  explained  by  the  fact  that 
this  place  is  selected  by  persons  suffering  from  complaints  of  this  character  to  recover  their 
health  and  die  there.  "  There  is  a  large  number  of  ill-dcfiiied  diseases  (mostly  dropsy)  and 
where  the  cause  is  unknown.  I  attribute  anemia  as  the  cause  of  both,  which  disease,  as 
already  stated,  is  endemic  there.  This  supposition  is  far  from  being  a  capricious  one;  it  is 
based  on  a  report  in  my  hands  signed  by  my  esteemed  colleague.  Dr.  Perdomo  Hurtado, 
who  is  engaged  in  his  profession  there. 

In  Carrizal,  San  Pedro,  San  Antonio,  and  San  Diego  tuberculosis  and  anemia  were  respon- 
sible for  many  deaths,  and  in  Tacata  and  Paracotos  dysentery,  malarial  fevers,  and  anemia 
by  anchylostomasia. 

MORTALITY   STATISTICS. 

Deaths  by  cause,  age,  sex,  and  nationality,  in  the  Department  of  Guaicaifuro  in  the  second 

semester  of  1904- 


[Population  oí  the  Department  of  Guaicaipuro,  8,00  •.] 


Epidemic  diseases: 
Typhoid  fever . . . 

Diphtheria 

Whooping  cough. 


Total 5 


Respiratory  system — Continued. 

Congestion  of  the  lungs 1 

Broncho-pneumonia 5 


Total. 


15 


•General  diseases: 

Tuberculosis  of  the  lungs. 

Syphilis 

Cancer  and  other  tumors. 

Anemia  and  chlorosis 

Malarial  fevers 

Rheumatism 


Total. 


Diseases  of  the  nervous  system  and  or- 
gans of  the  senses: 

Cerebral  congestion 

Cerebral  hemorrhage 

Epilepsy 

General  paralysis 

Nonpuerperal  convulsions 

Infantile  convulsions 

Tetanus 


Total. 


31 

1 

5 

31 

19 

1 

98 


5 
1 
1 
2 
16 
18 
3 

46 


Digestive  system: 

Enteritis 10 

Hernia  and  intestinal  obstructions.  1 

Intestinal  parasites 18 

Dysentery 26 

Cirrhosis 6 

Abcesses  of  the  liver 2 

Peritonitis 3 


Total. 


66 


■Circulatory  system: 

Pericarditis 3 

Organic  diseases  of  the  heart 3 

Valvular  diseases 1 

Arterial  diseases 4 

Aneurisms 3 

Total 14 

Respiratory  system: 

Pneumonia 7 

Pleurisy 2 


Genito-urinary  system: 

Acute  nephritis 2 

Puerperal  diseases: 

Other  accidents 1 

Skin  and  cellular  tissue: 

Gangrene 1 

Old  age: 

Congenital  debility 18 

Senile  debility 4 

Total 22 

Violent  deaths: 

By  firearms 1 

Burns  and  scalds 2 

Suicides 1 

Poisoning 3 

Other  violent  deaths 3 

Total 10 

lU-defined  diseases 45 

Unknown  causes 16 

Total 61 


SECOND    INTERNATIONAL    HANITARY    CONVENTION.  209 

RE0APITULATÍON. 

Nervous  system 46  \  Congenital  flebility 18 

Circulatory  system 14  '  Senile  debility 4 

Kespiratory  system 15      Violent  deaths 10 

Digestive  system GG     Skin  and  cellular  tissue 1 

Oenito-urinaiy  system 2  !   Ill-defined  diseases 45 

Epidemic  diseases 5      Unknown  causes 16 

General  diseases 98  :  

Puerperal  diseases 1  |              Total 341 

Civil  status. 

Unmarried 283 

Married. 31 

Widowed 27 

Total 341 

Ages  of  the  deceased. 


From  0  to  11  years 65 

From  1  to  10  years 73 

From  11  to  20  years 26 

From  21  to  30  years 47 

From  31  to  40  years 34 

From  41  to  50  years 39 


From  51  to  60  years 27 

From  61  to  70  years 15 

From  71  to  80  years 9 

81  years  and  over 6 

Total 341 


Nationality. 

Venezuelans 339 

Spaniards 2 

Total 341 

Births. 

Illegitimate  females 176 

Total 580 

Marriages 14 

Depabtment  of  Sucee. 


Legitimate  males 105 

Legitimate  females 104 

Illegitimate  males 195 


The  Department  of  Sucre  having  been  incorporated  to  gether  with  Guaicaipuro  last 
year  to  the  western  section  of  the  federal  district,  it  began  to  figure  in  statistics  in  July  of 
this    year. 

Its  component  parts,  Petare,  Baruta,  Hatillo,  and  Chacao,  form  a  total  of  about  20,000 
inhabitants,  distributed  in  innumerable  villages  and  hamlets. 

Tuberculosis,  dysentery,  infantile  convulsions,  and  malaria  constitute  the  sahent  causes 
of  death  in  this  department. 

Malaria  here,  as  in  Guaicaipuro,  is  endemic,  for  which  reason  it  would  be  a  measure  of 
great  judgment  and  benefit  to  extend  thereto  the  scientific  measures  I  request  for  the 
Department  of  Guaicaipuro. 

Even  at  the  risk.  Citizen  Governor,  of  making  this  report  longer  than  it  should  be,  I  am 
going  to  take  the  liberty  of  informing  you  of  my  anxiety  that  you  make  a  personal  investi- 
gation of  that  most  important  matter,  anemia  by  anchylostomy,  a  disease  which  attacks 
the  most  useful,  healthiest,  and  most  laborious  portion  of  the  populators  of  the  so-called 
"Los  Altos."  Í  believe  that  if  your  enlightened  Government  would  appoint  a  commission 
composed  of  Bachelor  Rangel,  as  intelligent  as  he  is  modest,  of  Dr.  Perdomo  Hurtado,  a 
practicing  physician  in  Los  Teques,  and  consequently  acquainted  with  the  country  and  the 
disease,  and  of  the  undersigned,  who  would  contribute  no  other  scientific  capital  but  his 
love  of  medicine,  and  especially  of  hygiene,  which  commission  wül  study  the  disease,  its 
causes,  and  the  manner  of  avoiding  it,  the  little  money  which  this  would  cost  could  not  be 
invested  to  better  purpose,  in  view  of  the  great  benefit  which  would  be  felt  in  the  near 
future. 

Table  No.  10  wiU  give  a  clearer  idea  of  what  I  have  said  and  will  show  the  movement  of 
population,  with  all  its  details,  in  the  year  1904. 

5610—06 14 


210 


SECOND    INTERNATIONAL    SANITARY    CONVENTION. 


MORTAUTT   STATISTICS. 


Deaths  hy  cause,  age,  sex,  and  nationality  in  the  Defartment  of  Sucre  in  the  year  1904. 


[Population  oí  the  Department  oí  Sucre,  20,000.] 


Epidemic  diseases: 

Diphtheria 

Whoophig  coufih. 
Grippe 


Total 11 


General  diseases: 

Tuberculosis  of  the  lungs. 

Syphilis 

Cancer  and  other  tumors. 

Anemia  and  chlorosis . 

Malarial  fevers 


Total 

Diseases  of  the  nervous  system  and 
of  the  organs  of  the  senses: 

Meningitis 

Cerebral  hemorrhage 

General  paralysis 

Nonpuerperal  convulsions 

Infantile  convulsions 

Tetanus 


Total 

Circulatory  system: 

Endocarditis 

Organic  diseases  of  the  heart 

Arterial  diseases 

Anem'isms 

Embolism 


Respiratory  system: 
Acute  bronchitis. 
Pneumonia 


29 


15 
14 

62 


7 
3 
1 
14 
20 
1 

46 


Total 24 


Total 10 

Digestive  system: 

Enteritis 22 

Dysentery 19 

Cirrhosis 6 

Peritonitis 1 

Appendicitis 3 

Cholera  morbus 2 

Total 53 

Genito-urinary  sj^stem: 

Acute  nephritis 2 


Bright's  disease. 
Diseases  of  the  bladder. 

Total 


Puerperal  diseases: 

Convulsions 

Other  accidents. 


Total 10 

Skin  and  cellular  tissue: 

Gangrene 1 

Old  age: 

Congenital  debility 6 

Violent  deaths: 

By  firearms 3 

Ill-defined  diseases 18 


REOAPITtJLATION. 


Nervous  system 46 

Circulatory  system 24 

Respiratory  sj'stem 10 

Digestive  system 53 

Genito-urinary  system 6 

Epidemic  diseases 11 

General  diseases 62 


Puerperal  diseases 11 

Congenital  debility 6 

Violent  deaths 3 

Skin  and  cellular  tissue 1 

Ill-defined  diseases 17 

Grand  total 250 


Ages. 


From  0  to  11  months 69 

From  1  to  10  years 32 

From  11  to  20  years 30 

From  21  to  30  years 40 

From  31  to  40  years 27 

From  41  to  50  years 13 


From  51  to  60  years 14 

From  61  to  70  years 13 

From  71  to  80  years 2 

81  years  and  over 10 

Total 250 


SECOND    INTERNATIONAL    SANITARY    CONVENTION. 


211 


Civil  filalufi  of  deceased. 


Births. 


Legitimate  males 60 

Legitimate  females 67 

Illegitimate  males 99 


Illegitimate  females -94 

Total 320 


Citizen  Governor,  all  that  has  been  stated  in  minute  detail,  in  which  if  anything  be  lack- 
ing it  should  be  attributed  not  to  neglect,  but  to  my  intellectual  failings,  covers  everything 
which  has  occurred  from  a  sanitary  and  demographic  standpoint  in  the  vast  territory 
intnisted  by  the  citizen  provisional  President  of  the  Republic  to  your  piitriotism  and  fjar- 
tisan  decision.  The  needs  are  numerous.  I  recognize  them.  The  time  during  which  the 
country  has  been  enjoying  peace  is  short.  Tiie  good  will  to  remedy  them  is  sufficient  for 
their  realization.  IN'iay  God  grant  us  tranquillity  and  the  miracle  of  seeing  Caracas  first, 
and  then  the  other  towns,  enjoying  conditions  which  can  not  be  bettered  in  a  short  time, 
in  so  far  as  health  is  concerned. 

I  would  consider  myself  fortunate  if  this  report  meets  with  your  approval. 

A.  Herrera  Vegas, 
Director  of  Hygiene  and  Statistics. 


ExrasiT  "B." 
NATIONAL  MORTALITY. 

STATISTICS   OF   DISEASES. 

P  Below  may  be  seen  the  general  statistical  tables  of  the  mortality  in  the  second  semester 
of  1904  in  the  States  of  the  Republic  and  in  the  Federal  district,  classified  by  diseases  and 
causes  of  death. 

The  classification  of  M.  Bertillon  has  been  adopted  by  the  statistical  office  of  Venezuela, 
and  these  tables  are  a  recapitulation  of  the  work  of  classification  for  the  said  six  months. 

Only  two  States  did  not  send  their  reports — Guarico  and  Táchira;  but  surely  we  will 
have  the  data  for  these  two  entities  in  the  new  year.  On  account  of  the  absence  of  these 
two  States  and  on  account  of  a  large  number  of  diseases  not  being  classified,  the  general 
computation  of  mortality  here  is  not  equal  to  the  mortality  shown  by  the  demographic 
table. 

The  total  number  of  classified  deaths  reached  23,603,  of  which  39  per  cent  were  caused 
by  the  four  following  diseases : 

Malarial  fevers  (all  manifestations) 4, 132 

Tuberculosis 2, 116 

Dysentery 1 ,  630 

Tetanus 1 ,  445 

Then  follow  in  order  of  magnitude : 

Infantile  convulsions  (eclampsia,  etc.),  463;  pneumonia,  416;  organic  diseases  of  the 
heart,  432;  anemia,  chlorosis,  416;  whooping  cough,  379 ;  diarrhea  and  enteritis  in  children 
2  yeai-s  of  age  and  over,  338;  nonpueperal  convulsions,  318;  diarrhea  and  enteritis  in 
children  under  2  years  of  age,  299;  intestinal  parasites,  293,  etc. 

The  four  principal  diseases  produced,  of  the  total  number  of  deaths,  the  following  propor- 
tions, in  round  numbers: 

Percent. 

Malarial  fevers 18 

Tuberculosis 8 

Dysenteiy 6 

Tetanus 6 


212  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

NATIONAL  MORBILITY. 


STATISTICS   OF  DEATHS. 


General  statement  of  the  deaths  which  occurred  in  the  Repubhc  during  the  second  six 
months  of  the  year  1904,  classified  by  diseases  and  causes  of  death. 


Nomenclature  of  diseases  and  causes 
of  death. 


I.  Diseases  in  general. 


10. 
11. 
12. 
13. 
14. 
14b 
15. 
16. 
17. 
18. 
19. 
20. 
21. 
22. 
23. 
24. 
25. 
26. 
27. 
28. 
29. 
30. 
31. 

32. 
33. 
34. 
35. 
36. 
37. 
38. 


Typhoid  fever 

Exantheraatic  tj'plius 

Relapsing  fever 

lutermitteut  fever  and  malarial  ca- 
chexia. 

Malarial  cachexia 

Smallpox 

Measles 

Scarlet  fever 

Whooping  cough 

Diphtheria  and  croup 

Diphtheria 

Influenza 


Cholera  nostras 

Dysentery 

Epidemic  dysentery 

Bubonic  plague 

Yellow  fever 

Leprosy 

Erysipelas 

Other  epidemic  diseases 

Purulent  infection  and  septicemia . 

Glanders  and  farcy 

Malignant  pustule 

Rabies 

Actinomycosis,  trichinosis,  etc 

Pellagra '. 

Tuberculosis  of  the  larynx 

Tubercxilosis  of  the  lungs 

Tuberculosis  of  the  meninges 

Abdominal  tuberculosis 

Pott's  disease 

Cold  abscess  and  abscess  by  conges- 
tion   

White  swelling 

Tuberculosis  of  other  organs 

General  tuberculosis 

Scroñila 

Syphilis 

Gonorrhea  in  adults 

Gonococcical  diseases  of  children. . . 

Cancer  and  other  malignant  tumors. 

39.  Of  the  bucal  cavity 

40.  Of  the  stomach,  of  the  liver 

41.  Of  the  peritoneum,  intestines,  and 

rectum 

42.  Of  the  genital  organs  of  women 

43.  Of  the  breast 

44.  Of  the  skin 

4,5.    Of  other  or  unspecified  organs 

40.    Other    tumors    (excepting  female 

genital  organs) 

47.  Acute  articular  rheumatism 

48.  Chronic  rheumatism  and  gout 

49.  Scurvy 

50.  Diabetes 

51.  Exophthalmic  goiter 

52.  Addison's  disease 

63.  Leukemia 

54.  .Anemia,  chlorosis 

55.  Other  general  diseases 

56.  Acute  and  chronic  alcohoUsm 

57.  Lead  poisoning 

58.  Other  chrome  poisonings , 

59.  Other  poisonings 


Gen- 
eral 
total. 


564 

79 

644 

2,762 

83 
125 
73 
20 
379 
108 
22 
77 


14 

1,631 

116 

16 

48 

31 

66 

30 

8 

43 

4 

4 


1,726 
41 
92 
11 

20 

14 

102 

69 

57 

103 

6 

6 


40 

46 

10 

1 

2 

416 


Nomenclature  of  diseases  and  causes 
of  death. 


II.  Diseases  of  the  nervous  spstem  and  of 
the  organs  of  the  senses. 


60.  Encephalitis 

61 .  M  eningitis 

61b.  Epidemic  cerebrospinal  meningitis. 

62.  Progressive  locomotor  ataxia 

63.  Other  diseases  of  the  spinal  cord 

64.  Congestion  and  hemhorrhage  of  the 

brain 

65.  Softening  of  the  brain 

66.  Paralysis    without    any  indicated 

cause 

67.  General  paralysis 

68.  Other  forms  of  mental  diseases 

69.  Epilepsy 

70.  Convulsions  (nonpuerperal) 

71 .  Convulsions  of  children  (eclampsia) . 

72.  Tetanus 

73.  Chorea 

74.  Other  diseases  of  the  nervous  system 

75.  Diseases  of  the  eyes  and  annexes  . . . 

76.  Diseases  of  the  ear 


III.  Diseases  of  the  circulatory  sys- 
tem. 


77. 

78. 

79. 

SO. 

81. 

81a. 

82. 

83. 


85. 
85a 


Pericarditis 

Acute  endocarditis 

Organic  diseases  of  the  heart 

Angina  pectoris ■ 

Diseases  of  the  arteries,  atheroma. . 

Aneurism,  etc 

Embohsm  and  thrombosis 

Diseases  of  the  veins  (varicose  veins, 

hemorrhoids,  phlebitis,  etc.) 

Diseases  of  the  lymphatic  system 

(lymphangitis,  etc.) 

Hemorrhage 

Vahnilar  diseases 

Other  diseases  of    the  circulatory 

system 


Gen- 
eral 
total- 


ly. Diseases  of  the  respiratory  system. 


87.  Diseases  of  the  nasal  fossae 

88.  Diseases  of  the  larynx 

89.  Diseases  of  the  thyroid  body 

90.  Acute  bronchitis ■ 

91.  Chronic  bronchitis 

92.  Bronchopneumonia 

93.  Pneumonia 

94.  Pleurisy ■ 

95.  Congestion   and  apoplexy  of   the 

lungs 

96.  Gangrene  of  the  lungs 

97.  Asthma ■ 

99.  Other  diseases  of  the  respiratory 

system  (excepting  consumption) 


V.  Diseases  of  the  digestive  system. 


100.  Diseases  of  the  mouth 

101 .  Diseases  of  the  larynx 

102.  Diseases  of  the  esoj^hagus 

103.  Ulcer  of  the  stomach 

104.  Other  diseases  of  the  stomach  (ex- 

cepting cancer) 

105.  Diarrhea  and  enteritis  (in  children 

vmder  2  years  of  age) 

105b.  Chronic  enteritis 


SECOND    INTERNATIONAL    BANITAKY    CONVENTION. 


218 


Nomenclature  of  diseases  and  causes 
of  death. 


V.  Diseases  of  the  digestive  system- 
CoiitinuL'd. 


106. 

107. 

108. 

109. 

110. 

111. 

112. 

113. 

113a, 

114. 

115. 

11Ü. 

117. 


118. 
llSa, 


Diarrhea  and  enteritis  (in  children 
2  years  oí  aRo  and  over) 

Intestinal  parasites 

IforJiia,  intestinal  obstructions. . . 

Other  intestinal  diseases 

Jaundice 

Hydatic  tumors  of  the  liver 

Cirrhosis  oí  tlio  liver 

Biliary  calculi 

AlDsccsses  of  the  liver 

Otiier  diseases  oí  the  liver 

Diseases  of  the  spleen 

Peritonitis  (nonpuerperal) 

Other  diseases  of  the  digestive  sys- 
tem (excepting  cancer  and  tuber- 
culosis)  

Appendicitis  and  phlegmon  of  the 
iliac  fossa 

Infantile  cholera 


VI.  Diseases  of  the  qenitourinary  sys- 
tem. 


119. 
120. 
121. 

122. 
123. 
124. 

125. 
126. 

127. 
128. 
129. 
130. 
131. 


133. 


134. 
135. 
136. 
137. 
138. 

139. 
140. 


Acute  nephritis 

Brlght's  disease 

Other  diseases  of  the  kidneys  and 
annexes 

Calculi  of  the  urinary  tract 

Diseases  of  the  bladder 

Other  diseases  of  the  urethra,  urin- 
ary abscesses 

Diseases  of  the  prostate  gland 

Nonvenereal  diseases  of  the  male 
genital  organs 

Metritis 

Uterine  hemorrhage,  nonpuerperal. 

Uterine  tumors,  noncancerous 

Other  uterine  diseases 

Cysts  and  other  tumors  of  the 
ovary  

Other  diseases  of  the  female  gen- 
ital organs 

Nonpuerperal  diseases  of  the 
breast  (excepting  cancer) , 


VII.   The  puerperal  state. 

Accidents  of  pregnancy 

Puerperal  hemorrhage 

Other  accidents  of  labor 

Puerperal  septicemia 

Puerperal   albuminuria  and  con- 
vulsions   , 

Phlegmasia  alba  dolens,  puerperal. 
Other  puerperal  accidents , 


Sudden  death. 

141.    Puerperal  diseases  of  the  breast  or 
mammal  gland 


VIII.  Diseases  of  the  skin  and  cellular 
tissue. 


142. 
143. 
144. 
145. 


Gangrene 

Anthrax  or  furuncle 

Phlegmon,  acute  abscess 

Other  diseases  of  the  skin  and  an- 
nexes   


XI.  Diseases  of  the  locomotor  system. 

146.  Nontuberculous    diseases    of    the 

bones 

147.  Arthritis  and  other  diseases  of  the 

joints  (except  tuberculosis  and 
rheumatism) 


Gen- 
eral 
total. 


338 
293 
40 
67 
24 
36 
94 
33 
89 
114 
50 
54 


39 


Nomenclature  of  diseases  and  causes 
oí  death. 


XI.  Diseases  of  the  locomotor  system — 
Continued. 


148. 
149. 


Amputation 

Other  diseases  of  the  organs   oí 
locomotion 


X.  Malformations. 

150.  Congenital  malformations  (not  in- 

cluding still  births) 

XI.  Early  infancy. 

151.  Congenital   debility,    icterus   and 

sclerema 

152.  Other  diseases  peculiar  to  early  in- 

fancy   

153.  Lack  of  care 

XII.  Old  age. 

154.  Senile  debility 

XIII.  Diseases  due  to  external  causes. 


Gen- 
eral 
total. 


155. 
156. 
157. 

158. 
159. 
160. 
161. 

162. 
163. 


A.  Suicide. 


Suicide  by  poison 

Suicide  by  asphyxia 

Suicide  bj'  hanging  or  strangula- 
tion  

Suicide  by  drowning 

Suicide  by  firearms 

Suicide  by  sharp  instruments 

Suicide  by  precipitation  from  an 
elevation 

Suicide  by  crushing 

Other  suicides 


113 


222 
63 


101 


B.  Homicide.  I 

163a.  Homicide  by  a  sharp  instrument. .'  22 

163b.  Homicide  by  firearms ;  37 

163c.  Homicide  by  fracture j  4 

163d .  Homicide  by  poisoning 5 

163e.  Homicide  by  asphyxia 1  1 

163f.  Homicide  by  drowTiing i  2 

163g.  Homicide  by  precipitation  from  an 

elevation 1 

C.  Other  external  causes.  j 

164.  Fractures i  14 

165.  Dislocations. 1 

166.  Other  accidental  traumatisms 46 

167.  Bums  by  fire 27 

168.  Burns  by  corrosive  substances 1 

169.  Sunstroke 8 

170 

171.    Electric  shock 2 

j  172.    Accidental  drowning 27 

173.  Inanition 19 

174.  Absorption  of  deleterious  gases 2 

175.  Other  acute  poisonings 19 

176.  Other  external  violence 34 

176a.  Bites  of  poisonous  animals 43 

XIV.  in-dcñned  diseases. 

177.  Dropsv 1,285 

17S.    Suddeii  death 131 

179.    Causes  of  death  not  specified  or 

iU-defined 2, 676 

Total 23, 603 


214  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Total  of  deatlis  occurring  during  the  second  half  of  the  year  1904,  classified  by  diseases 
and  causes  of  death: 

Per  cont. 

Tetanus 6 

Dysentery 6 

Tuberculosis  in  general 8 

Malaria  under  several  forms 18 

Several  diseases  and  causes  of  death 62 

REMARKS  ON  THE  GEOGRAPHIC  DISTRIBUTION  OF  THE  YELLOW- 
FEVER  MOSQUITO,  AND  SOME  OTHER  POINTS  CONNECTED  WITH 
THIS  INSECT.  BY  DR.  L.  O.  HOWARD,  PH.  D.,  CHIEF  OF  THE 
BUREAU  OF  ENTOMOLOGY  OF  THE  U.  S.  DEPARTMENT  OF 
AGRICULTURE  AND  CONSULTING  ENTOMOLOGIST  OF  THE 
UNITED  STATES  PUBLIC  HEALTH  AND  MARINE-HOSPITAL 
SERVICE. 

Doctor  Howard  expressed  his  pleasure  at  the  honor  conferred  upon  him  by  the  congress 
in  affording  him  the  privileges  of  the  floor  and  in  inviting  him  to  say  something  on  the 
subject  of  his  recent  work  connected  with  Stegomyia  fasciata.  He  stated  that  he  had 
noticed  in  the  newspapers  that  the  president,  Surgeon-General  Wyman,  had  distributed 
to  members  of  the  congress  the  recent  revision  of  the  paper  entitled  "Concerning  the 
Geographic  Distribution  of  the  Yellow-Fever  Mosquito,"  originally  published  in  November, 
1903,  but  now  revised  to  September  10,  1905. 

The  speaker  expressed  the  hope  that  members  of  the  congress  coming  from  Central 
American  and  South  American  countries  would  do  him  the  great  service  to  read  with  some 
care  tlie  generalizations  made  on  pages  7  and  8  of  the  paper  in  question,  and  that  they 
would  apply  the  temperature  law  there  formulated  to  regions  in  their  own  countries  in 
wkich  Stegomyia  exists  and  into  which  they  fear  it  may  be  introduced. 

Corroborating  evidence,  especially  from  the  Southern  Hemisphere,  would  be  of  gi'eat 
importance.  He  also  begged  that  representatives  ft-om  Central  Anierican  and  South 
American  countries  would  do  him  the  gi'eat  favor  of  securing,  if  possible,  the  sending  of 
species  of  mosquitoes  ñom  these  countries  to  the  United  States  National  ]\iuseum.  Persons 
in  those  countries  working  especially  upon  mosquitoes  would  gladly  be  assisted  by  Doctor 
Howard's  corps  of  assistants  in  the  determination  of  species,  and  the  speaker  v/ould  gladly 
exc'nange  named  specimens  for  unnamed  specimens. 

When  Doctors  Reed,  Carroll,  and  Lazear  first  went  to  Cuba  all  of  them  came  to  the 
Department  of  Agriculture  and  made  some  preliminary  studies  of  the  mosquitoes  in  the 
collections  of  which  the  speaker  had  charge.  They  studied  with  especial  care  the  anatomi- 
cal peculiarities  of  mosquitoes,  of  importance  in  determining  species,  and  were  therefore 
thorouglily  posted  when  they  proceeded  to  Cuba  and  began  their  epoch-making  experiments. 

Doctor  Howard  early  realized,  after  the  satisfactory  proof  gained  of  the  yellow-fever 
relation  of  Stegomyia,  that  the  geographic  distribution  of  this  species  is  of  enormous  impor- 
tance as  a  basis  of  sound  quarantine  measures,  and  he  therefore  began  at  once  with  the 
limited  means  ao  his  command  to  investigate  this  important  subject. 

The  preliminary  results  were  published  in  the  first  edition  of  the  paper  just  referred  to 
in  November,  1903.  In  1904,  however,  after  having  made  his  generalizations  and  satisfied 
himself  that  for  all  practical  purposes  Stegomyia  fasciata  is  a  tropical  and  Lower  Austral 
species,  he  made  an  effort  to  determine  the  line  of  northern  distribution  of  the  species  in 
the  United  States.  He  started  an  assistant  in  Texas  in  June,  who  followed  up  the  supposed 
northern  line  of  distribution  to  Tennessee,  where  his  place  was  taken  by  another  assistant 
in  August,  who  carried  the  investigation  on  to  the  Atlantic  coast.  The  results  of  this  work 
have  been  t)f  great  importance,  as  indicated  in  the  second  edition  of  the  paper  in  question. 
Surgeon-General  Wyman  has  been  good  enough  to  say  that  the  facts  ascertained  in  this 
investigation  have  been  of  great  service  to  the  Public  Health  and  Marine-Hospital  Service 
during  the  yeUow-fever  outbreak  of  the  present  year. 

It  so  happened  that,  while  it  was  important  to  issue  this  paper  at  the  earliest  possible 
moment,  two  impoitant  lines  of  investigation  bearing  on  this  point  were  in  progress  in 
Central  America  and  in  the  West  Indies.  Neither  of  the  investigators  in  these  regions 
had  returned  to  Washington  at  the  date  the  paper  was  written  and  neither  of  them  had 
sent  in  full  reports.  Within  the  past  few  days  both  men  have  returned  to  Washington 
and  have  submitted  verbal  reports,  and  the  speaker  is  therefore  able  at  this  time,  fortu- 
nately, to^ve,  very  bi'iefly,  some  of  the  additional  facts  ascertained  by  these  investigators. 

Mr.  Frederick  Knab  started  at  Veracruz  in  June,  went  to  Cordova,  Mexico,  south  to  the 
Tehuantepec  Hailroad  and  crossed  the  isthmus  ft'om  Santa  Lucreria  to  Salina  Cruz,  stop- 
ping at  Rincón  Antonio  and  at  Tehuantepec.     He  afterwards  visited  points  m  Guatemala, 


SECOND    INTERNATFONAL    HANITARY    CONVIONTKJN. 


215 


Costa  Rica,  and  Salvador.     The  points  at  which  he  found  Stegomyiafasciaia,  and  which 
are  not  recorded  in  the  paper  distributed  at  this  meeting,  were  as  follows: 


Rincón  Antonio  (Oaxaca),  Mexico. 
Tohuantepoc  (Oaxaca),  Mexico. 
Salina  Cruz  (Oaxaca),  Mexico. 
Acapulco,  Mexico. 
Champerico,  Guatemala. 
San  Jose,  Guatemala. 
San  Salvador,  Salvador. 

The  other  investigator,  Mr.  A.  Busck,  started  at  Trinidad  and  proceeded  northward 
through  the  Antilles  to  Santo  Domingo,  thence  returning  to  Washington.  The  points  at 
which  Mr.  Busck  found  Steqcmyia  fasciata,  and  which  are  not  recorded  in  this  paper,  are 
as  follows: 


Sonsonate,  Salvador. 

Corinto,  Nicaragua. 
Punta  Arenas,  Costa  Rica. 
Esparta,  Costa  Rica. 
San  José,  Costa  Rica. 
Port  Lirnon,  Costa  Rica. 


Trinidad:  Cedros  (extreme  southwest  cor- 
ner). Pitch  Lake,  Port  of  Spain,  Monser- 
rat,  Arima  (center  of  island). 

Tobago  Island. 

Grenada. 

St.  Vincent. 

Barbados. 

St.  Lucia. 


Martinique,  Port  of  France,  but  not  Pelee. 
Dominica. 

Guadeloupe,  Basse  Terre. 
St.  Thomas. 

Porto  Rico:  Ponce  and  Mayaguez. 
Santo  Domingo:  St.  Cristobal   (2,000  feet 
elevation),  Sanchez,  Port  of  Plata. 


Some  interesting  points  have  been  brought  out  by  the  observations  of  both  of  these 
workers.  For  example,  Mr.  Knab  found  that  at  San  José,  Costa  Rica,  a  city  which  has  an 
elevation  of  perhaps  3,000  feet,  the  yellow-fever  mosquito  is  not  abundant,  and  he  is 
informed  that  there  is  no  history  of  yellow  fever  at  that  place;  in  fact,  convalescents  from 
the  coast  are  brought  to  San  José  by  railroad.  It  occurs  to  the  speaker  that  we  have  here 
possibly  a  case  comparable  with  the  extraUmital  regions  in  the  United  States  to  which  the 
yeUow-fever  mosquito  is  carried  during  the  summer  time  on  railroads  or  by  steamboats,  and 
where  it  breeds  for  one  or  more  generations  before  the  close  of  the  season.  These  are 
not  permanent  breeding  regions,  but  regions  where  the  yellow-fever  mosquito  may  be  found 
some  years — perhaps  every  year — late  in  the  summer. 

Mr.  Busck  found  that  the  yellow-fever  mosquito  is  strangely  scarce  in  Santo  Domingo 
City.  It  is  coromon  in  St.  Cristobal,  2,000  feet  elevation,  twenty  miles  inland.  This 
curious  fact  seems  inexplicable.  It  is  the  history  of  the  distribution  of  this  mosquito  in 
other  parts  of  the  world  that  the  coast-lying  cities  are  most  seriously  affected;  mosquitoes 
are  most  numerous  there,  and  the  disease  is  of  course  most  prevalent.  Mr.  Busck  was 
informed  that  there  has  never  been  an  epidemic  of  yeUow  fever  in  Santo  Domingo  City. 
Neither  he  nor  I  have  consulted  the  records  to  ascertain  the  accuracy  of  this  report. 

The  highest  point  of  the  Tehuantepec  Railroad  is  Rincón  Antonio.  The  railroad  sur- 
geon at  that  point,  Doctor  Athey,  was  making  a  strong  antimosquito  fight,  but  was  not 
certain  that  Stegomyia  existed  at" that  point.  Mr.  Knab  found  it  abundantly  in  the  work- 
men's houses,  and  discovered  that  much  labor  was  being  wasted  in  the  kerosene  operations, 
since  ditches  and  large  pools  which  were  not  breeding  mosquitos  of  any  kind  were  being 
treated,  whereas  small  accidental  receptacles  and  small  breeding  places  like  the  footprints  of 
cattle  in  wet  land,  were  being  overlooked.  He  also  found  that  one  large  water  barrel  in 
which  there  were  hundreds  of  larvae,  had  been  overlooked. 

So  much  concerning  distribution.  Many  observations  were  made  in  tropical  regions  by 
both  of  these  observers  which  are  all  more  or  less  interesting.  Ivlr.  Knab  caught  Stegomyia 
on  the  steamer  a  day  out  of  Kingston,  Jamaica.  On  a  former  trip  Mr.  Busck  caught 
Stegomyia  on  a  Ward  Line  steamer  in  New  York  Harbor  after  returning  from  Cuba. 

in  regard  to  breeding  places,  both  of  these  observers  were  interested  in  the  fact  that 
Stegomyia  breeds  always  in  clear  water,  and  seldom  or  never  in  foul  water,  and  always  in 
artificial  receptacles,  except  in  one  case  where  Mr.  Knab  found,  at  Cordova,  Mexico,  this 
species  breeding  in  a  transient  street  puddle.  The  almost  universal  clear-water  breeding 
noted  by  these  observers  is  of  especial  interest  in  comparison  with  the  fact  noted  by  Carroll, 
Dupree,  and  other  observers  that  the  growth  of  Stegomyia  lai-va?  is  greatly  hastened  in  the 
laboratory  by  placing  a  small  amomit  of  human  excrement  in  the  water.  The  house  of 
the  American  counsul  at  San  Salvador  was  especially  infested  with  Stegomyia.  In  a  church 
at  Grenada  Mr.  Busck  found  Stegomyia  breeding  abundantly  in  the  holy-water  font,  and 
also  in  several  other  churches  in  different  West  Indian  islands.  The  adiüt  mosquitoes 
were  abundant  in  these  churches. 

I  would  say  that  I  took  the  trouble,  when  Mr.  Busck  told  me  this,  to  telephone  to  Rev. 
Dr.  Stafford,  here  in  Washington,  and  ask  him  a  few  questions  to  find  out  what  was  put 
in  the  holy  water  in  the  fonts,  and  he  told  me  that  they  were  in  the  habit  of  putting  salt 


216  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

in  the  ordinary  fonts.  Now  they  are  using  salt  as  a  mosquito  killer  in  New  Orleans  in  the 
ditches  and  gutters,  during  the  last  year,  and  therefore  it  seems  to  me  if  the  priests  would 
put  a  httle  more  salt  in  the  fonts,  not  a  mere  pinch  but  enough  to  have  an  appreciable 
eü'ect,  that  much  good  would  be  accomplished;  because  not  only  was  the  Stegomyia  found 
breeding  in  all  the  holy-water  fonts  but  Mr.  Busck  found  in  all  the  churches  the  Stegomyia 
flying  about  and  biting  the  people. 

In  Trinidad  he  found  that  beer  bottles  were  used  as  a  border  ornament  for  flower  beds. 
The  necks  of  the  bottles  were  stuck  into  the  ground  and  in  the  slightly  concave  bottoms 
(turned  upward)  water  had  accumulated  and  Stegomyia  was  breeding.  In  the  broken 
bottles  forming  the  chevaldefrise  on  the  stone  wall  around  the  jail  he  found  that  water  had 
accumulated  and  Stegomyia  was  breeding. 

Mr.  Knab,  at  Acapulco,  found  the  mosquitoes  especially  abundant  in  the  patio  of  the 
hotel  where  there  were  beautiful  flowers  protected  from  ants  by  water  in  shaUow  trenches. 
In  this  water  Stegomyia  was  breeding  abundantly. 

Many  mental  notes  were  made  by  both  gentlemen  which  bear  upon  the  fact  that  Stegomyia 
fasciata  has  become  practically  a  domesticated  species,  or  at  all  events  a  domestic  species. 
The  hiding  habits  of  the  adult,  its  general  air  of  familiarity  with  man,  its  habit  of  approach- 
ing from  behind  instead  of  from  in  front,  its  habit  of  concealment  in  garments,  working 
into  the  pockets  and  under  the  coat  lapels  and  collars,  and  of  crawling  up  under  the  clothes 
to  bite  the  legs  rather  than  the  exposed  ankles,  are  all  indications  of  familiarity  with  the 
human  species  for  very  manj^  generations.  It  is  suggested  by  Mr.  Knab  also  that  the  loss 
of  sound  by  this  species  may  have  been  the  result  of  the  law  of  the  sunával  of  the  fittest. 
It  is  interesting  to  note  that  Goeldi,  of  Brazil,  has  advanced  the  theory  that  this  species 
bites  during  the  warm  part  of  the  day  more  frequently  than  at  any  other  time,  because  it 
is  attracted  by  the  odor  of  perspiration,  and  ]\Ir.  Knab,  from  his  obsei-vations  this  summer, 
is  inchned  to  think  that  Stegomyia  does  bite  more  frequently  during  the  middle  of  the  day. 
Mr.  Busck,  from  his  obsei-vations  in  the  West  Indies,  is  inclined  to  think  that  the  time  of 
most  vigorous  biting  is  late  in  the  afternoon. 

There  is  much  still  to  be  learned  about  this  insect,  as  much  as  it  has  been  studied  in 
many  diffei'ent  countries.  Conflicting  reports  of  its  habits  in  different  localities  indicate 
either  a  considerable  variation  in  habit  or  the  possible  publication  of  erroneous  data. 
Argramonte  says  that  in  Cuba  Stegomyia  can  rarely  be  induced  to  bite  until  four  daj'^s  old. 
Mr.  Busck,  who  represented  the  Bureau  of  Entomology  of  the  United  States  Department 
of  Agriculture  at  the  St.  Louis  Exposition,  and  who  made  the  observations  on  the  extra- 
limital  breeding  of  this  species  in  the  autumnal  months  at  St.  Louis,  states  that  specimens 
bred  in  the  morning  would  bite  in  the  evening.  Dupree  states  that  in  Louisiana  the  species 
bites  without  coaxing  in  twenty-four  hours. 

Another  interesting  point  is  the  contention  of  Doctor  Souchon,  president  of  the  State 
board  of  health  of  Louisiana,  of  the  improbability  of  Stegomyia  on  infected  fruit  vessels 
coming  from  Central  American  ports  to  New  Orleans  becoming  infected  before  arrival  at 
quarantine  stations.  This  is  based  upon  the  statement,  probably  derived  from  Cuban 
sources,  that  females  must  be  impregnated  before  they  wiU  bite,  and  that  five  to  seven  days 
elapse  before  a  second  biting.  The  observations  of  Mr.  Busck,  just  quoted,  show  that 
impregnation  is  not  necessary  before  biting,  and  that  reared  females  would  bite  a  second 
time  after  the  lapse  of  forty-eight  hours.  Doctor  Dupree,  of  Baton  Kouge,  found  that 
females  isolated  in  the  pupal  state  and  reared  apart  from  the  males  "bite  frequently  and 
promptly."  Is  it  possible  that  reliance  upon  the  apparently  erroneous  conclusions  above 
stated  may  be  responsible  for  the  New  Orleans  outbreak  of  the  present  year? 

The  question  of  the  distance  to  which  infected  Stegomyia  will  fly  as  affecting  the  distances 
at  which  vessels  should  be  anchored  from  infected  ports  is  another  important  point  which 
deserves  more  extensive  investigation.  Surg.  A.  H.  H.  Russell,  of  the  United  States  Navy, 
has  made  some  interesting  but  as  yet  inconclusive  observations  on  this  point  which  have 
not  yet  been  published.  As  bearing  upon  this  point,  Mr.  Busck  states  that  at  L'Abrea, 
Trinidad,  there  is  a  long  pier  built  by  the  asphalt  company,  near  the  end  of  which  the  super- 
intendent erected  his  house  in  order  to  be  free  from  mosquito  molestation.  The  experi- 
ment was  successful,  and  he  lived  in  peace  until  later  another  official  built,  for  similar  pur- 
poses, his  house  in  the  middle  of  the  pier.  This  apparently  afl^orded  just  the  right  interval 
for  the  Stegomyia  to  spread  from  the  shore  to  the  house  in  the  middle  of  the  pier,  and  from 
that  house  to  the  one  on  the  end  of  the  pier,  and  both  houses  became  infected.  The  entire 
length  of  the  pier  was  about  400  feet. 

These  are  a  few  of  the  many  important  points  stiU  demanding  attention  of  the  ento- 
mologists and  medical  men. 

It  is  perhaps  hardly  necessaiy  to  add,  since  so  much  evidence  has  already  been  published 
in  regard  to  the  fact  that  Stegomyia  fasciata  is  a  house  mosquito,  that  it  is  never  found  in 
the  bush.  And  yet  it  may  be  of  some  importance  to  emphasize  the  point  here,  since  both 
Mr.  Busck  and  Mr.  Knab  are  skilled  entomologists  and  skilled  students  of  mosquitoes.  The 
nonrecognition  of  Stegomyia  in  the  bush  by  any  one  else,  therefore,  should  not  be  received 
with  the  same  credence  as  a  statement  of  this  kind  coming  from  these  men. 


SECOND    INTEENATIONAL    BANITARY    CONVENTION.  217 

REMARKS  OF  DR.  H.  L.  E.  JOHNSON,  OF  WASHINGTON,  D.  C, 
MEMBER  OF  THE  BOARD  OF  TRUSTEES  OF  THE  AMERICAN 
MEDICAL  ASSOCIATION. 

Mr.  President,  members  of  the  Convention,  and  guests,  the  title  of  this  paper  is,  "Will 
SBtologic  naming  of  diseases  influence  pul>Hc  opinion?"  The  principal  object  of  sanitary 
and  medical  science  and  study  at  the  present  time  is  the  prevention  and  limitation  of 


Pathologic,  biologic,  and  chemic  laboratory  investigation  have  made  valuable  advances 
in  determining  the  cause  and  origin  transmission,  scientific  recognition,  modification,  and 
arrest  of  many  of  the  morbid  processes  ail'ecting  mankind  and  the  lower  animals. 

Much  good  has  been  accomplished,  more  good  will  follow  as  a  result  of  future  labors,  but 
before  á  universal  acceptation  and  a  successful  practical  application  of  the  facts  demon- 
strated in  the  laboratory  is  possible,  it  is  apparent  that  the  lay  public  mast  be  instructed 
and  convinced. 

The  lay  public  is  generally  skeptical  about  new  medical  facts  and  discoveries,  and  until 
they  appreciate  the  value  and  importance  of  sanitary,  curative,  and  preventative  measures 
they  will  ridicule  our  teachings  and  obstruct  our  methods.  Legislators  keep  par»  with  the 
lay  public  and  press,  consequent^  suflBcient  appropriations  for  maintaining  proper  health 
conditions  are  seldom  made,  either  by  a  State  or  nation.  Generally  speaking,  behef  on  the 
part  of  the  public  in  our  theories  of  cause  and  prevention  of  disease  is  essential  in  our  cru- 
sades for  health,  and  to  this  end  health  matters  should  be  made  a  part  of  even  a  common- 
school  education  and  should  be  supplimented  by  systematic  lectures  in  terms  appreciable 
by  all.  The  baths  gave  Rome  her  health  and  vigor.  The  relation  of  fly  infection  as  a  factor 
in  enteric  fever  and  tuberculosis  is  established,  also  the  role  played  by  the  mosquito  in 
malaria  and  yellow  fever,  but  the  lay  public  and  press,  notwithstanding  the  unanimity  of 
medical  opinion  on  these  points,  has  not  entirely  indorsed  our  views  or  given  us  necessary 
support  in  our  efforts  to  overcome  there  preventable  diseases. 

Cause  and  eflect  in  each  class  should  be  clearly  demonstrated  to  the  public,  and  those  dis- 
eases which  depend  for  their  dissemination  upon  an  intermediary  host,  as,  for  example, 
malaria  and  yeUow  fever,  should  be  given  a  name  associated  with  or  indicating  their 
aetiology,  viz:  Malarial  fever  should  be  called  anopheles  fever,  infection  or  poisoning.  Yel- 
low fever,  Stegomyia  fever,  infection  or  poisoning.  Thus  named,  their  origin  would  be  indi- 
"cated  and  the  necessity  for  the  extermination  of  the  insects  which  cause  the  respective  dis- 
eases forcibly  suggested. 

The  medical  profession  and  the  public  are  mutuaUy  dependent  for  the  promotion  of  sani- 
tation and  elimination  of  disease,  and  cooperation  in  these  matters  depends  largely  on  a 
liberal  education  of  the  public,  along  the  established  health  lines. 


REPORT  ON  THE  YELLOW  FEVER  IN  CUBA,  BY  DR.  JUAN 

GUITERAS. 

The  maintenance  in  Cuba  of  the  prophylactic  measures  invented  by  Dr.  C.  J.  Finlay  and 
instituted  by  the  America^  Government  of  intervention  against  the  yellow  fever  has  resulted 
in:  First,  the  continued  freedom  from  yellow  fever  throughout  our  territory;  and,  second, 
the  conclusive  demonstration  that  the  bite  of  an  mfected  mosquito  is  the  only  natural  way 
of  transmission  of  yellow  fever. 

In  presenting  this  resume  of  what  has  been  done  in  Cuba  during  the  last  three  years,  I 
shall  advance  argument  in  favor  of  the  second  of  these  two  propositions. 

This  has  been  done,  because  in  some  of  our  sister  republics  there  is  still  some  hesitancy 
in  admitting  and  following  up  to  all  its  logical  conclusions  the  doctrine  of  the  mosquito 
transmission  of  yellow  fever.  The  people  of  these  countries  have  not  been  educated  to  a 
complete  understanding  of  this  doctrine,  and  hence  the  continued  prevalence  of  the  disease 
in  some  of  them,  and  its  invasion  of  others. 

I  repeat  what  I  stated  at  the  last  meeting  of  this  conference — namely,  that  it  is  not  pos- 
sible to  carry  out  successfuUy  the  prophylactic  measures  against  yeUow  fever  without  the 
cooperation  of  the  people.  A  community  in  which  the  announcement  of  the  presence  of  a 
case  of  yeUow  fever  produces  ungovernable  excitement  is  not  going  to  permit  its  health 
authorities  to  make  such  an  announcement  or  to  surround  the  patient  with  the  proper  safe- 
guards. Such  aimouncement  is  sure  to  be  followed  by  serious  interruption  of  business, 
commercial  restrictions,  and  violent  quarantines.  A  curious  vicious  circle  is,  in  fact, 
established,  which  may  be  concisely  expressed  as  follows:  Great  excitement  and  disturbance 
foUows  upon  the  announcement  of  a  case  of  yellow  fever,  because  everybody  fears — often 
with  reason — that  there  must  be  other  cases  concealed;  and,  on  the  other  hand,  cases  are 
concealed  for  fear  of  brmging  about  damaging  excitement. 


218  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

The  feeling  of  security  that  prevails  in  Habana  is  based  on  the  acceptance  of  the  mos- 
quito doctrine  by  the  people,  and  the  conviction  that  the  health  authorities  will  act  promptly 
and  openly  in  the  presence  of  any  suspicious  case. 

In  Las  Animas  Hospital,  the  yellow-fever  hospital  of  Habana,  we  find  perpetually  present 
and  in  active  operation  all  the  causes  that  might,  according  to  tlie  older  views,  give  rise  to 
the  spontaneous  origin  or  to  the  propagation  of  yellow  fever.  It  is  now  over  four  years  that 
the  theorists  of  the  old  school  have  been  in  vain  watching  for  these  causes,  still  supposed 
to  be  lurking  in  the  soil,  to  renovate  their  activity  and  again  renew  the  horrors  of  the  old 
endemic  of  the  Caribbean  Sea. 

The  last  days  of  the  isterode  endemic  in  Cuba  have  been  related  in  a  paper  read  before 
the  Sociedad  de  Estudios  Clínicos  of  Habana  by  Dr.  J.  Le  Roy  in  April  of  1902,  under  the 
title  of  "Statistics  of  bellow  Fever  and  Disappearance  of  the  Disease  ft-om  Habana  as 
Demonstrated  by  the  Data  of  the  said  Statistics." 

The  agony  of  the  great  endemic  extended  over  a  period  of  seven  months,  namely,  from 
the  I6th  of  February  to  the  28th  of  September  of  1901,  the  date  of  the  last  autoctonous  case 
in  Habana. 

It  is  well  to  recall  that  at  the  time  of  starting  the  antimosquito  campaign,  in  February  of 
I90I,  tliere  had  been  since  1898  an  inflow  of  42,000  immigrants.  There  was,  therefore,  no 
lack  of  raw  material  for  the  infection  to  work  upon. 

We  shall  not  repeat  the  details  of  the  new  method  employed  to  combat  yellow  fever. 
The  method  has  been  accepted,  at  least  in  theory,  as  the  only  procedure  for  the  eradi- 
cation of  the  disease.  Suffice  it  to  say  that  it  consists  in 'protecting  every  case  of  yel- 
low fever  from  the  bite  of  -mosquitoes  and  in  destroying  all  the  mosquitoes  that  may 
have  bitten  patients  with  yellow  fever — that  is  to  say,  aU  the  insects  found  in  the  vicinity 
of  the  patient,.  This  was  done  with  our  autoctonous  cases,  and  the  vigilance  of  our  maritime 
quarantine  and  of  our  immigration  bureau  enabled  us  to  act  in  the  same  manner  with  all 
imported  cases. 

The  effect  of  these  measxu-es  may  be  followed  in  the  statistics  for  the  year  1901 : 

In  January  we  had  27  cases  of  yellow  fever. 

In  February  we  had  10  cases.  The  campaign  was  started  in  this  month,  at  the  time  when, 
as  was  usually  the  case,  the  morbidity  from  yellow  fever  was  reaching  its  minimum.  The 
success  obtained  in  Halsana,  as  well  as  other  theoretical  considerations,  lead  us  to  believe 
that  this  is  the  best  time  to  initiate  the  campaign  in  the  endemic  foci. 

In  March  we  had  2  cases  and  1  imported. 

In  AprU  we  had  2  cases. 

In  Ivlay  we  had  5  cases  and  1  imported,  thus  showing  that  the  customary  annual 
epidemic  was  beginning  to  assert  itself. 

In  June  we  had  1  case  and  1' imported. 

In  July  we  had  6  cases  and  6  were  imported  ÍTom  a  neighboring  town. 

In  August  we  had  7  cases  and  4  were  imported. 

In  September  we  had  9  cases.  Two  of  these  were  taken  sick  on  the  28th,  and  they  were 
the  last  to  originate  in  the  city  of  Habana. 

We  present  this  statistical  resume  because  the  last  cases  of  the  dying  endemic  have  a 
very  special  interest  in  connection  with  the  experimental  cases  inoculated  at  Las  Animas 
Hospital.  These  were,  generally  speaking,  the  most  severe  that  have  been  obtained  by  the 
application  of  laboratory  mosquitoes,  and  they  possess  special  interest  as  evidence  of  the 
transmission  of  the  infection  of  the  mosquito,  because  in  two  of  them  the  post-mortem 
lesions  characteristic  of  yellow  fever  were  demonstrated. 

Some  authors,  however,  who  have  attempted  to  argue  against  the  acceptance  of  this 
mode  of  transmission  of  the  disease  have  rejected  the  evidence  of  all  the  experimental  cases. 
The  mild  cases  have  been  rejected  because  their  symptoms  were  not  sufficiently  developed, 
and  of  the  severe  cases  it  has  been  said  that  they  did  not  contract  the  disease  tlu-ough  the 
mosquito  inoculation,  but  through  ordinary  exposure  to  the  unknown  cause. 

Thus  Professor  Zanarelli  and  some  of  our  Brazilian  conferees  have  maintained  that  the 
experimental  cases  at  Las  Animas  Hospital  are  of  no  value  because  they  occurred  in  a 
yellow-fever  hospital  and  in  a  city  where  there  was  prevailing  at  the  time  an  epidemic  of 
the  disease.  Om-  conferees  are  mistaken.  We  have  seen,  in  fact,  from  the  statistics  above 
quoted,  that  there  was  no  epidemic  at  the  time,  but  only  the  last  manifestations  of  the 
passing  of  the  great  endemic  in  the  shape  of  a  few  sporadic  cases. 

N  othing  is  easier  than  the  demonstration  that  Las  Animas  Hospital  was  not  infected  at 
the  time  of  these  experiments.  The  inoculated  cases  in  question  were  taken  sick  on  the 
11th,  12th,  14th,  17th,  18th,  and  20th  of  August.  Let  us  now  look  at  the  movement  of 
other  yellow-fever  cases  in  the  said  hospital  during  those  days  and  during  the  preceding 
months  of  1901,  as  represented  in  the  followLug  table: 


HKOOND    INTKKNATIONAL    SANITAUY    (JON  V  EN'I'lON. 


219 


Table  of  cases  of  yellow  fever  treated  in  Las  Animus  Hospital  durinr/  the  year  lUOt  up  to  the 
1st  of  September,  classified  according  to  their  source. 


Month. 

January 

February 

March 

April 

May 

June 

July '■ 

August 


Cases 
from 

Imported 

Habana. 
3 

2 

1 

1 

0 

1 

1 

0 

0 

0 

0 

0 

1 

Experi- 
mental 
caBcs. 


It  will  bo  seen  that  the  cases  treated  in  hospital  had  gradually  fallen  ofT,  and  reased  alto- 
gether during  June  and  July,  which  is  the  very  period  in  which  an  infected  building  ought 
to  have  begun  to  produce  its  crop  of  amarillic  infections.  And  it  can  not  be  said  that  this 
immunity  was  due  to  the  absence  of  susceptible  individuals  in  the  hospital,  because  we  had 
there,  since  the  22d  of  February,  1901,  besides  the  ordinary  run  of  cases  of  other  fevers, 
most  of  whom  were  nonimmunes — we  had,  I  say,  a  number  of  young  immigrants,- recently 
arrived,  who  had  been  brought  from  the  immigration  station  at  Triscornia  for  our  inoculation 
experiments.  During  the  month  of  August  there  were  12  of  these  young  Spaniards  in  the 
hospital  buildings.  The  nonimmime  population  of  the  hospital  appears  in  tlie  following 
table: 

Table  of  nonimmunes  residing  in  Las  Animas  Hospital  during  the  month  of  August,  J901 

Cases  of  typhoid  fever 3 

Cases  of  orchitis 1 

Cases  of  uncinariasis 4 

Cases  of  febrícula 2 

Total  of  nonimmune  patients 10 

Nurses  and  attendants ■- 5 

Young  immigrants 12 

Grand  total  of  nonimmunes 27 

Of  this  nonimmune  population,  consisting  of  27  individuals,  only  6  were  attacked  by  the 
fever,  and  they  were  precisely  the  6  who  were  experimentally  bitten  by  mosquitoes  infected 
on  a  grave  case  of  yellow  fever. 

We  have  still  to  "study  the  one  case  that  appears  in  the  column  of  imported  cases  for  the 
month  of  August  in  our  ñrst  table.  Let  us  see  whether  this  patient  might  have  given  origin 
to  the  small  epidemic  of  six  cases  during  August  at  Las  Animas  Hospital.  He  was  admitted 
on  the  6th  of  August  from  the  steamer  Monterey  from  Mexico.  According  to  our  knowl- 
edge of  the  epidemiólogo^  of  yellow  fever  this  imported  case  could  not  have  produced  the 
small  epidemic  ia  question.  The  patient  was  admitted  on  the  6th  of  August,  and  the  epi- 
denüc  began  only  five  days  later,  on  the  Uth.  The  cycle  of  development  of  the  yellow- 
fever  parasite  i-equires  at  least  ten  days  in  the  mosquito  and  two  in  man,  a  total  of  twelve 
days.  Let  it  not  be  said  that  this  period  of  epidemiologic  incubation  is  observed  only  in 
the  experimental  inoculations,  since  we  knov/  that  some  time  before  the  conclusive  demon- 
strations of  the  United  States  Ai-my  Commission  Doctor  Carter  had  akeady  called  attention 
to  the  fact  that  a  period  of  twelve  daj^s  or  more  must  elapse  between  the  introduction  of  a 
case  of  yellow  fever  and  the  development  of  secondary  cases. 

It  is  evident,  therefore,  that  the  infection  at  Las  Animas  Hospital  was  contained  in  the 
wide-mouthed  jar  covered  with  gauze  in  which  infected  mosquitoes  were  kept.  The  appli- 
cation of  these  insects  to  nonimmunes  was  discontinued,  and  the  small  epidemic  at  Las 
Animas  Hospisal  ceased.  It  became  necessary  a  few  weeks  later  to  produce  a  case  of  yellow 
fever  in  order  to  show  the  fallacy  of  a  certain  vaccine,  and  a  mosquito  was  taken  out  of  the 
jar  and  apphed  to  a  susceptible  individual,  and  he  had  yellow  fever. 

One  more  case  was  required  later  on  by  Doctor  CarroU  to  cany  out  certain  experiments 
with  filtered  sei-um,  and  another  case  was  produced  by  the  same  procedure.  The  local 
epidemic  at  Las  Animas  Hospital  was,  therefore,  made  or  unmade  bj"  opening  or  closing  the 
jar  containmg  hifected  mosquitoes. 


220  SECOND    INTERNATIONAL    SANITARY    CONVENTION. 

Since  that  time  we  have  had  onh'  imported  cases  at  Las  Animas,  to  wit: 

September  to  December,  1901 2 

In  1902 7 

In  1903 10 

In  1904 2 

January,  1905 3 

Total 24 

There  can  be  no  doubt  that  the  system  of  prophylaxis  employed  in  the  above-mentioned 
hospital  has  been  successñil,  because  during  the  time  that  these  24  cases  have  been  treated 
there  we  have  had  in  the  wards  numerous  other  patients  suffering  from  other  diseases,  and 
who  were  mostly  nonimmunes,  and  yet,  without  any  other  isolation  than  the  separation 
by  wii'e  screens,  the  disease  has  never  spread. 

According  to  the  old  theories  that  hospital  should  be  a  pestilent  focus  of  amarillic  infec- 
tion. No  disinfection  in  the  ordinary  sense  of  the  word  is  ever  done  there  against  yeUow 
fever,  and  quite  frequently  nonimmune  relatives  remain  in  the  same  room  with  yellow-fever 
patients  throughout  the  attack.  The  wards  and  patients  are  frequently  \'isited  by  American 
and  European  physicians  who  are  nonimmunes.  A  number  of  conferees,  members  of  the 
American  Public  Health  Association,  during  the  meeting  in  Habana  last  January,  visited 
the  three  cases  we  then  had  in  the  hospital,  imported  from  Colon.  •  In  the  laboratory  con- 
nected wdth  that  institution  the  blood  and  the  excreta — never  disinfected — from  cases  of 
yellow  fever  are  examined.  The  assistant  who  manipulates  these  things  and  who  goes  to 
the  bedside  to  get  them  is  a  nonimmune.  The  autopsies  are  made  in  the  same  laboratory 
building  with  the  help  of  the  same  attendant.  The  last  two  necropsies  were  done  in  the 
presence  of  seven  members  of  the  PubHc  Health  Association,  who  were  nonimmunes. 

In  that  same  laboratoryl  still  use  upon  the  wide-mouthed  jars  for  breeding  mosquitoes  the 
same  gauze  sleeves  that  were  emploj^ed  during  the  epidemic  of  1900  over  the  mouths  of  the 
jars  containing  infected  mosquitoes.  Through  these  sleeves  the  sweaty  hands  and  arms  of 
many  a  case  of  yellow  fever  have  passed.  I  have  never  had  them  washed,  but  keep  them  in 
their  dirty  condition  as  perfect  .specimens  of  fomites. 

May  we  not  then  assert,  without  fear  of  contradiction,  that  every  opportunity,  other 
than  the  infected  mosquito,  is  there  fm-nished,  in  the  old  home  of  yellow  fever,  for  the 
propagation  of  the  disease? 

I  need  not  repeat  here  the  details  of  the  preventive  system  estabhshed  in  Habana.  They 
will  be  foimd  in  the  transactions  of  our  last  conference. 

As  far  as  possible  the  same  system  of  defenses  has  been  established  in  the  other  ports  of  the 
Republic,  and  wherever  there  has  been  any  threatening  break  in  the  defenses,  all  th(; 
resources  of  the  superior  board  of  health  and  of  our  maritime  quarantine  are  concentrated 
upon  the  weak  point. 

An  instance  of  this  was  seen  recently  in  Santiago,  where,  for  the  first  time  since  1901,  the 
yellow  fever  succeeded  in  penetrating  our  defenses  and  producing  two  cases  of  the  disease. 

The  first  case  was  that  of  S.  A.  Fuller,  a  native  of  the  United  States,  who  was  taken  sick 
on  October  18  of  last  year  at  Punta  de  Sal,  in  Santiago  Bay.  Mr.  Fuller  had  been  on  the 
island  twcntj-four  days  when  he  was  taken  sick.  We  were  therefore  forced  to  the  con- 
clusion that  he  had  been  infected  either  at  Santiago  or  at  Punta  de  Sal,  the  only  places  that 
he  had  visited  during  the  five  days  preceding  his  attack. 

I  was  ordered  by  my  Government  to  investigate  tliis  veiy  grave  case,  and  I  came  to  the 
conclusion  that  the  focus  of  im'ection  must  have  been  at  Punta  de  Sal,  because  the  visits 
of  Ml'.  Fuller  to  Santiago  were  too  near  or  too  far  ft'om  the  date  of  his  ilhiess  to  come  within 
the  limits  of  the  period  of  incubation  of  yellow  fever.  Fortunately  I  found  that  the  situa- 
tion of  Punta  de  Sal  was  very  favorable  for  the  isolation  of  the  sick  and  the  observation  of 
all  those  who  might  have  been  exposed  to  the  infection.  The  place  lies  about  3  miles 
distant  from  Santiago  by  water.  It  was  therefore  easy  to  detain  there  the  nonimmune 
population  and  to  keep  it  from  starting  elsewhere  new  foci  of  infection.  The  individuals 
thus  detained  could  be  defended  against  further  infection  by  the  rapid  destruction  of  aU  the 
mosquitoes  in  the  men's  quarters.  All  the  buildings  were  fumigated  at  once,  and  we  suc- 
ceeded in  hmiting  the  propagation  of  the  disease  to  one  secondary  case.  The  patient  him- 
self was  removed  to  the  isolation  hospital  on  one  of  the  islands  in  the  bay  and  was  screened 
as  soon  as  the  diagnosis  was  made.  In  the  hospital  the  patient  was  surrounded  by  non- 
imm  vines. 

We  do  not  know  how  the  infection  was  introduced.  Of  course  there  can  be  but  one  of 
two  possibilities,  namely,  either  a  case  of  yellow  fever  had  been  introduced  undiagnosed 
into  Punta  de  Sal,  or  an  infected  mosquito  had  been  landed  from  a  vessel  coming  from  an 
infected  port.  In  the  first  instanci-  we  must  suppose  an  extremely  mild  case  that  escaped 
observation.  The  objection  to  this  theory  is  that  such  a  patient,  not  being  recognized, 
must  have  been  treated  without  any  precautions   and  should  therefore  have  infected  a 


SP^COND    INTERNATIONAL    SANi'i'AKY    CONVENTION.  221 

«onsidorablo  number  of  mosquitors.  The  result  of  this  should  have  hccn  the  simultaneous 
appearance;  of  several  cases  at  the  sarni!  time  with  Fuller.  I  am  therefore  inclined  to  acc<!pt 
the  second  theory — that  is,  the;  importation  of  one  infected  mosquito  from  a  ship;  if  not 
one,  certainly  not  many,  for  they  all  perislied  without  pioducing  more  than  one  case,  that 
of  Fuller.» 

The  diagnosis  was  made  on  the  third  day  of  the  attack.  It  became  necessary,  therefore, 
to  destroy  the  insects  that  had  bitten  Mr.  Fuller  duiing  these  three  days  that  constitute 
the  period  of  danger.  Fortunately  we  had  still  eight  or  nine  days  in  whicli  to  carry  this 
out  before  the  infected  insects  could  begin  to  transmit  their  infection.  This  time  was 
put  to  such  good  advantage  that  only  one  sccondaiy  case  occurred,  that  of  Mr.  Salter, 
who  was  taken  on  the  1st  of  November.  With  this  the  little  outljreak  became  extin- 
guished. When  Fuller  and  Slater  were  discharged  from  the  isolation  hospital  at  Key 
Duan,  all  mosquitoes  were  destroyed  in  that  building. 

There  was  still  one  other  serious  threat  of  invasion  of  yellow  fever,  in  which  instance, 
as  in  the  one  just  related,  the  successful  measures  instituted  bore  evidence  to  the  truth  of 
the  principles  upon  which  our  system  of  defense  is  founded.  In  July,  1903,  a  pa.ssengcr 
on  the  steamer  Vigilancia,  from  Mexico,  succeeded  by  means  of  a  false  certificatr'  of  im- 
munity in  breaking  through  our  quarantine  inspection  at  Habana.  This  man  took  lodging 
at  No.  29  Inquisidor  street,  where  he  passed  the  first  forty-eight  hours  of  his  attack  in  a 
house  where  there  were  a  large  number  of  nonimmune  boarders.  He  asked  them  to  be  sent 
to  a  hospital,  and  on  admission  to  the  Mercedes  Hospital  the  nature  of  the  complaint  was 
at  once  recognized  and  the  patient  was  immediately  transferred  to  Las  Animas. 

The  prophylactic  measures  in  this  case  consisted  in  the  desti-uction  by  the  burning  of 
pyrethrum  powder  of  all  the  mosquitoes  in  the  block  around  the  house  on  Inquisidor 
street  and  in  the  Mercedes  Hospital.  A  list  was  made  of  all  nonimmunes  n  siding  at  the 
time  in  these  localities.  The  temperature  of  all  these  were  taken  twice  daily  to  detect 
the  first  appearance  of  a  secondary  manifestation.  Thanks  to  the  prompt  action  taken, 
there  was  no  spread  of  the  disease. 

In  concluding,  gentlemen  of  the  conference,  I  wish  to  ask  you  once  more  to  contemplate 
for  a  moment  the  picture  represented  in  the  earlier  part  of  this  paper;  the  passing  of  a 
great  epidemic  disease.  What  a  source  of  satisfaction  to  have  witnessed  the  last  hours 
of  the  dread  malady;  to  have  seen  the  wonderful  result  of  the  work  of  Reed,  Lazear,  Cari'oU, 
and  Agrámente.  This  is  the  first  time  in  the  history  of  medicine  that  such  things  have 
been  witnessed  as  are  now  passing  before  us — within  a  short  decade  the  agony  and  the 
extinction  forever  of  a  widespread  and  deeply  rooted  plague. 

If  our  satisfaction  on  contemplating  these  performances  be  great,  how  much  greater 
must  be  that  of  the  man  who,  by  a  mental  effort  that  stands  unexcelled  in  the  history  of 
human  thought,  made  all  these  things  and  this  great  benefaction  possible. 


SUGGESTIONS    BY    DR.    A.    H.    DOTY,    HEALTH  OFFICER    OF    THE 
PORT  OF  NEW  YORK. 

ELetter  of  transmittal.] 

"State  of  New  York, 
"Health  Officer's  Department, 

"Quarantine,  L.  I.,  Oct.  9,  1905. 
"  Dear  Doctor  Wyman:  At  present  I  am  unable  i^o  say  just  when  I  can  reach  Wash- 
ington, for  which  I  am  very  sorry.  Vessels  are  coming  here  daily  from  yellow  fever  and 
cholera  infected  districts,  and  for  various  reasons  I  desire  to  be  present  when  they  arrive. 
However,  I  may  be  able  to  reach  Washington  before  the  convention  is  over.  In  the  mean- 
time I  inclose  some  suggestions  relative  to  quarantine  inspection,  etc.,  which  I  should  like 
to  have  you  present  to  the  convention  for  me  if  you  find  it  consistent  to  do  so.  I  have 
made  the  paper  as  brief  as  possible  and  hope  that  it  will  meet  with  your  approval. 
"  Trulj  yours, 

(Signed)  "A.  H.  Doty." 

(1)  That  methods  of  inspection  commonly  employed  at  quarantine  stations  throughout 
the  world  aro  inadequate  to  detect  the  presence  of  mild,  ambulant,  or  unrecognized  cases 
of  infectious  disease,  which  so  far  as  the  public  health  is  concerned  constitute  one  of  the 
most  dangerous  factors  with  which  we  have  to  deal. 

o  I  have  since  seen  evidence  of  the  existence  of  one  single  infected  mosquito  on  board  a 
vessel.  The  crew  of  this  vessel  were  taken  sick  one  after  the  other  with  intervals  of  three 
or  four  days,  which  is  the  time  that  the  mosquito  requires  to  digest  its  meal  of  blood  and 
make  ready  for  the  next  one.  More  than  one  mosquito  should  produce  simultaneous  cases 
or  at  closer  intervals. 


2'2'2  SECOND    INTEKNATIONAL    SANITARY    CONVENTION. 

(2)  That  too  much  dtpcndonce  is  placed  upon  the  expiration  of  the  period  of  incubation 
of  yellow  fever  in  considering  the  release  of  persons  arriving  at  quarantine  from  districts 
infected  with  this  dispasL\ 

(3)  That  a  want  of  the  proper  appreciation  of  the  necessity  for  detecting  mild  or  ambu- 
lant cases  and  the  frequency  with  which  they  are  responsible  for  outbreaks  of  disease, 
the  origin  of  which  is  unknown,  have  contributed  largely  to  the  support  of  the  theory  that 
cargoes  of  a'csscIs  frequently  transmit  infc  ction,  which  is  not  true. 

(4)  That  the  dissemination  of  yellow  fev(  r  and  bubonic  plague  as  well  as  other  infectious 
diseases  is  not  unconmionly  due  to  the  practice  on  the  part  of  some  public  health  officials 
of  concealing  and  not  reporting  the  iii-st  or  early  cases  which  are  brought  under  their 
obsel•^■'ation.  This  policy  is  not  only  frequently  responsible  for  unnecrssar}'  loss  of  life, 
but  is  not  in  accord  with  modi  m  sanitation,  which  requires  that  the  public  sliall  be  promptly 
notified  of  outbreaks  of  infictious  disrase,  particularly  the  more  formidable  types.  In 
this  way  public  confidence  and  cooperation  are  secured,  which  is  of  gi-eat  aid  in  controlling 
the  said  outljn  aks. 

I  presi  nt  the  above  as  the  n  suit  of  my  (experience  as  a  public  health  official,  and  I  believe, 
as  1  have  already  stated,  that  the  methods  of  quarantine  inspection  now  commonly  em- 
ployed are  not  as  a  rule  thorough  enough  to  detect  the  presenc  of  mild,  ambulant,  or 
unrecognized  cases — a  most  important  consideration.  The  fact  that  a  vessel  reaches  a 
quarantine  station  after  having  been  five  daj's  in  transit  from  a  yellow-fever-infected  port, 
and  that  those  on  board  are  able  to  appear  before  the  medical  inspector  and  state  that 
thej'^  are  well  and  present  an  appearance  which  tends  to  corroborate  this,  is  by  no  means 
conclusive  evidence  that  some  one  of  the  number  is  not  suñ'ering  from  the  disease.  This 
may  also  apply  to  the  examination  of  those  arriving  from  bubonic-plagu'^-infected  ports. 
While  I  am  willing  to  brlieve  that  five  days  is  in  the  gi-eat  majority  of  cases  the  maximum 
period  of  incubation  in  yellow  fever,  I  am  satisfied  that  in  many  cases  the  disease  may 
pass  imrccognizcd  during  the  stage  of  invasion,  or  even  later,  or  throughout  the  disease 
if  it  be  a  mild  case.  Furthermore,  if  a  person  does  not  present  evidence  of  the  disease 
until  after  the  sixth  or  seventh  day  from  the  time  of  his  departure  from  a  yellow-fever- 
infected  port,  it  does  not  by  any  means  indicate  that  he  has  been  infected  by  mosquitoes 
on  shipboard,  inasmuch  as  he  may  have  been  suft'ering  from  the  disease  for  two  or  three 
days  before  it  was  recognized.  Unfortunately  many  mild  or  ambulant  cases  of  bubonic 
plague  are  admitted  into  port;  this  is  largely  due  to  the  fact  that  only  severe  and  typical 
cases  are  as  a  rule  watched  for,  and  the  mild  ones  escape  detection.  Over  two-thirds  of  the 
bubonic-plague  cases  which  have  reached  the  New  York  quarantine  station  have  been 
of  the  mild  type  and  would  have  passed  the  ordinaiy  visual  examination.  They  were 
detected  only  after  an  examination  of  the  superficial  glands  of  the  body  was  made  and  the 
temperature  taken  of  those  under  observation. 

Of  the  six  cases  of  yellow  fever  which  have  reached  this  station  on  incoming  vessels  during 
the  present  year,  tliree  of  them  were  able  to  present  themselves  for  inspection  on  their 
arrival  and  would  have  passed  a  visual  examination.  Their  condition  was  detected  mainly 
by  the  use  of  the  thermometer.  Furthermore  the  vessels  upon  which  these  cases  arrived 
had  been  six  days  in  transit.  I  may  add  that  after  the  removal  to  the  hospital  of  the  per- 
sons to  whom  I  have  just  referred  they  frankly  admitted  that  they  had  a  chill  or  had  been 
sick  two  or  three  daj's  before  arrival.  There  is  no  doubt  that  failure  to  detect  mild  or 
unrecognized  cases  is  responsible  for  many  outbreaks  of  infectious  disease  the  origin  of 
which  is  attributed  to  other  sources.  Mild  cases  of  bubonic  plague  which  have  passed 
quarantine  unrecognized  may  transmit  infection  at  some  seaport.  These  have  contributed 
largely  to  the  theoiy  that  rats  are  usyaUy  responsible  for  outbreaks  of  this  disease.  While 
there  is  no  doubt  that  this  variety  of  vermin  does  transmit  bubonic  plague,  I  beheve  that 
the  frequency  with  which  this  occurs  is  overestimated  and  that  sooner  or  later  we  will  find 
it  to  be  so.  Furthermore,  sufficient  attention  is  not  given  to  the  appearance  of  irregular 
cases  on.  shipboard,  particularly  in  vessels  coming  from  infected  ports.  It  is  stated  on 
excellent  authority  that  the  first  case  of  cholera  which  recently  appeared  at  Hamburg  was 
admitted  to  the  hospital  as  a  case  of  pneumonia  and  that  the  true  character  of  the  disease 
was  not  ascertained  until  some  time  afterwards.  Comphcations  may  also  occur  which  will 
mislead  or  mask  the  presence  of  infectious  disease.  Such  cases  have  repeatedly  come  under 
my  observation. 

I  believe  that  the  thermometer  if  carefuU}'  and  scientifically  used  is  one  of  the  most 
valuable  means  of  detecting  the  presence  of  mild  or  otherwise  unrecognized  cases  of  disease. 

It  would  seem  to  me  that  it  is  veiy  important  for  the  convention  to  take  such  action  as 
win  tend  to  bring  about  on  the  part  of  the  different  nations  an  agreement  to  promptly 
report  outbreaks  of  infectious  disease.  This  would  constitute  one  of  the  most  efi^ective 
means  of  preventing  the  transmission  of  infectious  disease  and  would  substantially  aid  in  the 
preservation  of  the  pubhc  health. 


SECOND    INTERNATIONAL    SANITAKY    CONVENTION.  22^ 

REMARKS  OF  PRESIDENT  ROOSEVELT  TO  THE  MEMBERS  OF  THE 
SECOND  INTERNATIONAL  SANITARY  CONVENTION  (^AT  THE 
EXECUTIVE  OFFICE),  WASHINGTON,   D.  C,  OCTOBER  12,  1905. 

Dr.  Wyman,  and  Gentlemjon  and  Lai^ieh  of  the  Convention:  1  .slioukJ  like  to  ^rcct 
you  and  say  with  what  peculiar  plcasuní  1  wc^lcoinc  you,  bccausi^  hotli  of  thf  profession  you 
represent,  and  of  the  fact  that  you  come,  from  our  sister  liepuhlics  of  America. 

I  believe  that  we  on  this  hemisphere  are  goinj^  to  show  to  all  the.  world,  are,  ííoinj;  to  teach 
all  the  world  by  an  object  lesson  that  separate  States,  separate  nations,  can  dwell  together 
in  absolute  harmony,  and  can  unite  in  a  common  effort,  as  you  are  uniting  here;,  for  the 
betterment  of  tfie  conditions  affecting  them  all. 

Tlic  outside  world  is  only  beginning  to  understand  tfic  astonishing  progress  made,  not 
only  socially  and  industrially,  but  in  science,  literature,  and  art,  by  the  Central  and  South 
American  Kepubiics.  In  medical  matters,  in  industrial,  scientific,  social,  artistic  matters, 
each  of  our  countries  has  something  to  learn  from  the  others,  and  I  welcome  you  as  col- 
leagues and  as  teachers. 

Of  course,  I  could  not  overstate  the  all-importance  of  the  medical  profession  in  modem 
life,  and  as  it  is  now  becoming,  in  modern  international  life.  In  the  old  days  a  plague  that 
happened  in  one  country  was  regarded  as  only  concerning  that  country,  until  it  spread  over 
into  some  other  helpless  to  defend  itself  against  it.  Now  we  recognize  that  the  stamping 
out  of  disease,  the  warfare  against  unhygienic  conditions,  must  be  done  by  the  organized 
effort  of  the  medical  profession  of  all  the  countries  joined  together. 


FUNCIONAEIOS  DE  LA  CONVENCIÓN. 


Presidente. 


Cirujano-General  Wyman,  Servicio  de  Sanidad  y  Hospitales  Marítimos  de  loa  Estados 
Unidos  de  Ajnérica. 

V  ice-presidentes. 

Sefior  Doctor  Don  Eduaedo  Moore,  Chile. 

Señor  Doctor  Don  Juan  J.  Ulloa,  Costa  Rica, 

Señor  Doctor  Don  Juan  Guiteras,  Cuba. 

Señor  Don  Emilio  Joubert,  República  Dominicana. 

Señor  Don  Serafín  S.  Whither,  Ecuador. 

Señor  Doctor  Don  Joaquín  Yela,  Guatemala. 

Señor  Doctor  Don  Eduardo  Licéaga,  Méjico. 

Señor  Doctor  J.  L.  Medina,  Nicaragua. 

Señor  Doctor  Don  Daniel  E.  Lavorería,  Perú. 

Dr.  H.  L.  E.  Johnson,  Estados  Unidos. 

Señor  Don  Nicolás  Veloz-Goiticoa,  Venezuela. 

Secretario  Permanente. 

Señor  Doctor  Don  Juan  J.  Ulloa,  Costa  Rica. 

Junta  Consultora. 

Señor  Doctor  Don  Eduardo  Moore,  Chile,  Presidente. 

Señor  Doctor  Don  Eduardo  Licéaga,  Méjico. 

Dr.  H.  D.  Geddings,  Estados  Unidos. 

Dr.  Walter  D.  McCaw,  Comandante,  Estados  Unidos. 

Señor  Doctor  Don  Juan  Guiteeas,  Cuba. 

Dr.  J.  D.  Gatewood,  Cinijano  de  la  Armada  de  los  Estados  Unidos. 

•    1112a— 06 15  225 


CONVOCATORÍA  I'AIU   LA  SKíMINDA  (CONVENCIÓN  SANITARIA 
INTERNACIONAL  DE  LAS  REPÚBLICAS  AiMERICANAS. 


Procediendo  de  conformidad  con  lo  acordado  en  la  Segunda  Con- 
ferencia Panamericana  que  se  celebró  en  la  Ciudad  de  Méjico  en 
el  invierno  de  1901  á  1902,  se  fijó  la  fecha  del  9  de  octubre  del  co- 
rriente año  de  1905  para  que  tenga  lugar  en  esta  ciudad  de  Washington 
la  reunión  de  la  Segunda  Convención  Sanitaria  Internacional  de  las 
mencionadas  Repúl)licas. 

Precedieron  á  este  aviso  las  comunicaciones  oficiales  que  se  copian 
á  continuación. 

Departamento  del  Tesoro, 

Wáfihiru/ton,  abril  29  de  1905. 
Muy  Señor  Mío:  Tengo  el  honor  de  incluir  una  copia  de  la  convocatoria  para  la  Se;^nda 
Convención  General  Sanitaria  Internacional  de  las  Repúblicas  Americanas,  cuya  celebra- 
ción en  Washington  en  9  de  octubre  de  1905,  empezando  á  las  11  de  la  mañana,  sí? "ordenó  por 
la  Oficina  Sanitaria  Internacional. 

Esta  convocatoria  está  expedida  de  acuerdo  con  las  resoluciones  adoptadas  por  la  Segunda 
Conferencia  Internacional  Panamericana,  tenida  en  la  capital  de  Méjico  del  22  de  octubre 
de  1901  al  22  de  enero  de  1902,  en  lo  relativo  á  la  policía  sanitaria  internacional,  y  á  las 
convenciones  sanitarias. 

De  acuerdo  con  el  párrafo  7  de  las  referidas  resoluciones  tengo  que  suplicar  á  Vd.  se  sirva 
dictar  las  medidas  necesarias  para  que  se  dé  publicidad  á  la  referida  convocatoria. 
De  Vd.  respetuosamente, 

Walter  Wtman, 
Cirujano  Maxjor,  Presidente  de  la  Oficina  Sanitaria  Internacional. 
Señor  W.  C.  Fox, 

Director  de  la  Oficina  de  las  Repúilicas  Americanas,  Washington,  D.  C. 

Departamento  del  Tesoro, 

Washington,  abril  29  de  1905. 

SEGUNDA  convención  GENERAL  SANITARIA  INTERNACIONAL  DE  LAS  REPÚBLICAS  AMERICANAS. 

Por  orden  de  la  Oficina  Sanitaria  Internacional  se  convoca  la  Segunda  Convención  Gene- 
ral Sanitaria  Internacional  de  las  Repúblicas  Americanas,  para  que  se  reúna  en  esta  ciudad 
de  Washington,  en  el  hotel  Uamado  New  Willard,  á  las  11  de  la  mañana,  el  9  de  octubre  del 
corriente  año  de  1905.  El  programa  de  la  reunión  será  publicado  dentro  de  poco,  y  de  las 
alteraciones  que  en  él  se  hagan  se  dará  cuenta  oportunamente  en  el  Boletín  Mensual  de  las 
Repúblicas  Americanas. 
Respetuosamente, 

Walter  Wtman, 
Presidente  de  la  Oficina  Sanitaria  Internacional. 

Al  recibo  de  la  anterior  comunicación  y  documento  anexo,  el  Direc- 
tor de  la  Oficina  Internacional  de  las  Repúblicas  Americanas  dirigió 
á  los  señores  representantes  de  los  países  que  componen  la  Unión 
Internacional  de  las  mismas  Repúblicas  el  despacho  que  sigue : 

^Iato  1  DE  1905. 
Muy  Señor  Mío:  Tengo  el  honor  de  transmitii-  con  ésta  una  copia  de  la  comunicación 
que  me  ha  dirigido  el  Señor  Walter  Wyman,  Médico  Mayor  y  Presidente  de  la  Oficina  Sani- 
taria Internacional,  incluyendo  una  convocatoria  para  la  Segunda  Convención  General 
Sanitaria  Internacional  de  las  Repúblicas  Americanas,  con  el  fin  de  que  se  reúna  en  ésta 
ciudad  de  Washington  el  9  de  octubre  de  1905,  á  las  11  de  la  mañana,  la  referida  asamblea. 
Soy  de  Vd.  atento  servidor, 

Wtt.t.tams  C.  Fox,  Director. 

227 


228  SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL. 

SEGUNDA   CONVENCIÓN    SANITAKA   INTERNACIONAL   DE    LAS  REPÚBLICAS   AMERICANAS. 

WASHINGTON,  D.  C,  octoher  9, 1905. 

PROGRAMA   CIENTÍFICO. 

(Sujeto  á  los  cambios  que  sugiera  la  Oficina  Sanitaria  Internacional.^ 

1.  Informes  de  los  delegados  de  cada  República.  Estos  informes  deben  contener:  (o) 
Datos  sobre  la  prevalencia  de  las  enfermedades,  especialmente  la  plaga,  la  fiebre  amarilla  y 
la  malaria,  á  partii'  del  1°  de  enero  de  1904,  que  fué  aproximadamente  la  fecha  de  clausm-a 
de  la  última  convención;  (b)  un  sumario  de  las  leyes  sanitarias  y  de  cuarentena  que  se  hayan 
dictado  después  de  la  primera  convención;  (c)  todo  trabajo  sanitario  especial  que  sé  esté 
ejecutando,  ó  que  se  trate  de  llevar  á  cabo.  Estos  inl'ormes  se  darán  en  nombre  de  cada 
República,  y  podi'án  comprender  la  totalidad  de  los  asuntos  indicados,  ó  dividirse  en  partes 
de  que  cada  una  se  haya  encargado  á  un  delegado  especial.  Se  supfica  que  se  presente  un 
informe  escrito,  á  fin  de  publicarlo. 

2.  Plaga:  (a)  Diagnosis;  (b)  Profilaxia  y  terapéutica;  (c)  Cuarentena  marítima;  (tZ) 
Cuarentena  terrestre;  (e)  Medidas  locales  para  hacer  desaparecer  la  enfermedad. 

3.  El  mosquito  en  sus  relaciones  con  la  fiebre  amarilla  y  las  debidas  á  la  malaria.  Impe- 
dir la  propagación  de  dichas  fiebres  por  la  destrucción  y  eliminación  del  mosquito. 

4.  Discusiones  sobre  la  mejora  del  estado  sanitario  de  las  ciudades  con  referencia  especial 
á  la  ventilación  de  las  habitaciones  y  á  la  disposición  de  los  residuos  y  desechos  domésticos. 


SEGUNDA  CONFERENCIA  SANITARIA  INTERNACIONAL  DE  LAS 
REPÚBLICAS  AMERICANAS. 


PRIMER  día— LUNES,  9  DE  OCTUBRE. 

El  Cirujano  General  Wyman,  presidente,  declaró  constituida  la 
conferencia  á  las  11.15  a.  m. 

ALOCUCIÓN  INAUGURAL  DEL  DOCTOR  WALTER  WYMAN,  CIRUJANO 
GENERAL  DEL  SERVICIO  DE  SANIDAD  PÚBLICA  Y  HOSPITALES 
MARÍTIMOS. 

Señores  :  Tengo  el  honor  de  declarar  constituida  la  Segunda  Con- 
ferencia Sanitaria  Internacional  de  las  Repúblicas  Americanas,  con- 
vocada de  acuerdo  con  las  resoluciones  adoptadas  por  la  Segunda 
Conferencia  Internacional  de  los  Estados  Americanos,  en  la  Ciudad 
de  México,  en  29  enero  de  1902. 

En  diciembre  próximo  hará  tres  años  que  la  Primera  Conferencia 
se  celebró  en  esta  capital,  estando  representadas  once  repúblicas  por 
veintisiete  delegados.  Según  tengo  entendido,  doce  son  las  repú- 
blicas representadas  en  esta  Conferencia.  Ustedes  recordarán  que  se 
decidió  celebrar  la  Segunda  Conferencia  el  15  de  marzo  en  Santiago 
de  Chile,  de  conformidad  con  la  cordial  invitación  presentada  por  los 
distinguidos  delegados  de  Chile.  Á  medida  que  se  aproximaba  la 
fecha  resultó  evidente  que  á  causa  de  una  fuerte  epidemia  de  fiebre 
amarilla  que  prevalecía  en  ciertas  partes  de  los  Estados  Unidos  j 
México,  y  de  la  necesidad  de  adoptarse  medidas  preventivas  para  el 
año  entrante,  sería  muy  difícil  para  los  delegados  de  estas  dos  repú- 
blicas ausentarse  de  ellas;  por  lo  cual,  la  Oficina  Sanitaria  Interna- 
cional, con  la  cortés  conformidad  de  las  autoridades  cliilenas,  acordó 
el  aplazamiento  y,  finalmente,  fijó  esta  fecha  y  esta  ciudad  para  la 
presente  Conferencia. 

Los  buenos  resultados  de  la  primera  se  han  puesto  de  manifiesto  en 
varias  maneras,  y  las  resoluciones  que  fueron  adoptadas  han  sido, 
ciertamente,  de  valor  para  las  autoridades  sanitarias  de  los  Estados 
Unidos,  y,  á  mi  juicio,  para  las  de  las  otras  repúblicas.  Voy  á  hacer 
un  repaso  de  estas  resoluciones,  que  son  siete,  dando  sus  títulos,  pero 
sin  dar  lectura  á  su  texto. 

Primera,  la  Convención  se  ha  de  regir  por  las  resoluciones  de  la  con 
f erencia  de  México ; 

Segunda,  resoluciones  relativas  al  tiempo  de  detención  y  desinfec 
ción  en  cuarentena; 

Tercera,  resoluciones  relativas  á  la  fiebre  amarilla,  mosquitos  y 
cuarentenas ;         v 

Cuarta,  resolución  relativa  á  la  distribución  geográfica  del  mos- 
quito de  la  fiebre  amarilla ; 

229 


230  SEGUNDA    CONFEKENCTA    SANITARIA    INTERNACIONAL. 

Quinta,  resolución  declarando  la  relación  entre  animales  inferiores, 
basura  y  enfermedades; 

Sexta,  resolución  relativa  á  la  fiebre  tifoidea  y  el  cólera,  c[ue  declara 
la  necesidad  de  desinfectar  las  defecaciones; 

Séptima,  resoluciones  relativas  á  la  Oficina  Sanitaria  Internacional, 
sus  funciones,  y  á  la  recaudación  de  un  fondo  para  su  uso. 

No  dudo  C[ue-los  buenos  resultados  de  la  Primera  Conferencia,  y  el 
efecto  provechoso  de  las  resoluciones  que  acabo  de  enumerar,  serán 
objeto  de  los  informes  y  comentarios  de  los  delegados  en  esta  Segunda 
Convención.  Citaré  aquí  un  ejemplo  ú  guisa  de  explicación:  Después 
de  la  epidemia  de  fiebre  amarilla  que  hubo  en  México  y  Texas  en  1903 
se  temió  mucho  c[ue  se  reprodujera  en  ambos  países  en  el  verano  y  el 
otoño  de  1904,  haciéndose  evidente  la  necesidad  de  que  se  adoptaran 
en  ambos  países  medidas  preventivas  similares  en  carácter  y  perfección. 
Por  medio  de  la  Conferencia  Sanitaria  Internacional  el  camino  estaba 
expedito  para  obtener  la  acción  combinada  de  las  autoridades  más 
altas  de  ambas  naciones.  Habiéndose  preparado  un  plan  de  opera- 
ciones en  la  Oficina  del  Servicio  de  Sanidad  Pública  y  Hospitales 
Marítimos,  extenso  en  la  forma  y  conciso  en  los  detalles,  aprobado 
por  el  Presidente  en  lo  tocante  á  los  gastos  del  fondo  votado,  por  el 
Secretario  del. Tesoro  en  lo  relativo  á  la  aplicación  del  fondo  y  al  objeto 
del  trabajo  que  se  había  de  emprender,  y  por  el  Secretario  de  Estado 
en  lo  que  se  refería  á  las  relaciones  con  una  república  vecina,  tuve  el 
honor  de  hacer  una  visita  en  enero  de  1904  á  nuestro  distinguido 
colega  el  Doctor  Licéaga,  presidente  de  la  Junta  Superior  de  Sanidad 
de  México.  Tuve  la  satisfacción  de  ver  c[ue  el  mismo  plan,  práctica- 
mente, tanto  en  el  fondo  como  en  la  forma,  había  sido  ya  proclamado 
por  las  autoridades  mexicanas,  y  no  hubo  dificultad  en  convenir  sobre 
una  acción  mancomunada  y  combinada.  El  Presidente  Díaz  mani- 
festó su  interés  y  aprobación.  Como  resultado  no  hubo  virtualmente 
fiebre  amarilla  en  ninguna  de  las  dos  repúblicas  durante  la  estación 
siguiente.  Los  delegados  de  ambos  países  harán,  indudablemente, 
una  descripción  de  los  métodos  empleados. 

Este  es  solamente  uno  de  los  muchos  casos  que  pudieran  citarse 
para  demostrar  lo  efectivo  que  puede  ser  el  trabajo  de  saneamiento 
cuando  es  llevado  á  cabo  mediante  la  amistosa  cooperación  entre  dos 
naciones,  cada  una  guiada  por  sentimientos  amistosos  y  el  deseo  de 
protejer  á  la  otra  tanto  como  á  sí  misma. 

El  plan  del  saneamiento  mediante  acuerdos  internacionales  es  una 
de  las  pruebas  de  que  todas  las  naciones  están  en  la  actualidad  en  las 
relaciones  más  íntimas  que  se  han  registrado  en  los  anales  de  la  his- 
toria dei  mundo.     Un  moderno  escritor  dijo: 

No  sólo  los  estrechos  se  han  abolido  de  hecho,  sino  que  también  atraviesan  el  ancho  Océano 
buques  de  pasaje  en  cinco  días,  y  pensamientos,  trasfonnados  en  palabras,  en  pocos 
segundos. 

En  donde  se  ha  demostrado  esto  más  palpablemente  es  en  la  guerra 
contra  las  enfermedades  infecciosas.  No  hace  sino  pocos  años  c[ue 
las  violentas  epidemias  de  fiebre  amarilla  pasaban  desapercibidas  en 
Cuba,  mientras  que  ahora  uno  ó  dos  casos  que  tuvieren  lugar  en  cual- 
quiera parte  del  litoral  de  nuestro  Hemisferio  Occidental  serían  notifi- 
cados inmediatamente  á  los  Estados  Unidos  y  á  otros  países.  Unos 
cuantos  casos  de  peste  bubónica  en  el  Oriente,  que  liace  pocos  años  no 
hubieran  recibido  atención  alguna,  son  notificados  y  publicados 
instantáneamente,  y  un  caso  de  cólera  ocurrido  á  bordo  de  un  buque  en 


SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL.  231 

el  Mediterráneo  queda  notificado  por  telégrafo  á  las  principales 
ciudades  del  mundo.  Son  frecuentes  los  congresos,  conicroncias  y 
convenciones  internacionales,  los  cuales  unen  á  las  naciones,  cual  una 
sola  familia,  en  la  lucha  contra  el  enemigo  común  de  la  humanidad. 
En  la  actualidad  se  habla  con  frecuencia  de  congresos  interna- 
cionales sobre  la  paz  y  tratados  de  arbitraje.  ¿Es  mucho  esperar, 
como  un  corolario,  ó  como  un  movimiento  paralelo,  que  se  consiga 
finalmente  la  cooperación  de  todas  las  naciones  para  el  exterminio 
de  las  enfermedades  contagiosas  ?  Bien  puede  considerarse  el  sanea- 
miento internacional  como  parte  inherente  de  la  evolución  para  la 
paz  universal.  Pudiera  ser  realizado  más  fácilmente  que  el  arbitraje 
absoluto,  ó  podría  ser  un  factor  importante  en  el  establecimiento 
de  éste.  Cierto  ex-presidente  de  la  República  Francesa,  en  la  aper- 
tura de  la  Conferencia  Higiénica  celebrada  en  París  en  1894,  expresó 
los  siguientes  sentimientos: 

Los  principios  internacionales  que  tuvieron  su  origen  en  el  laboratorio  y  que  tienen  su 
base  en  la  ciencia  son  los  únicos  que  unen  á  las  naciones  con  fuertes  lazos,  y  que  establecen 
leyes  equitativas  é  inmutables. 

Bien  podrían  tomar  en  consideración  este  principio  aquellos  que 
persiguen  la  consecución  de  la  paz  universal;  del  mismo  modo,  la 
responsabilidad  internacional  con  respecto  á  enfermedades  se  merece 
la  atención  de  los  que  se  interesan  por  el  desarrollo  del  derecho 
internacional.  Creo  que  las  obras  que  tratan  del  derecho  interna- 
cional no  hacen  mención  de  las  responsabilidades  de  un  gobierno  con 
respecto  á  otro  en  lo  tocante  á  la  salud  pública,  pero  ya  es  tiempo 
de  que  se  añada  un  capítulo  sobre  este  asunto. 

Dice  un  moderno  escritor: 

Parece  que  empieza  á  desarrollarse  en  las  naciones  una  conciencia  y  un  espíritu  de  justi- 
cia con  respecto  á  los  derechos  de  otras  naciones.  En  conjunto,  el  movimiento  hacia  la 
paz  es  otro  paso  hacia  el  logro  de  la  perfección  ideal  de  gobierno. 

El  pensamiento  del  autor  de  esta  cita  no  podría  explicarse  de 
mejor  modo  que  con  los  incidentes  relacionados  con  el  tratado  de  paz 
recientemente  firmado  en  Portsmouth. 

Con  este  sentimiento  creciente  de  armonía  y  fraternidad  entre  las 
naciones,  debería  desarrollarse  un  sentimiento  internacional  hacia  el 
saneamiento  y  la  supresión  de  enfermedadas.  Si,  como  Tolstoi  dice, 
el  único  sustituto  de  la  guerra  es  la  religión,  el  saneamiento  interna- 
cional debería  ser  un  arma  poderosa  en  manos  de  la  religión,  si,  en 
verdad,  no  pudiera  hacerse  en  sí  un  sustituto  de  la  guerra.  Induda- 
blemente proporcionaría  un  campo  en  donde  las  naciones  podrían 
encontrarse,  y  un  objeto  de  más  valor  que  la  guerra  para  el  gasto 
de  energía  y  dinero. 

Ya  he  manifestado  antes  algunos  de  estos  pensamientos,  pero  los 
he  considerado  particularmente  adecuados  para  la  presente  ocasión. 
Sólo  me  resta  expresar  la  esperanza  de  que  esta  Segunda  Convención 
será  fructífera  en  beneficios,  que  nos  acercará  más  íntimamente  y 
que  nos  hará  sentir  que  los  intereses  de  un  país  son  en  realidad  los 
de  los  otros,  más  especialmente  en  los  asuntos  relativos  á  la  salud 
pública. 

El  Presidente  (continuando).  Señores,  hállase  entre  nosotros  el 
distinguido  Secretario  de  Estado,  al  cual  tengo  el  placer  de  presentar 
para  que  les  dirija  unas  cuantas  palabras  de  bienvenida.  Tengo  el 
honor  de  presentarles  al  Honorable  Elihu  Root. 


232  SEGUNDA   CONFERENCIA   SANITARIA   INTERNACION.^L. 

DISCURSO   DE    BIENVENIDA   DEL   HONORABLE     SECRETARIO    DE    ESTADO 

ELIIIU    ROOT. 

Señor  Presidente,  Señores:  Es  para  mí  un  honor  y  un  placer 
darles  la  bienvenida  á  Washington  en  nombre  del  Gobierno  ae  los 
Estados  Unidos,  y  manifestarles  la  expresión  de  los  buenos  deseos  de 
nuestro  Gobierno  para  el  éxito  de  \n.iestras  deliberaciones. 

Es  objeto  de  sincera  satisfacción  por  parte  del  pueblo  de  los 
Estados  Unidos  el  que  el  suelo  de  nuestra  patria  sea  considerado 
como  un  lugar  propicio  para  las  obras  de  paz,  justicia  y  humanidad; 
el  que  la  atmósfera  que  aquí  se  respira  se  considere  beneficiosa  á  los 
sentimientos  benignos  de  los  habitantes  de  la  tierra.  Antes  que  á  la 
destrucción  de  vidas,  contribuiriamos  á  la  salvación  de  ellas.  No 
opino  que  tengamos  razón  para  creer  que  la  inteligencia  individual 
del  hombre  sea  más  poderosa  ahora  que  dos  mil  años  atrás;  pero  sí 
existen  razones  para  creer  que  el  desarrollo  de  organización  entre 
los  hombres  proporciona  actualmente  á  la  inteligencia  individual 
humana  una  plataforma  en  la  cual  puede  sostenerse  y  desde  la  cual 
puede  partir  hacia  la  consecución  de  resultados  que  eran  imposibles 
á  ios  hombres  de  las  edades  pasadas  aún  cuando  sus  mteligencias 
hayan  sido  poderosas.  Y  también  hay  motivos  para  creer  que  la 
inteligencia  humana  es  capaz  de  mucho  más  grandes  prendas  bajo  las 
influencias  magnéticas  de  asociación  con  otras  inteligencias  vivas 
para  los  mismos  intereses  y  que  persiguen  un  mismo  fin.  Es  mi 
sincero  deseo  que  Vds.  fomenten  la  gran  obra  de  elevar  el  nivel  desde 
el  cual  vosotros,  vuestros  semejantes  y  vuestros  sucesores  puedan 
tomar  nuevas  orientaciones  para  la  consumación  de  grandes  actos 
en  pro  de  la  humanidad;  que  sintáis  y  comuniquéis  esa  mfluencia 
magnética  que  tiende  á  estimular  la  actividad  eficaz  de  la  inteli- 
gencia humana. 

Á  mi  juicio  casi  todas  las  guerras,  controversias  y  rencores  entre 
las  naciones  han  resultado  de  la  falta  de  buena  inteligencia,  del 
malogro  de  los  habitantes  de  una  nación  de  entender  y  apreciar 
verdaderamente  á  los  de  otra  nación,  y  creo  que  el  verdadero  remedio 
é  impedimento  contra  controversias  nacionales  es  el  conocimiento, 
las  buenas  relaciones  personales  y  la  amistad  entre  los  individuos  de 
dos  países;  nada  mejor,  ciertamente,  puede  contribuir  á  las  buenas 
relaciones  que  deben  existir  entre  todos  los  pueblos  del  Hemisferio 
Occidental  que  el  hacer  que  se  conozcan  y  entiendan  unos  á  otros 
todos  los  hombres  que  representan,  como  Vds.,  esa  humanidad  que 
está  por  encima  de  todos  los  intereses  y  divisiones  nacionales. 

Tenéis  nuestros  mejores  deseos  y  les  damos  nuestras  gracias  por 
habernos  honrado  con  vuestra  presencia  en  el  interés  de  esa  humani- 
dad común  por  la  cual  nos  unimos  todos  en  nuestros  más  sinceros 
deseos  y  en  nuestras  más  fervientes  oraciones.     [Aplausos.] 

El  Presidente.  Como  es  bien  sabido,  el  Servicio  de  Sanidad 
Pública  y  Hospitales  Marítimos  es  una  oficina  que  está  bajo  el 
Departamento  del  Tesoro,  y  entre  nosotros  se  halla  esta  mañana  el 
Secretario  Interino  del  Tesoro,  á  quien  tengo  el  honor  de  presentarles, 
el  Honorable  Horace  A.  Taylor.     [Aplausos.] 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  283 

DISCURSO  DEL  HONORABLE  HORACE  A.  TAYLOR,  SECRETARIO  AUXILIAR 

DEL    TESORO. 

Señor  Presidente,  Señores  :  Como  jefe  interino  del  Departamento 
del  Tesoro,  del  cual,  como  ya  les  ha  dicho  el  Cirujano  General,  el 
Servicio  de  Sanidad  Pública  y  Hospitales  Marítimos  es  una  de  las 
principales  oficinas,  me  uno  al  Secretario  de  Estado,  quien  repre- 
senta al  Gobierno  en  general,  para  darles  una  cordial  bienvenida  á 
Washington. 

Constantemente  vienen  á  esta  capital,  como  muchos  de  Vds.  saben, 
gran  número  de  distinguidos  transeúntes,  ya  por  negocios  ó  bien  por 
vía  de  recreo,  y  desde  hace  algunos  años  esta  ciudad  ha  llegado  á  ser 
un  centro  popular  en  donde  muchas  asociaciones,  dedicadas  á  las 
diversas  actividades  de  la  vida,  celebran  sus  reuniones,  y  para  noso- 
tros es  siempre  un  placer  verles  aquí,  bien  sean  ciudadanos  de  nuestro 
propio  país,  ó  bien  de  otros,  como  ocurre  en  este  caso. 

FJspero,  señores,  que  la  Conferencia  que  vais  á  celebrar  dé  tan 
buenos  resultados  como  los  producidos  por  las  precedentes.  Vuestra 
Convención  no  es  tan  grande  como  muchas  de  las  que  se  celebran 
aquí,  pero  ninguna  persigue  fines  tan  elevados  como  los  que  Vds. 
aspiran  alcanzar.  Los  métodos  que  vais  á  discutir,  las  cuestiones 
que  se  presentarán  para  vuestro  estudio,  son  aquéllos  que  afectan 
los  más  altos  intereses  de  la  comunidad.  Nada  como  la  salud  es  tan 
caro  para  todo  hombre,  mujer,  ó  niño  de  cualquier  país,  y  Vds.  se 
hallan  aquí  á  causa  del  resultado  del  progreso  alcanzado  por  la 
ciencia  médica  durante  los  últimos  años.  No  se  hallan  Vds.  aquí 
para  considerar  cuestiones  sobre  enfermedades,  sino  para  tomar 
medidas  preventivas  contra  ellas,  y,  ciertamente,  sábemeos  todos 
que,  según  reza  el  antiguo  adagio,  una  onza  de  precaución  equivale 
á  una  libra  de  remedio.  Así  pues  me  alegro  de  saber  que  el  mundo 
médico  y  que  los  hombres  eminentes  de  la  profesión,  como  los  caba- 
lleros aquí  presentes  son,  dirigen  su  atención,  no  tanto  á  la  curación 
de  las  personas  una  vez  enfermas,  como  á  impedir  que  se  enfermen. 

Como  el  Secretario  Root  dijo,  grandes  son  los  resultados  que 
emanan  de  la  organización.  La  organización  y  la  asociación  y  la 
discusión  y  el  debate  son  los  agentes  más  eficaces  del  mundo.  La 
paralización  es  siempre  el  enemigo  del  progreso,  así  como  en  el  mundo 
natural  es  una  amenaza  á  la  existencia  sana.  En  la  naturaleza  y 
en  la  sociedad,  en  el  gobierno  y  en  el  comercio,  en  las  ciencias,  pro- 
fesiones y  demás  actividades  de  la  vida,  es  la  discusión  la  que  aporta 
reformas  y  seguridad.  Dicen,  Señor  Presidente,  que  solamente  hay  un 
mar  en  el  mundo  cuyas  olas  nunca  se  rompen  en  las  plaj'as;  es  el 
Mar  Muerto.  Sus  aguas  están  siempre  tranquilas,  y  allí  encontraréis 
paralización  é  infección.  Á  la  tempestad,  á  los  truenos  y  relámpagos, 
y  al  vendaval  suceden  el  aire  puro,  la  luz  del  sol  y  el  canto  de  los 
pájaros. 

Deseo  expresarles  mi  agradecimiento  por  la  selección  de  uno  de 
los  preeminentes  funcionarios  del  Departamento  de  Tesoro,  el  Cirujano 
General  Wyman,  para  el  alto  y  honroso  cargo  de  Presidente  de  esta 
Asociación.  Bien  se  merece  la  distinción,  porque  los  que  le  conocen 
oficial  y  personalmente  saben  que  siempre  está  alerta  para  cualquier 
movimiento  que  tenga  por  objeto  el  acrecentamiento  de  la  salud 
pública  [aplausos],  y,  como  Vds.  saben,  cuando  una  parte  de  nuestra 
nación  fué  azotada  por  una  epidemia  de  fiebre  amarilla,  sus  esfuerzos 
para  suprimirla  fueron  coronados  con  notable  éxito. 


234  SEGUNDA    CONFERENCIA   SANITARIA    INTERNACIONAL'. 

Nos  alegramos  de  verles  entre  nosotros  y  esperamos  que  lo  pasarán 
divertidamente.  Les  aseguro  que  nuestros  ciudadanos  les  acojerán 
con  la  más  cordial  hospitalidad  y  los  mejores  deseos,  y  todos  se  unirán 
á  mí  al  expresar  la  esperanza  de  que  vuestras  deliberaciones  tendrán 
como  resultado  la  adopción  de  métodos  y  el  establecimiento  de  prin- 
cipios que  cuando  se  pongan  en  vigor  sean  de  grande  provecho  para 
la  salud  pública  de  las  naciones  y  comunidades  que  Vds.  representan. 
[Aplausos.] 

El  Presidente.  El  Secretario  de  Estado  y  el  Secretario  Interino 
del  Tesoro  han  creído,  parece  ser,  que  podrían  marcharse  una  vez  pro- 
nunciados sus  discursos.  Deseo  manisfestar,  en  beneficio  del  siguiente 
orador,  que  desearíamos  mucho  que  se  quede,  y  tengo  la  seguridad  que 
Vds.  estarán  conformes  conmio-o  cuando  sepan  quién  és.  Tenemos 
entre  nosotros  á  uno  de  los  miembros  de  la  Junta  Directiva  de  la 
Oficina  de  las  Repúblicas  Americanas,  el  cual,  en  nombre  de  tan 
eficaz  y  útil  entidad,  nos  dirigirá  la  palabra.  Me  refiero  al  Hono- 
rable Gonzalo  de  Quesada,  ministro  de  Cuba  en  los  Estados  Unidos, 
y  tengo  el  sumo  placer  de  presentarle  á  Vds. 

DISCURSO    DEL    MINISTRO    QUESADA,  DE    CUBA. 

Señor  Presidente,  Señores  y  caballeros  de  la  Segunda  Convención 
Sanitaria  Panamericana:  Doy  mis  más  sinceras  gracias  á  vuestro 
Presidente  por  la  oportunidad  que  me  ha  dado  para  dirigir  unas 
cuantas  palabras  á  los  delegados  del  Segundo  Congreso  Panameri- 
cano, en  nombre  de  la  Junta  de  Gobierno  de  la  Oficina  de  las  Repú- 
blicas Americanas.  De  este  mismo  privilegio  gocé  hace  dos  años 
cuando  Vds.  se  reunieron  por  la  primera  vez,  y  las  profecías  entonces 
hechas  con  respecto  al  resultado  de  los  trabajos  que  Vds.  iniciaron 
se  han  visto  cumplidas  en  gratas  realidades.  Han  unido  Vds.  á  las 
naciones  que  representan,  en  el  más  laudable  y  sincero  espíritu  de 
respeto  y  confianza  mutuos,  mediante  el  mejor  conocimiento  de  sus 
condiciones  sanitarias  é  inteligencia  entre  sus  respectivas  juntas  de 
sanidad,  y  por  la  tolerancia  y  simpatía  en  el  esfuerzo  común. 

En  el  pasado  quizás  habría  habido'  desconfianza  en  los  métodos 
adoptados  por  las  distintas  naciones,  ó  un  amor  propio  que  no  era 
conducente  para  las  altas  miras  de  los  hombres  de  ciencia;  hoy  en 
día  existe  colaboración  y  amistad  entre  los  distinguidos  médicos  en 
cuyas  manos  se  halla  encomendado  el  cuidado  de  las  vidas  é  intereses 
de  estas  comunidades  libres. 

Si  este  fuera  el  único  resultado  de  la  feliz  idea  de  estas  conferen- 
cias, por  sí  sólo  constituiría  una  gloria  para  los  que  las  propusieron  y 
para  los  que  han  puesto  sus  inspiraciones  en  práctica  fecunda. 

Pero  se  ha  conseguido  más;  el  canje  de  las  diferencias  leales  de 
opinión,  su  discusión  minuciosa  y  la  subsiguiente  publicación  que 
se  dá  á  vuestros  documentos  y  trabajos,  han  contribuido  induda- 
blemente á  la  propagación  de  medidas  científicas  sanitarias  y  á  la 
verdadera  adopción  de  los  métodos  profilácticos  y  preventivos  que 
Vds.  han  recomendado. 

En  este  respecto  tenemos  motivos  para  alabaros  calurosamente. 
La  sabia  dirección  de  algunos  de  los  miembros  presentes  en  esta 
Conferencia  ha  originado  cambios  dignos  del  más  cordial  encomio, 
y  tengo  la  seguridad  que  seré  eco  de  los  sentimientos  de  todos  los 
presentes,  con  el  mismo  entusiasmo  que  demostrasteis  antes  por  mí 


SEGUNDA    CONFERENCIA    SANITAKTA    INTERNACIONAL,  235 

país  natal,  cuando  felicito  á  los  representantes  de  Méjico  que  han 
adelantado  tanto,  desde  nuestra  última  reunión,  (!n  el  (íxtenninio 
de  la  íiel)re  amarilla  en  osa  progresiva  y  amada  República,  nuestra 
hermana.     [Aplausos.] 

Y  las  teorías  que  Vds.  sustentan  no  sólo  han  sido  probadas  allí  y 
en  otros  sitios,  sino  también,  durante  los  últimos  meses,  en  algunos 
puntos  de  los  Estados  del  Sur  de  esta  Unión,  con  cuyos  sufrimientos 
nuestros  corazones  están  de  unísono.  Hacemos  votos  por  que  en 
breve  dejen  de  ser  motivo  de  preocupación.  Pero  aún  dentro  de 
este  infortunio  podemos  encontrar  consuelo  fines  útiles,  porque,  no 
solamente  se  han  probado  y  han  resultado  ser  ciertas  las  teorías  que 
sustentáis,  y  se  están  haciendo  importantes  investigaciones  por 
cientíñcos  americanos,  las  cuales  esperamos  que  contribuirán  á 
ampliar  nuestro  conocimiento  de  la  enfermedad,  sino  que  también 
hemos  visto  la  edificante  presencia  de  médicos  de  otros  países  que 
han  venido  á  compartir  con  Vds.  las  dificultades  de  la  lucha  y  á 
ayudarles  en  la  grandiosa  obra  emprendida  por  vuestras  autoridades, 
de  las  cuales  nuestro  presidente  es  el  ilustre  jefe.  Lo  expuesto  es  un 
ejemplo  del  verdadero  interés  humano,  que  si  fuera  observado  en 
otras  fases  de  relaciones  internacionales  contribuiría  á  la  consumación 
del  supremo  ideal  de  la  humanidad,  la  fraternidad  universal. 

Señores,  con  ese  espíritu  y  bajo  el  siempre  vencedor  estandarte  de 
la  ciencia,  que  no  conoce  fronteras,  razas,  nacionalidades,  ni  tiempo, 
pero  que  sólo  tiene  por  adversarios  la  ignorancia  y  el  error,  demos 
comienzo  á  esta  Segunda  Conferencia  Panamericana,  asegurados  de 
antemano  que  sólo  puede  tener  un  fin— la  observancia  de  la  verdad 
y  el  progreso  del  bienestar  de  la  humanidad.     [Aplausos.] 

El  Presidente.  Ruego  al  Doctor  Ulloa,  de  Costa  Rica,  que  actúe 
como  secretario  temporal  de  esta  Convención,  así  como  también  le 
suplico  que  lea  la  lista  de  las  Repúblicas,  y  cada  vez  que  se  lea  el 
nombre  de  una  República  les  agradeceré  que  sus  delegados,  ó  uno  de 
ellos,  se  levanten,  den  sus  nombres  y  sus  tarjetas  al  secretario,  con 
sus  credenciales,  las  cuales  se  entregarán  á  la  junta  consultiva. 

El  Director  de  la  Oficina  de  las  Repúblicas  Americanas  me  ha 
dicho  que  aquí  tenemos  un  libro  en  el  cual  se  les  ruega  que  firmen 
sus  nombres  cuando  estén  desocupados. 

(Esté  mismo  ruego  y  aviso  fué  hecho  en  castellano  por  el  Doctor 
Ulloa.) 

Antes  de  comenzarse  la  lectura  de  la  lista,  me  tomo  el  privilegio 
de  invitar  á  que  asista  á  esta  reunión  un  distinguido  representante 
del  Japón,  que  se  halla  aquí  presente  y  está  interesado  en  esta  obra; 
deseo  presentarles  al  Doctor  Suzuki,  cirujano  general  de  la  marina 
japonesa.     [Aplausos.] 

El  Secretario  Interino  leyó  la  lista,  estando  presentes  los  siguientes 
delegados : 

La  República  de  Chile:  Dr.  Eduardo  Moore. 

La  República  de  Costa  Rica:  Dr.  Juan  J.  Ulloa. 

La  República  de  Cuba:  Dr.  Juan  Guiteras  y  el  Dr.  Enrique  B. 
Barnet. 

La  República  del  Ecuador:  Dr.  Serafín  S.  Wliither  y  el  Dr.  ^liguel 
H.  Alcivar. 

La  República  de  los  Estados  Unidos,  Dr.  Walter  Wvman,  Dr.  H.  D. 
Geddings,  Dr.  J.  F.  Kennedy,  Dr.  John  S.  Fulton,  Dr.  Walter  D. 
McCaw,  Dr.  J.  D.  Gatewood,  Dr.  H.  L.  E.  Johnson. 


236  SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL. 

La  República  de  Guatemala:  Dr.  Joaquín  Yela. 

La  República  de  Méjico:  Dr.  Eduardo  Licéaga. 

La  República  de  Nicaragua:  Dr.  J.  L.  Medina. 

La  República  del  Perú:  Dr.  Daniel  Eduardo  Lavorería. 

La  República  de  Santo  Domingo:  Sr.  Don  Emilio  C.  Joubert. 

La  República  del  UrugTiay:  Sr.  Don  P.  Requena  Bermudez 

La  República  de  Venezuela:  Sr.  Don  Nicolás  Veloz-Goiticoa. 

El  Presidente.  Señores,  hállase  entre  nosotros  uno  que  contribuyó 
al  éxito  de  nuestra  última  conferencia,  cuyo  interés  en  ella  fué  muy 
marcado  y  cu37"a  capacidad  en  la  dirección  de  conferencias  de  esta 
clase  ha  sido  demostrada  en  varias  ocasiones,  y  que  se  está  de  nuestra 
parte,  con  el  alma  y  el  corazón,  en  nuestro  esfuerzo  para  hacer  de  ésta 
una  convención  eficaz.  Me  refiero  al  recien  nombrado  Director  de  la 
Oficina  de  las  Repúblicas  Americanas,  Señor  W.  C.  Fox,  á  quien  tengo 
el  honor  de  presentarles.     [Aplausos.] 

ALOCUCIÓN  DEL  HONORABLE   AV.    C.    FOX,   DIRECTOR  DE  LA  OFICINA  DE 
LAS    REPÚBLICAS    AMERICANAS. 

Señor  Presidente.  Señores:  Aprecio  profundamente  el  alto  honor 
que  se  me  confiere  al  llamárseme  en  esta  ocasión. 

Gracias  á  la  tolerancia  de  los  honorables  representantes  de  la 
L^nión  Internacional  de  las  Repúblicas  Americanas,  desempeño,  por 
ahora,  las  funciones  de  Director  de  la  Oficina  Internacional  de  las 
Repúblicas  Americanas. 

En  tanto  que  aparentemente  los  lazos  que  atan  esta  Lünión  son  de 
un  tejido  tan  fino  y  delicado  que  uno  creería  que  el  más  mínimo 
elemento  de  discordia  los  rompería,  el  mero  hecho  de  su  existencia 
bajo  estas  circunstancias  es  una  prueba  de  su  consistencia. 

Si  es  exacto  mi  modo  de  entender  la  razón  de  ser  de  una  Unión 
Internacional  de  Repúblicas  Americanas,  diré  que  no  es  la  de  establecer 
armonía,  sino  que  la  Unión  existe  porqiie  hay  armonía.  Esta  armo- 
nía es  un  hecho  porque  los  distinguidos  hombres  que  rigen  los  destinos 
de  las  varias  Repúblicas  están  de  mutuo  acuerdo;  y  creo,  sin  temor  á 
contradecirme,  que  esta  Unión  tiene  el  sostén  de  la  inteligencia,  del 
fuerte  brazo  y  del  valeroso  corazón  del  Presidente  de  los  Estados 
Unidos. 

Señores,  nos  hemos  reunido  aquí  para  demostrar  una  vez  más 
nuestra  fidelidad  y  lealtad  á  los  intereses  del  Continente  Americano. 
Hallámonos  aquí  para  realizar  en  parte  los  mandatos  de  la  Primera 
Conferencia  Internacional  de  las  Repúblicas  Americanas,  celebrada 
en  esta  ciudad  en  1889,  y  los  de  la  Segunda  Conferencia  Americana 
que  tuvo  lugar  en  Méjico  en  1901.  Ya  nos  hemos  reunido  hace  dos 
años,  y  ahora  estamos  forjando  otro  eslabón  para  la  cadena  que  une  á 
las  Repúblicas  Americanas  tan  fuertemente. 

No  creo  que  puedo  añadir  una  palabra  más  á  lo  que  ya  se  ha 
dicho,  sólo  me  resta  decirles  que  es  mi  deber  poner  en  vuestro  cono- 
cimiento lo  que  modestamente  hemos  tratado  de  hacer  para  vuestra 
comodidad  y  recreo  durante  el  tiempo  c{ue  permanezcáis  en  Washing- 
ton; con  vuestro  permiso,  pues,  leeré  el  programa. 

Se  servirá  un  almuerzo  hoy,  y  un  día  sí  y  otro  nó,  durante  las 
sesiones  de  la  Convención,  al  cual  se  les  invita  cordialmente. 


SEGUNDA    CONFEEENCIA   SANITARIA   INTERNACIONAI^.  '¿'-jI 

Esta  tarde  á  las  3.30  nos  reuniremos  aquí  para  tomar  un  auto- 
móvil con  el  fin  de  ir  á  ver  la  nueva  maquinaria  de  destilación  del 
servicio  de  aguas  de  esta  ciudad. 

El  miércoles,  11  de  octubre,  gracias  á  la  cortesía  del  Secretario  del 
Tesoro,  se  verificará  una  excursión  en  una  lancha  del  resguardo  por 
el  Río  Potomac.  La  comitiva  irá  á  Indian  IToad  y  Mount  Vernon, 
retornando  á  la  capital  antes  de  que  anocluízca. 

A  mi  juicio  lo  mejor  es  reunimos  todos  íu\üí  á  las  9.30  de  la 
mañana  y  de  aquí  irnos  juntos  al  muelle  en  donde  nos  estará  espe- 
rando la  lancha. 

La  Dirección  de  la  Convención  de  Banqueros,  que  se  celebra 
simultáneamente  á  la  nuestra,  ha  enviado  corteses  invitaciones  á 
los  delegados  para  la  recepción  que  se  celebrará  en  la  Corcoran  Gallery 
of  Art  en  la  noche  del  miércoles,  y  para  la  recepción  general,  que  se 
celebrará  en  este  hotel  en  la  noche  del  viernes  próximo. 

Dr.  ri.  L.  E.  Johnson.  Señor  Presidente,  pido  que  se  hagan  exten- 
sivas las  prerrogativas  de  la  Convención  á  los  siguientes  médicos  y 
otros : 

Dr.  George  M.  Kober,  Washington,  D.  C. 

Cirujano  Preston  H.  Bailhache,  Servicio  de  Sanidad  Pública  y 
Hospitales  Marítimos. 

Dr.  Peid  Hunt,  farmacólogo,  Servicio  de  Sanidad  Pública  y  Hos- 
pitales Marítimos. 

El  presidente  de  la  Escuela  Médica  Naval,  Washington,  D.  C. 

El  presidente  de  la  Escuela  Médica  Militar,  Washington,  D.  C. 

El  Cirujano  General  de  la  Armada  de  los  Estados  Unidos. 

El  Cirujano  General  del  Ejército  de  los  Estados  Unidos. 

El  Cirujano  General  George  M.  Sternberg,  Ejército  de  los  Estados 
Unidos  (retirado). 

Dr.  Ch.  Wardell  Stiles,  zoólogo,  Servicio  de  Sanidad  Pública  y 
Hospitales  Marítimos. 

Dr.  William  C.  Woodward,  funcionario  de  sanidad  del  Distrito 
de  Columbia. 

El  Cirujano  General  Suzuki  de  la  Armada  Imperial  Japonesa. 

Profesor  H.  C,  Wood,  Filadelfia,  Pennsylvania. 

La  petición  fué  secundada  y,  una  vez  discutida,  fué  unanimamente 
aprobada. 

El  Presidente.  Para  esta  tarde  tenemos  una  invitación  para 
inspeccionar  la  maquinaria  de  destilación  de  Washington.  Creo  que 
bien  valdrá  la  pena  de  ir  á  visitarla,  pues  es  una  maquinaria  para 
purificar  el  agua  del  Río  Potomac  para  beber,  y  es  una  de  las  instala- 
ciones más  modernas  en  su  clase.  Partiremos  á  las  3.30  como  nos 
ha  dicho  Mr.  Fox,  en  automóviles,  del  New  Willard  Hotel. 

Lo  único  que  queda  por  hacerse,  por  lo  que  veo  y  lo  que  creo  son 
vuestros  deseos,  es  nombrar  una  comisión  de  organización  para  que 
decida  la  forma  en  que  se  ha  de  dirigir  la  presente  Convención,  y  si 
alguno  de  los  señores  desea  pedir  que  se  nombre  dicha  comisión 
someteré  la  petición,  y  la  comisión  podrá  preparar  su  informe  entre 
hoy  y  la  reunión  de  mañana  por  la  mañana. 

Dr.  H.  L.  E.  Johnson.  Pido  que  el  Presidente  nombre  dicha 
comisión. 

La  petición  fué  numerosamente  secundada,  y  una  vez  discutida, 
aprobada. 


238  SEGUNDA    CONFERENCIA   SANITAKIA    INTERNACIONAL. 

El  Presidente.  Nombro,  como  miembros  de  dicha  comisión,  al 
Doctor  Licéaga,  de  Méjico,  al  Doctor  Moore,  de  Chile,  al  Cirujano 
General  Auxiliar  Geddings,  del  Servicio  de  Sanidad  Pública  y  Hospi- 
tales Marítimos,  y  al  Comandante  McCaw,  del  Ejército;  y  ruego  á 
estos  señores  que  se  queden  después  que  se  levante  la  sesión. 

Doctor  GuiTERAS.  Señor  Presidente,  pido  que  se  nombre  al  Dr. 
Juan  J.  Ulloa  secretario  de  esta  Convención. 

Varios  Delegados.  Apoyo  la  petición. 

La  -cuestión  ñié  discutida  y  el  Doctor.Ulloa  quedó  elegido  secretario. 

El  Presidente.  Deseo  añadir  el  Doctor  Guiteras  á  la  comisión  de 
organización,  haciendo  un  total  de  cinco  miembros. 

Con  esto  queda  terminado  el  programa  de  esta  mañana,  pero  si 
algún  delegado  desea  someter  algún  asunto  á  la  consideración  de  la 
Convención  nos  alegraremos  que  así  lo  haga. 

Doctor  Guiteras.  Propongo  que  se  suspenda  la  sesión  hasta  las  10 
del  día  de  mañana. 

Se  aprobó  la  propuesta  después  de  discutida.  * 


SEGUNDO  día— MARTES,  10  DE  OCTUBRE. 

Sesión  de  la  mañana. 

Bajo  la  presidencia  del  Dr.  Eduardo  Moore,  se  declaró  abierta  la 
sesión  á  las  10.20  de  la  mañana. 

Doctor  MooiiE.  Como  Presidente  de  la  junta  consultora  declaro 
abierta  la  sesión  y  ruego  al  Doctor  Ulloa  que  dé  lectura  á  las  resolu- 
ciones adoptadas  por  la  comisión  nombrada  ayer. 

Las  resoluciones  fueron  Jeídas  por  el  secretario  y  son  como  sigue : 

(1)  Se  resuelve,  Que  el  nombre  del  Cirujano  General  Wyman  sea  propuesto  á  esta  Conven- 
ción para  Presidente  de  ella,  el  del  Dr.  Eduardo  Licéaga  para  Presidente  de  la  próxima  Con- 
vención y  el  del  Dr.  Juan  J.  Ulloa  para  secretario  permanente. 

(2)  Se  resuelve,  Que  estas  Conferencias  se  celebren  cada  dos  años. 

(3)  Se  resuelve.  Que  la  próxima  Convención  se  celebre  en  la  Ciudad  de  México  en  diciembre 
de  1907,  á  convocatoria  de  la  Oficina  Sanitaria  Internacional. 

(4)  Se  resuelve,  Que  tan  pronto  como  se  complete  la  organización,  el  Presidente  conceda 
la  palabra  al  Dr.  Eduardo  Licéaga  para  que  lea  una  memoria  de  interés  general. 

(5)  Se  resuelve.  Que  la  comisión  proponga  que  los  informes  de  las  Repúblicas  que  sean 
muy  extensos  se  presenten  á  la  Convención  en  forma  extractada.  Dichos  informes  se  publi- 
carán, en  toda  su  extensión,  con  los  trabajos  de  la  Convención. 

Doctor  GuiTERAS.  Señor  Presidente,  propongo  que  estas  resolu- 
ciones sean  discutidas  una  por  una  y  sometidas  á  la  Convención  por 
separado. 

La  propuesta  fué  secundada. 

Se  discutió  el  asunto  y  la  propuesta  fué  aprobada. 

El  Secretario.  La  primera  resolución  es  como  sigue : 

Se  resuelve,  Que  el  nombre  del  Cirujano  General  Wyman  sea  propuesto  á  esta  Convención 
para  Presidente  de  ella,  el  del  Dr.  Eduardo  Licéaga  para  Presidente  de  la  próxima  Conven- 
ción y  el  del  Dr.  Juan  J.  Ulloa  para  secretario  permanente. 

Doctor  GuiTERAS.  Pido  que  esta  resolución  sea  adoptada. 

Esta  propuesta  fué  apoyada. 

Se  discutió  el  asunto  y  quedó  aprobada  la  resolución. 

Entonces  el  Cirujano  General  Wyman  tomó  posesión  de  la  silla 
presidencial. 

El  Presidente.  Deseo  darles  las  gracias  por  este  honor  que  me  con- 
fieren de  nuevo.  Personalmente,  hubiera  deseado  mejor  que  la 
elección  hubiere  recaído  en  otro  delegado  y  se  le  hubiere  dado  este 
honor  en  la  presente  Convención.  Parece,  sin  embargo,  que  el  que 
preside  debe  ser  un  ciudadano  del  país  en  don  de  se  celebra  la  Conven- 
ción, y  por  cuanto,  naturalmente,  tiene  á  su  cargo  la  preparación 
de  las  reuniones,  y  está  más  íntimamente  relacionado  con  los  detalles 
del  programa  que  otros  pudieran  estarlo,  por  estas  razones,  tengo  la 
satisfacción  de  aceptar  este  alto  honor  con  que  Vds.  me  vuelven  á 
investir. 

La  segunda  resolución  es : 

Se  resuelve,  Que  las  Conferencias  se  celebren  cada  dos  años 

¿Están  Vds,  dispuestos  para  la  discusión? 

Se  discutió  el  asunto  y  la  resolución  fué  adoptada. 

^  239 


240  SEGUNDA    COKFEREJSTCIA    SANIT.-UíIA    INTERNACIONAL. 

El  PREsroENTE.  La  tercera  resolución  es: 

Se  resuelve,  Que  la  próxima  Convención  se  celebre  en  la  Ciudad  de  México  en  diciembre 
de  1907,  á  convocatoria  de  la  Oficina  Sanitaria  Internacional.  ^ 

i  Existe  alguna  objeción  contra  ésta  ?    Si  no,  votemos  su  aprobación. 

El  asunto  fué  discutido  y  la  resolución  aprobada. 

Aquí. el  Doctor  Licéaga  hizo  uso  de  la  palabra  dando  gracias  á  la 
Convención  por  el  honor  que  se  hacía  á  su  nación  al  acordarse  la 
celebración  de  la  siguiente  Conferencia  Sanitaria  en  la  Ciudad  de 
México.  Expresó  el  sumo  placer  que  esta  solución  del  asunto  le 
proporcionaba,  porque  el  Segundo  Congreso  Panamericano  se  celebró 
en  la  Ciudad  de  México,  en  el  cual  se  adoptaron  varias  resoluciones, 
una  de  las  cuales  fué  sobre  la  celebración  del  Congreso  Sanitario 
Internacional.  Manifestó  su  agradecimiento  por  la  cortesía,  y  sus 
deseos  de  que  el  éxito  de  esta  Convención  tendería  á  reforzar  los  lazos 
que  unen  á  los  países  de  este  continente.  Habló  en  términos  muy 
encomiásticos  de  los  modernos  métodos  para  unir  las  naciones  y 
juntarlas  en  asuntos  intelectuales,  sociales  y  morales,  los  cuales  en 
su  opinión  son  los  medios  más  eficaces  para  la  consecución  de  los 
fines  que  las  más  altas  aspiraciones  de  las  naciones  desean  alcanzar. 

El  Presidente.  Leeré  la  quinta  resolución  antes  que  la  cuarta: 

Se  res'ielce,  Que  la  Comisión  proponga  que  los  informes  de  las  repúblicas  que  sean  muy 
extensos  se  presenten  á  la  Convención  en  forma  extractada.  Dichos  informes  se  publicarán, 
en  toda  su  extensión,  aon  los  trabajos  de  la  Convención. 

Esta  resolución  fué  aprobada  después  de  ser  discutida. 
El  Presidente.  La  cuarta  resolución  es : 

Se  resuelve,  Que  tan  pronto  como  se  complete  la  organización,  el  Presidente  conceda  la 
palabra  al  Dr.  Eduardo  Licéaga  para  que  lea  una  memoria  de  interés  general. 

Después  de  discutida  fué  aprobada  esta  resolución. 

El  í*RESiDENTE.  La  resolucióu  ha  sido  aprobada.  Oigamos  ahora 
al  Doctor  Licéaga. 

El  Doctor  Licéaga  leyó  la  memoria  de  referencia  en  castellano. 
O'^éase  el  Apéndice,  pág.  329.) 

El  Presidente.  Señores,  acabáis  de  oir  este  interesante  docu- 
mento del  Doctor  Licéaga,  y  ahora  queda  abierto  el  asunto  para  su 
discusión.  Nos  alegraremos  mucho  de  oir  al  delegado  que  desee 
hablar  sobre  la  cuestión. 

Diré  además  que,  con  la  aprobación  del  Doctor  Licéaga,  esta 
memoria,  después  de  ser  discutida,  se  someterá  á  la  consideración 
de  la  junta  consultora,  la  cual  la  estudiará  detalladamente,  la  comen- 
tará y  la  presentará  de  nuevo  á  la  Convención.  Este  fué  el  proce- 
dimiento que  se  siguió  el  año  pasado,  y  supongo  que  todos  convendrán 
en  qiie  sea  el  mismo  para  este  año;  pero  cj[uisieramos  por  ahora  oir 
observaciones,  sin  que  se  emitan  votos  ni  se  acuerden  resoluciones. 
Quisiéramos  oir  las  observaciones  del  delegado  que  deseare  expresar 
sus  opiniones  sobre  el  tema. 

Doctor  GuiTERAS.  En  vista  de  que  Vds.  desean  oir  una  opinión 
sobre  el  asunto  en  cuestión,  diré  que  nuestro  colega  de  México, 
indudablemente,  tiene  razón  al  declarar  que  deberíamos  empezar 
tan  pronto  como  sea  posible  y  dedicarnos  á  preparar  y  terminar  los 
reglamentos  sanitarios  que  rijan  uniformemente  en  el  Hemisferio 
Occidental.  Este  es,  en  verdad,  el  objeto  por  que  estamos  aquí.  Al 
mismo  tiempo,  me  parece  que  actualmente  no  estamos  bien  prepara- 
dos para  emprender  esa  obra.     Opino  que  podremos  prepararnos 


SEGUNDA    CONl^EKENCIA    SANITAKIA    INTERNACIONAL.  241 

para  ella  durante  el  año  próximo.  Debíamos  haber  presentado  ante 
esta  Convención,  creo  yo,  una  especie  de  plan  de  organización  ó  un 
reglamento  de  ese  género.  A  mi  juicio  podemos  tomar  una  deter- 
minación en  la  actual  Convención  en  este  respecto;  podríamos  dar 
instrucciones  á  la  comisión  de  organización  para  someter  á  los  repre- 
sentantes de  las  varias  repúblicas  en  esta  Convención  un  V)Osquejo  del 
plan  de  un  convenio  de  esa  clase  entre  los  distintos  gobicírnos,  y,  una 
vez  presentado  dicho  plan,  tendríamos  un  año  para  estudiarlo,  y  de 
este  modo,  cuando  fuéramos  á  México  para  la  próxima  conferencia, 
estaríamos  preparados  y  dispuestos  á  hacer  el  convenio. 

Aquí  el  Doctor  Licéaga  hizo  uso  de  la  palabra. 

(El  Señor  Guiteras  repitió  en  castellano  las  observaciones  que  hizo 
en  inglés.) 

Doctor  Guiteras.  El  Doctor  Licéaga  ha  dicho  que  se  opone  á  mis 
observaciones.  Declara  que  parece  ser  que  no  he  entendido  lo  que 
él  ha  propuesto.  No  cree  que  estemos  dispuestos  á  llegar  á  una  con- 
clusión muy  definitiva  ó  á  establecer  una  convención  sanitaria 
positivamente  científica;  pero  cree  que  debiéramos  dar  más  vigor 
á  los  acuerdos  tomados  en  la  última  conferencia,  y  los  que  tomemos 
en  la  presente.  Según  él,  aparentemente  tienen  su  base  en  el  aire, 
pero  no  se  han  puesto  en  vigor  á  pesar  de  que  les  hemos  aceptado, 
y  cree  que  debemos  darles  valor  y  peso  en  alguna  manera. 

^\  Presidente.  Deseo  hacer  constar  que  las  resoluciones  adoptadas 
en  la  última  Convención  han  sido  puestas  en  práctica  en  los  Estados 
Unidos  por  el  Servicio  de  Sanidad  Pública  y  Hospitales  Marítimos. 
No  puedo  decir  que  lo  hayan  sido  en  todos  los  Estados  de  la  Unión, 
pero  nos  hemos  ceñido  á  ellas  tan  fielmente  como  hemos  podido.  Y 
en  este  respecto,  creo  que  sería  de  interés  oir  á  uno  de  los  delegados 
de  los  Estados  Unidos,  que  fué  miembro  de  la  Conferencia  Inter- 
nacional sobre  la  peste  bubónica,  celebrada  en  París  en  1903,  en  la  que 
se  tomó  un  acuerdo  por  el  estilo,  yo  creo,  del  que  el  Doctor  Licéaga 
tiene  ideado,  y  el  cual  ha  sido  puesto  en  forma  de  tratado  por  los 
distintos  países,  ó  por  un  número  de  ellos,  al  menos.  No  puedo  decir 
ahora  si  todas  las  naciones  que  enviaron  representantes  á  aquella  Con- 
ferencia han  hecho  ó  no  tratados  en  forma,  ó  firmado  este  tratado; 
los  Estados  Unidos  lo  han  hecho,  según  tengo  entendido. 

Deseo  rogar  al  Cirujano  General  Auxiliar  Geddings  que  haga  una 
breve  relación  de  aquella  Conferencia,  de  las  naciones  representadas 
en  ella,  del  sitio  en  que  fué  celebrada  y  de  la  determinación  final 
tomada  de  acuerdo  con  los  resultados. 

En  este  momento  el  Doctor  Licéaga  pidió  la  palabra  para  hacer 
una  breve  alocución.  Haciendo  referencia  á  lo  manifestado  por  el 
General  Wyman,  dijo  que  deseaba  expresar  la  grande  satisfacción 
que  tenía  al  reconocer  que  los  Estados  Unidos  han  observado  real- 
mente todas  las  resoluciones  adoptadas  en  la  anterior  conferencia 
sanitaria;  pero  indicó  que  los  Estados  Unidos  han  cumplido  con  las 
instrucciones  de  aquella  Convención  porque  quisieron  hacerlo;  que 
prefería  mucho  más  que  un  país  cumpla  con  los  requisitos  higiénicos 
adecuados  porque  está  obligado  á  hacerlo  y  no  porque  le  parezca 
conveniente  hacerlo,  diciendo  además  que  desearía  que  esos  requisitos 
se  observaran  en  la  forma  prescrita  por  las  resoluciones  acordadas  en 
la  conferencia  anterior. 
in2A— 06 16 


242  SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAL. 

Doctor  Geddings.  Señor  Presidente,  Señores:  Accediendo  al 
ruego  del  Presidente,  me  permitiré  describir,  tan  bien  como  mi 
memoria  me  lo  permita  y  tan  brevemente  como  lo  exige  la  ocasión, 
los  resultados  de  la  Conferencia  Sanitaria  Internacional  celebrada  en 
París  en  octubre  de  1903  hasta  diciembre  del  mismo  año. 

Esta  Convención  tuvo  por  objeto  especial  las  cuestiones  de  la 
peste  bubónica  y  el  cólera.  Los  miembros  de  dicha  conferencia 
hicieron  varias"  importantes  declaraciones.  Con  respecto  á  la  peste 
bubónica  sustentaron  la  atrevida  y  perfectamente  justificada  con- 
clusión de  que  dicha  peste  es  trasmisible  solamente  por  las  deyecciones 
y  deposiciones,  y  por  la  impregnación  de  artículos  y  viviendas  con  los 
excrementos  y  secreciones  de  los  atacados  por  la  peste;  que  las 
mercancías,  por  sí  mismas,  no  eran  susceptibles  de  trasmitir  la  peste, 
siendo  solamente  peligrosas  cuando  se  empleaban  como  vehículo 
para  animales  atacados,  ó  cuando  han  sido  impregnadas  con  las 
defecaciones  de  las  personas  atacadas  con  el  mal. 

La  misma  opinión  se  sustentó  con  respecto  al  cólera,  que  los  bu- 
ques, viviendas  ó  mercancías  son  solamente  peligrosos  con  respecto 
á  la  comunicabilidad  del  cólera,  cuando  han  sido  infestados  con  las 
de3''ecciones  de  los  que  han  estado  enfermos  de  dicho  mal. 

Aciuella  conferencia  contribu3^ó  eficazmente  á  la  abolición  de  hecho 
de  las  cuarentenas.  Clasificó  los  buques  en  tres  categorías,  á  saber, 
limpios,  sospechosos  é  infectados.  Entrar  en  detalles  sobre  las 
definiciones  de  estas  categorías  sería  una  larga  tarea;  sólo  diré  que 
las  restricciones  impuestas  á  lo  que  constituía  un  bucj^ue  sospechoso 
ó  infectado  son  mucho  más  leves  que  las  que  acostumbramos  á  imponer 
aquí  en  los  Estados  Unidos.  Las  medidas  de  cuarentena  adoptadas 
en  aquella  convención  serían  eficaces  si  pudieran  observarse  en  su 
totalidad;  pero  su  seguridad  depende  en  la  absoluta  integridad  de 
las  medidas  dirigidas  contra  un  mal  en  cuestión.  La  más  ligera 
equivocación,  el  más  insignificante  descuido,  la  más  mínima  omisión, 
producirían  probablemente  una  catástrofe.  En  consideración  á  este 
hecho,  los  Estados  Unidos  se  vieron  obligados  á  disentir  de  los  fallos 
de  la  Convención,  y  sus  representantes  firmaron  los  acuerdos  haciendo 
excepción  de  este  punto.  No  podemos,  de  acuerdo  con  nuestras 
leyes  j  nuestro  sistema,  reconocer  la  vigilancia  como  equivalente  á 
la  observación;  para  nosotros  la  vigilancia  significa  que  cuando  un 
buque  llega  con  pasajeros  que  se  sospecha  tienen  la  peste,  ó  que  la 
han  tenido,  y  con  personas  expuestas  á  la  infección,  se  permite  á 
dichos  pasajeros  que  vayan  á  sus  puntos  de  destino  quedando  sujetos 
á  la  vigilancia  de  las  autoridades  locales,  ú  obligados  á  presentarse 
ante  éstas  de  vez  en  cuando  hasta  que  el  período  de  la  incubación 
del  mal  ha  trascurrido.  En  la  observación,  según  la  entendemos, 
dirigimos  nuestras  medidas  contra  el  buque,  pero  detenemos  ai 
personal  y  lo  sujetamos  á  observación.  Los  delegados  de  los  Estados 
Unidos  disintieron  con  respecto  al  sistema  de  vigilancia,  fy  fií^maron 
los  resultados  de  la  Conferencia  sin  dar  su  conformidad  en  lo  tocante 
á  que  la  observación  debe  ser  sustituida  por  la  vigilancia.  En  lo 
que  se  relacionaba  con  la  fiebre  amarilla,  es  de  lamentar  que  la 
representación  del  Hemisferio  Occidental  quedara  limitada  á  los 
Estados  Unidos,  la  República  Argentina  y  al  Brasil.  Se  hizo  un 
marcado  esfuerzo  para  que  la  Conferencia  de  París  resolviera  defi- 
nitivamente la  cuestión  de  la  fiebre  amarilla.  Como  Vds.  recordarán, 
tuvo  lugar  hace  dos  años;  si  se  hubiera  celebrado  la  convención  hoy 


SEGUNDA    COISIFEliliJN'OIA.    tíANlTAKJA    INTEliJNAClOiS' AL.  24í5 

en  (lía  la  determinación  hubiera  sido  diferente,  pero  entonces  rehusó 
hacerlo  ó  formular  acuerdos  deíiniiivos  sobre  la  íiel>re  amarilla, 
contentándose  con  hacer  la  simple  declaración  de  que  en  el  asunto 
de  dicho  mal  se  recomendara  á  las  potencias  que  modificaran  sus 
reí^lamentos  de  acuerdo  con  los  descubrimientos  científicos  sobre  la 
materia.  Después  de  un  lart^o  debate  los  deleg;ados  de  la  Ar<^entina 
y  el  lírasil  dieron  su  conformidad  en  este  punto.  Es  mi  opinión 
que  la  Conferencia  de  París  ha  ado})tado  la  base  firme  y  sej^ura  para 
el  establecimiento  de  una'  estable  inteligencia  internacional. 

Tendré  muclio  placer  en  someter  á  la  comisión  de  orj^anización, 
de  acuerdo  con  el  rue^o  del  Presidente,  el  texto  impreso  de  la  Con- 
ferencia y  una  traducción  al  inglés  ({ue  hice  al  volver,  la  que,  supongo, 
responderá  á  los  fines  de  la  comisión. 

Él  Presidente.  Se  desean  hacer  algunas  observaciones  más  sobre 
esta  cuestión? 

El  Secretario  (Doctor  Ulloa).  Refiriéndome  á  la  petición  del 
Doctor  Licéaga,  objeto  de  la  discusión,  tengo  el  lionor  de  manifestar 
que  estoy  en  todo  conforme  con  este  señor.  Estoy  de  acuerdo  con 
él  sobre  el  hecho  de  que  estamos  aquí,  no  solamente  para  discutir 
distintas  cuestiones  relativas  á  la  ciencia  sanitaria  y  para  asistir  á 
esta  Convención  por  el  interés  y  el  placer  que  siempre  tenemos  al 
concurrir  á  congresos  científicos,  sino  también  para  llegar  á  un  acuerdo 
de  naturaleza  práctica.  Nuestra  representación  aquí  es  combinada, 
si  se  me  permite  la  frase.  Es  científica  y  diplomática,  como  yo  la 
denominaría.  Entiendo  que  nuestra  mayoría  asistió  á  la  anterior 
Conferencia  y  asiste  á  está  con  plenos  poderes  de  nuestros  respectivos 
Gobiernos  para  firmar  ad  referendum  todo  acuerdo  que  fuere  adop- 
tado. Nuestros  Gobiernos  han  depositado  su  confianza  en  nosotros 
al  eviarnos  aquí,  y  nos  han  autorizado  para  adoptar  acuerdos  y  votar, 
de  conformidad  con  nuestra  razón,  en  los  problemas  científicos  que 
se  han  de  discutir  aquí.  Estamos  autorizados  para  firmar  convenios 
en  materias  de  sanidad,  pero,  como  es  claro,  tenemos  que  someterlos 
á  la  aprobación  de  nuestros  respectivos  Gobiernos  después;  es  decir, 
estamos  autorizados  para  firmar  ad  referendum. 

Opino  con  el  Doctor  Licéaga  y  el  Doctor  Guiteras  que  podríamos 
firmar  la.s  resoluciones  ya  adoptadas,  teniendo  como  base  los  hechos 
científicos  ya  demostrados.  Los  acuerdos  de  la  última  convención 
sanitaria  abarcan,  creo  yo,  todas  las  materias  concernientes  á  la 
fiebre  amarilla.  Ahora  discutiremos  otros  asuntos  importantes,  la 
peste  bubónica  en  particular,  y  no  dudo  que  aprenderemos  mucho, 
algunos  de  nosotros  por  lo  menos,  de  las  discusiones  que  tengan 
lugar  sobre  dicha  peste.  Creo  que  aún  no  estoy  dispuesto  á  firmar 
nada  sobre  la  peste  bubónica,  pero  después  que  ha3"a  oído  ^^.lestras 
discusiones  sobre  la  materia,  aprenderé  mucho  más  sobre  ella,  3'  me 
sentiré  plenamente  autorizado  para  firmar  cualquier  acuerdo  á  que 
lleguemos.     [Aplausos.] 

El  Doctor  Lavorería,  después  de  argüir  una  por  una  las  cláusulas, 
señaladas  por  el  Doctor  Licéaga,  de  las  resoluciones  de  la  Segunda 
Conferencia  Panamericana  de  Méjico,  expresó  el  hecho  de  que,  aún 
cuando  el  Perú  no  estuvo  representado  en  la  última  convención  sani- 
taria, por  razones  que  él  no  creía  necesario  citar,  su  Gobierno  dio  su 
conformidad  á  todo  lo  que  fué  acordado  en  dicha  convención,  y 
manifestó  que  se  habían  promulgado  en  Perú  varios  decretos  ejecu- 
tivos declarando  legales  las  resoluciones  del  anterior  congreso  sani- 
tario.    Dijo  que  en  su  nación  tienen  la  junta  nacional  de  sanidad, 


244  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

la  cual  dicta  las  refalas  y  disposiciones  relativas  á  la  higiene,  y  que 
dichas  disposiciones  son  ohligatorias  en  todas  las  partes  del  país. 
Manifestó  que  aceptaba  todas  las  proposiciones  del  Doctor  Licéaga, 
y  que  uno  de  los  deseos  principales  del  Gobierno  del  Perú  es  que 
lleguemos  todos  á  un  acuerdo  mediante  el  cual  los  países  del  conti- 
nente sean  regidos  por  reglamentos  sanitarios  uniformes.  Dijo  que 
se  había  dictado  un  decreto  en  el  cual  adopta  Perú  los  distintos 
reglamentos,  entre  los  cuales  mencionó  la  Oñcina  Sanitaria  Inter- 
nacional. Entró  en  algunos  detalles  relativos  á  las  resoluciones 
citadas  por  el  Doctor  Licéaga,  que  han  sido  leídas  por  todos  los 
miembros  de  la  Convención. 

El  Señor  Whitliers  expresó  también  su  conformidad  con  la  propo- 
sición del  Doctor  Licéaga.  Manifestó  que  la  República  del  Ecuador 
ha  adoptado  las  resoluciones  acordadas  por  la  Primera  Convención 
Sanitaria  de  Washington,  y  que  creía  en  la  fiel  observancia  de  sus 
disposiciones.  Dijo  que  el  Ecuador  gozaba  del  privilegio  de  estar 
libre  de  la  peste  bubónica. 

Estaba  conforme  en  todo  con  el  Doctor  Licéaga,  y  dijo  que  en 
nombre  de  su  país  esperaba  que  se  llegara  á  un  arreglo  en  esta  Con- 
vención que  uniera  á  los  varios  países  de  este  continente. 

El  Doctor  Alcivar  expresó  su  opinión  de  conformidad  con  la  del 
Doctor  Licéaga.  Dijo  que  era  de  importancia  que  todos  los  delegados 
presentes  volvieran  á  sus  países  llevando  un  convenio  firmado  que 
obligara  á  las  varias  naciones  á  la  observancia  de  los  métodos  acorda- 
dos en  las  resoluciones  de  este  Congreso. 

El  Doctor  Medina  manifestó  también  su 'conformidad  con  la  pro- 
posición del  Doctor  Licéaga. 

El  Doctor  Moore  dijo  que  también  se  hallaba  conforme  con  el 
Doctor  Licéaga,  y  dijo  que  creía  que  todos  los  delegados  están  con- 
formes con  dicha  opinión;  que  dicha  proposición  debía  formar  parte 
de  los  acuerdos  que  se  firmarán  en  esta  Conferencia  y  después  some- 
terse á  los  respectivos  Gobiernos.  Manifestó  su  creencia  de  que  la 
discusión  se  había  llevado  bastante  lejos,  y  que  sería  mejor  someter 
una  resolución  á  la  junta  consultora  con  el  fin  de  que  se  firme  un 
acuerdo  que  se  someta  después  á  los  Gobiernos. 

El  Doctor  Licéaga  dijo  que  se  consideraba  muy  afortynado  y 
dichoso  al  oir  las  opiniones  expresadas  por  varios  de  los  delegados 
presentes;  hizo  constar  que  no  le  importaba  lo  que  los  Gobiernos 
hicieran,  pero  que  él  quería  que  todos  los  presentes  y  que  estén  con- 
vencidos de  la  fructuosidad  y  eficacia  de  las  resoluciones  tomadas 
aquí,  que  lo  demuestren  prácticamente  firmando  sus  nombres  en  las 
resoluciones,  y  cumpliendo  con  su  obligación  de  esta  manera;  y  que 
entonces  fueran  enviadas  á  los  respectivos  Gobiernos ;  si  éstos  las 
aprobaban,  muy  bien,  si  nó  peor  para  ellos,  pero  por  de  pronto  los 
delegados  habrían  cumplido  con  su  obligación. 

El  Presidente.  Hay  más  observaciones  sobre  esta  materia?  Si 
nó,  antes  de  terminarse  la  discusión  de  este  asunto,  rogaré  que  algún 
caballero  proponga  que  la  comisión  de  organización  nombrada  ayer 
sea  constituida  como  junta  consultora;  ó  si  alguno  desea  sugerir  otra 
idea,  le  agradeceremos  que  la  exponga.  De  otro  modo  no  tenemos 
una  junta  consultora  á  la  cual  someter  los  documentos,  resoluciones 
é  informes. 

Dr.  H.  L.  E.  Johnson.  Propongo  que  todas  las  cuestiones  que  se 
susciten  en  esta  Convención  sean  sometidas  á  la  comisión  de  organi- 
zación nombrada  ayer,  constituida  como  junta  consultora. 


SEGUNDA    CONFERENCIA    SANITARTA    INTERNACIONAL.  245 

La  propuesta  fué  apoyada. 

Una  vez  discutida,  fué  aprobada. 

Doctor  GuiTERAS.   i  Puedo  hacer  una  proposición? 

El  Presidente.  Doctor  Guiteras. 

Doctor  Guitp:ras.  No  sé  si  éste  es  el  sitio  adecuado  ó  si  debo  pre- 
sentar esta  petición  ante  la  junta  consultora,  pero  creo  que  en  la 
última  reunión  se  nombraron  vicepresidentes. 

El  Presidente.  Sí,  señor. 

Doctor  Guiteras.  Y  no  sería  conveniente  nombrar  vicepresidentes 
ahora  ?  , 

El  Presidente.  Tomaremos  en  consideración  la  petición  del  Doctor 
Guiteras  tan  pronto  como  se  termine  el  asunto  que  se  está  discutiendo. 
Debe  adoptarse  una  resolución  sometiendo  el  documento  del  Doctor 
Licéa^a  á  la  junta  consultora.  Si  nadie  disiente,  esta  cuestión  será 
sometida  á  la  junta  consultora.  ¿Le  es  esto  conveniente  al  Doctor 
Licéaga  ? 

El  Doctor  Licéaga  dio  su  consentimiento. 

Doctor  Guiteras.  Pido  que  se  nombren  á  los  vicepresidentes. 

El  Presidente.  ¿En  sesión  abierta  ó  por  la  comisión? 

El  Doctor  Guiteras.  Pido  que  lo  ha^a  la  comisión. 

El  Presidente.  No  oigo  ninguna  objeción,  por  lo  tanto  se  anuncia 
que  la  propuesta  está  aprobaba. 

El  programa  científico  dice : 

1 .  Un  informe  que  someterá  un  delegado  de  cada  República.  Este  informe  debe  contener: 
(a)  Datos  sobre  las  enfermedades  que  predominan,  con  mención  especial  de  la  peste  bubónica, 
de  la  fiebre  amarilla  y  de  la  palúdica,  desde  el  1"  de  enero  de  1E04,  que  es  próximamente  la 
fecba  de  la  clausura  de  la  última  convención;  (b)  un  sumario  de  las  leyes  de  cuarentena  y 
sanidad  dictadas  desde  la  primera  convención;  (c)  los  trabajos  especiales  de  higiene  que 
están  en  progreso  ó  en  proyecto.  Estos  informes  se  presentarán  en  nombre  de  cada  República 
ó  cada  división  del  asunto  puede  ser  entregada  á  un  delegado  para  su  presentación.  Se  ruega 
la  entrega  de  copias  de  los  informes  para  su  publicación. 

De  acuerdo  con  este  programa,  se  llamarán  las  Repúblicas  por  sus 
nombres,  y  ruego  á  los  delegados  que  hagan  informes  verbales; 
ó  si  los  tienen  por  escrito  que  los  presenten  para  que  durante  el  día 
podamos  oír  de  las  Repúblicas  sobre  los  asuntos  mencionados  en  este 
párrafo. 

Así  pues,  llamaremos  primero  á  Chile. 

Doctor  Guiteras.  Me  parece  que  quizás  sería  mejor  dar  comienzo 
á  estos  informes  durante  la  sesión  de  la  tardé,  porque  la  comisión 
ejecutiva  tiene  que  reunirse  antes  de  la  comida,  y  si  prolongamos 
esta  sesión  sería  difícil  que  dicha  comis  ón  tenga  tiempo  para  celebrar 
su  reunión.  Pido,  por  lo  tanto,  que  se  suspenda  la  sesión  y  que  se 
comiencen  estos  informes  en  la  sesión  de  esta  tarde. 

Esta  propuesta  fué  apoyada. 

El  Presidente.  Antes  de  suspender  la  sesión  deseo  manifestar 
que  hay  dos  ó  tres  avisos  que  hacer.     El  secreterio  los  leerá. 

El  secretario  anunció  que  se  habían  enviado  varias  invitaciones  á 
los  miembros  de  la  Convención  Sanitaria. 

El  Presidente.  Aquí  tenemos  cierto  número  de  ejemplares  de  la 
edición  revisada  del  informe  del  Dr.  L.  O.  Howard  sobre  el  predominio 
del  mosquito  Sfegomyia  en  los  Estados  Unidos  y  las  regiones  en  que 
más  abunda.  Nos  ha  sido  de  mucha  utilidad  en  la  supresión  de  la 
epidemia  de  fiebre  amarilla  que  hubo  en  el  sur  este  año.  Demuestra 
en  donde  prevalece  el  mosquito  Stegomyia.  El  Doctor  Howard  es  el 
Jefe  Entomólogo  del  Departamento  de  Agricultura  de  los  Estados 


24:6  SEGUXDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Unidos  y  también  entomólogo  consultor  del  Servicio  de  Sanidad 
Pública  y  Hospitales  ^íarítimos,  y  por  esta  razón  desearía  que 
estuviere  presente  j  que  se  le  concedan  las  prerrogativas  de  la  Con- 
vención durante  sus  sesiones.  Nos  podrá  dar  algunas  pláticas  sobre 
el  mosquito  de  la  fiebre  amarilla. 

Doctor  GriTERAS.  Pido  que  se  concedan  los  privilegios  de  la  Con- 
vención al  Doctor  Howard  y  también  al  Dr.  James  Carroll.  Creo  que 
esto  no  se  hizo  en  la  sesión  de  ñjer. 

La  petición  fué  secundada. 

Una  vez  discutida,  la  propuesta, quedó  aprobada. 

El  Presidente.  Estando  aprobada  la  propuesta,  ruego  al  Secre- 
tario que  notifique  á  los  señores  interesados. 

En  ausencia  del  Director  de  la  Oficina  de  las  Repúblicas  Ameri- 
canas, Señor  Fox,  deseo  notificarles  lo  que  hay  para  mañana,  de  modo 
que  todos  Vds.  lo  sepan  claramente.  Nos  reuniremos  aquí,  en  esta 
habitación  ó  en  el  vestíbulo,  de  la  entrada  de  la  Calle  F,  y  partiremos 
desde  dicho  lado  del  hotel,  porque  al  Miércoles  por  la  mañana  habrá 
en  el  hotel  un  gran  número  de  miembros  de  la  Sociedad  de  Banqueros 
Americanos,  la  cual  se  reúne  en  ese  día,  quedando  de  este  modo  el 
otro  vestíbulo  atestado  de  gente.  Saldremos  de  aquí  á  las  nueve  y 
inedia  para  ir  al  muelle  que  está  al  final  de  la  Calle  Undécima.  La 
lancha  debe  partir  del  muelle  á  las  diez,  y  estaremos  ausentes  durante 
todo  el  día  visitando  varios  puntos  á  lo  largo  del  río  Potomac,  Mount 
Vernon  y  otros  sitios.  Claro  es  que  se  espera  que  todos  los  delegados, 
señoras  y  demás  invitatos  estén  presentes.  Estaremos  ausentes  du- 
rante todo  el  día,  retornando  al  anochecer. 

Si  no  se  ha  de  presentar  otra  propuesta,  la  del  Doctor  Guiteras  para 
que  se  suspéndala  sesión,  que  ha  sido  apoyada,  será  sometida  ahora. 
La  propuesta  es  que  se  suspenda  la  sesión  hasta  las  tres  de  esta  tarde. 

La  cuestión  fué  discutida  y  la  propuesta  aprobada. 

Entonces  se  levantó  la  sesión  para  continuarla  á  las  tres  de  la  tarde. 

Sesión  de  la  tarde. 

El  presidente,  Cirujano  General  Wyman,  declaró  abierta  la  sesión. 

El  Presidente.  Lo  primero  que  se  hará  en  esta  sesión  será  la 
lectura  del  acta  de  la  primera  sesión. 

El  secretario  leyó  el  acta  de  la  primera  sesión  de  la  Convención. 

Doctor  Guiteras.  Pido  que  este  acta  sea  aprobada"  tal  como  ha 
sido  leída. 

El  Presidente.  Antes  de  que  esta  propuesta  sea  tomada  en  con- 
sideración, deseo  manifestar  que  creo  que  se  han  omitido  uno  ó  dos 
nombres  en  la  lista  de  las  personas  á  quienes  se  han  concedido  los 
privilegios  de  la  Convención.  El  Dr.  J.  S.  Anderson  es  uno.  Es  el 
Director  Auxiliar  del  Laboratorio  Higiénico  del  Servicio  de  Sanidad 
Pública  y  Hospitales  Marítimos  de  los  Estados  Unidos.  Con  el  con- 
sentimiento de  la  Convención  su  nombre  sera  añadido  á  dicha  lista. 

Habéis  oído  la  lectura  del  acta,  y  se  propone  que  sea  aprobada  tal 
cual  ha  sido  leída. 

La  cuestión  fué  discutida  y  la  propuesta  aprobada. 

El  Presidente.  Antes  de  seguir  adelante,  deseo  hacer  constar  que 
en  la  comisión  de  organización,  según  he  notado  al  escuchar  la  lectura 
del  acta,  se  ha  omitido  un  miembro,  que  yo  creo  debe  ser  incluido  por 
el  extenso  trabajo  encomendado  á  dicha  comisión,  la  cual  ha  sido 


SEGUNDA    CON.FERENCÍA    SANITAKÍA    INTERNACIONAL.  247 

además  constituida  en  junta  consultora,  y  opino  que  el  nombre  de  ese 
miembro  debe  añadirse  ahora,  porque  tenemos  dos  de  los  departa- 
mentos médiííos  de  este  Gobierno  roprescintados  y  por  un  descuido  uno 
de  ellos  no  íué  incluido  oiij^itialnicnte.  Con  vuestro  corisentiíiiiento, 
pues,  desearía  añadir  á  esa  connsión  el  nombre  de  un  funcioruirio  de  la 
Armada  de  los  Estados  Unidos,  el  Doctor  Gatewood,  que  es  el  delegado 
de  dicha  armada. 

Doctor  GuiTERAS.  Propongo  que  el  Doctor  Gatewood  sea  incluido 
en  la  junta  consultora. 

La  petición  fué  apoyada,  discutida  y  aprobada. 

El  Presidente.  Deseo  manifestar  que  es  de  suponer  que  nuestros 
convidados  asistan  con  nosotros  á  las  funciones  sociales,  particular- 
mente á  la  excursión  de  mañana  por  el  río  á  Indian  Head  y  Mount 
Vernon. 

Antes  de  dar  comienzo  á  los  trabajos  de  la  tarde,  preguntaré  si 
algún  delegado  tiene  alguna  medida  especial  que  proponer  ú  observa- 
ción especial  que  hacer.  Si  no,  procederemos  con  la  llamada  de  las 
Repúblicas  de  conformidad  con  el  programa  provisional.  Supongo 
que  todos  los  miembros  tendrán  una  copia  del  mismo,  el  programa 
científico,  cuyo  primer  párrafo  se  leyó  esta  mañana,  por  lo  que  no  se 
volverá  á  leer,  llamándose,  acto  continuo,  á  los  delegados,  lluego  al 
secretario  que  lo  haga  por  orden  alfabético. 

El  Secretario.  Chile,  Dr.  Eduardo  Moore. 

El  Doctor  Moore  leyó  su  informe  como  delegado  de  Chile.  (Véase 
el  apéndice,  página  333.) 

El  Señor  Whithers  propuso  que,  con  el  fin  de  ahorrar  tiempo,  se 
entregaran  todos  los  informes  de  las  Repúblicas  al  secretario,  sin  que 
se  leyeran. 

El  Presidente.  Habéis  oído  la  propuesta  de  que  los  documentos 
no  se  lean  y  que  cada  delegado  haga  un  breve  resumen,  extempore, 
de  lo  que  contiene  su  informe,  diciendo  de  que  trata  y  lo  que  demuestra. 

Doctor  GuiTERAS.  Creo  que  esto  es  lo  que  hemos  decidido  en  la 
reunión  de  la^  junta  ó  comisión  de  organización,  que  se  lean  breves 
resúmenes.     A  mi  juicio  no  se  empleará  mucho  tiempo  en  ello. 

El  Presidente.  Eso  fué  lo  que  acordó  la  Conve-nción,  ¿no  es  así? 

El  Doctor  GuiTERAS.  Sí,  señor. 

El  Presidente.  Esto  será  lo  acordado  entonces.  Después  sigue 
el  informe  del  Doctor  Ulloa,  el  delegado  de  Costa  Rica. 

El  Doctor  Ulloa  leyó  su  informe  en  inglés  (véase  el  Apéndice, 
pág.  334). 

El  Presidente.  El  Secretario  llamará  ahora  al  delegado  de  Cuba. 

El  Secretario.  Cuba;  Dr.  Juan  Guiteras. 

El  informe  de  Cuba  fué  leído  por  el  Doctor  Barnet  en  castellano 
(véase  el  Apéndice,  pág.  335). 

El  Secretario.  La  República  Dominicana,  Sr.  Don  Emilio  C. 
Joubert. 

El  Presidente.  El  Señor  Joubert  rogó  que  se  le  excusara  este  día, 
diciendo  que  tendría  mucho  gusto  en  leer  su  informe  el  miércoles; 
así,  pues,  aplazaremos  la  lectura  de  dicho  informe  hasta  ese  día.  El 
Señor  Joubert  estuvo  aquí  esta  tarde  pero  tuvo  que  marcharse  (véase 
el  Apéndice,  pág.  414). 

El  Secretario.  Ecuador. 

El  informe  del  Ecuador  fué  leído  por  el  Dr.  ^liguel  Alcivar  (véase 
el  Apéndice,  pág.  377). 


248  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

El  Secretario.  Guatemala. 

El  informe  de  Guatemala  fué  leído  por  el  Dr.  Joaquín  Tela  (véase 
el  Apéndice,  pág.  381). 

El  Secretario :   Méjico  ' 

El  informe  de  Méjico  fué  leído  por  el  Dr.  Eduardo  Licéaga  (véase 
el  Apéndice,  pág.  384). 

El  Secretario.  Nicaragua. 

El  informe  de  Nicaragua  fué  leído  por  el  Dr.  J.  L.  Medina  (véase 
el  Apéndice,  pág.  397). 

El  Secretario.  Perú,  Dr.  Daniel  E.  Lavoreria. 

El  informe  del  Perú  fué  leído  por  el  delegado  Doctor  Lavoreria 
(véase  el  Apéndice,  pág.  398). 

El  Presidente.  El  Dr.  H.  D.  Geddings  hablará  en  nombre  del 
Gobierno  nacional  de  los  Estados  Unidos  (véase  el  Apéndice,  pág.  416). 

El  Presidente.  Los  delegados  de  Uruguay  y  Venezuela  me  han 
rogado  c[ue  les  excuse  ante  esta  Convención  por  no  presentar  los 
informes  de  sus  respectivas  naciones. 

El  delegado  del  Uruguaj^  no  ha  recibido  todavía  todos  los  detalles 
que  necesita  para  su  informe,  y  ha  manifestado  que  muy  probable- 
mente no  podrá  presentarlo,  pero  que  estará  conforme  con  todo  lo 
que  se  acuerde  en  esta  Convención,  y  que  asistirá  en  nombre  de  su 
Gobierno  para  firmar  las  resoluciones  que  se  adopten  (véase  el  Apén- 
dice, pág.  418). 

El  delegado  de  Venezuela  no  pudó  presentar  su  informe  hoy,  pero 
me  dijo  que  lo  haría  á  tiempo  para  que  pueda  imprimirse  con  los 
trabajos  del  Congreso  (véase  el  Apéndice,  pág.  420). 

Deseo  leerles  un  telegrama  que  he  recibido  del  Dr.  Rhett  Goode. 
Es  como  sigue: 

Mobile,  Ala. 
Al  General  Walter  Wyman, 

Presidente  de  la  Oficina  Sanitaria  Internacional, 

Washington,  D.  C: 
La  inspección  de  las  cuarentenas  existentes  me  impide  asistir  á  la  Convención.     Las 
cuestiones  más  importantes  que  deben  considerarse  son  la  propagación  de  la  fiebre  amarilla 
y  el  saneamiento  de  ciudades.     Sírvase  expresar  á  los  miembros  mi  sincero  sentimiento  y 
mis  mejores  deseos  para  que  la  Convención  sea  coronada  con  el  éxito. 

Rhett  Goode,  jM.  D., 
Presidente  de  la  Junta  de  Cuarentena,  Mobile,  Ala. 

Deseo  anunciar  también  que  el  Presidente  de  los  Estados  Unidos 
recibirá  á  esta  Convención  el  jueves  á  las  12.  Estaremos  en  sesión 
entonces  y  á  las  11.45  partiremos  para  presentar  nuestros  respetos  al 
Presidente. 

Doctor  GuiTERAS.  Pido  que  se  suspenda  la  sesión  hasta  las  10  de 
la  mañana  del  jueves. 

Doctor  Medina.  Apoyo  la  petición. 

Después  de  discutida  se  aprobó  la  propuesta. 

Por  lo  cual,  á  las  5.20  p.  m.,  se  levantó  la  sesión  para  continuarla 
el  jueves,  12  de  octubre,  á  las  10  de  la  riiañana. 


TERCER  día— JUEVES,  12  DE  OCTUBRE. 

j  Sesión  de  la  mañana. 

El  Presidente,  Cirujano  General  Wyman,  declaró  abierta  la  sesión  á 
las  10.30  de  la  mañana. 

El  Presidente.  Con  el  fin  de  evitar  equivocaciones  deseo  anun- 
ciarles que  á  las  11.45  iremos  á  presentar  nuestros  respetos  al  Presi- 
dente Roosevelt.     Se  desea  que  todos  estén  presentes  entonces. 

El  acta  de  la  sesión  anterior  fué  leída  por  el  secretario.  Cuando 
éste  leyó  la  parte  que  contenía  las  observaciones  del  Doctor  Medina, 
este  señor  dijo:  Señor  Presidente,  deseo  decir  algo  sobre  lo  que 
ocurrió  ayer.  Mi  intención  no  fué  criticar  en  manera  alguna  las 
distintas  juntas  de  sanidad  de  Centro  América.  Mi  intención  fué 
simplemente  decir  que  dichas  juntas  debieran  unirse  mediante  reglas 
uniformes.  No  quise  criticar  a  ninguna  individualmente,  pero  simple- 
mente expresar  mi  opinión  de  que  si  el  sistema  se  pusiera  bajo  reglas 
uniformes  para  todas  las  repúblicas  centroamericanas,  que  están  tan 
próximas  unas  de  otras,  estando  un  puerto  á  algunas  horas  de 
distancia  solamente  de  otro,  habría  alguna  probabilidad  de  llevar  á 
cabo  este  proyecto.  Está  muy  lejos  de  mí  el  criticar  á  ninguna 
república  con  respecto  á  los  métodos  para  el  régimen  de  sus  juntas 
de  sanidad.  Cada  una  ha  hecho  lo  que  ha  podido.  La  mayor  parte 
de  ellas  se  halla  en  buen  estado  higiénico,  sólo  que  me  parece  que 
están  trabajando  en  distintas  direcciones,  sin  esa  uniformidad  que 
sería  muy  de  desear,  y  ahora  deseo  someter  un  documento  relativo  á 
este  asunto. 

El  Presidente.  ¿Desea  Vd.  sustituir  esto  por  lo  que  ha  declarado 
en  la  última  sesión?     ¿Desea  Vd.  modificar  el  acta  en  este  sentido? 

Doctor  MediNxV.  Sí,  deseo  retirar  la  proposición  que  hice  y  sus- 
tituirla por  ésta. 

El  Presidente.  Si  no  hay  inconveniente,  este  documento  será 
sustituido  por  el  que  el  Doctor  Medina  presento  ayer  y  será  impreso 
como  parte  de  los  trabajos  de  ayer.     Se  insertará  en  lugar  del  otro. 

El  Secretario  (Doctor  Ulloa).  Me  alegro  mucho  de  que  mi  estimado 
colega  de  Nicaragua,  el  Doctor  Medina,  haya  puesto  las  cosas  en  su 
lugar  con  respecto  á  las  infundadas  observaciones  que  hizo  en  la 
última  sesión  de  esta  Convención,  y  que  me  causaron  mala  impresión 
por  contradecir  de  una  manera  indirecta  las  declaraciones  que  hice 
con  relación  á  las  condiciones  de  Costa  Rica,  á  la  cual  tengo  el  honor 
de  representar  aquí,  en  lo  concerniente  á  los  reglamentos  de  higiene 
y  cuarentena. 

La  explicación  dada  por  el  Doctor  Medina  me  releva  del  enojoso 
deber  de  protestar  en  términos  vigorosos  contra  la  injusticia  hecha  á 
Costa  Rica  en  este  asunto.  En  materia  de  higiene,  no  pretendemos 
estar  á  la  misma  altura  de  otros  países  más  avanzados,  pero,  como 
dije  en  mi  informe,  ya  hemos  hecho  trabajos  eficaces  en  este  respeto, 

249 


250  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

y  esperamos  seguii'  adelante,  poco  á  poco,  y  conseguir  mucho  dentro 
de  breve  tiempo,  porque  queremos  llevar  el  mismo  paso,  en  todo  lo 
posible,  del  progreso  de  la  ciencia  sanitaria,  la  cual  podemos  decir  que 
ha  abolido  la  cuarentena  en  el  sentido  de  la  interpretación  ignorante. 
La  América  Central  comprende  cinco  repúblicas  soberanas,  tres  de 
las  cuales  tienen  representantes  autorizados  en  esta  conferencia,  los 
cuales  pueden  hablar  únicamente  por  su  respectivo  país.  Como 
tengo  conocimiento  del  mal  efecto  que  algunas  manifestaciones  sobre 
nuestros  países  han  producido  entre  gente  que  desgraciadamente 
sabe  poco  de  nosotros,  terminaré  haciendo  las  siguientes  observa- 
ciones, cuya  autenticidad  puede  ser  comprobada  por  cualquiera  c[ue 
tenga  algún  conocimiento  de  mi  nación.  En  Costa  Rica  se  celebran 
las  elecciones  presidenciales  cada  cuatro  años,  y  los  distintos 
departamentos  del  Gobierno  gozan  de  completa  independencia.  En 
asuntos  de  higiene,  nunca  hemos  tenido  en  Costa  Rica  la  acción 
coercitiva  de  la  espada  ó  de  los  procedimientos  ilegales,  y  todos 
nuestros  funcionarios  de  sanidad  son  hombres  de  la  profesión  que 
desempeñan  sus  deberes  concienzudamente  y  cuyos  mandatos  se 
ponen  en  vigor  debidamente  por  la  policía  de  sanidad. 

Doctor  Medina.  Mucho  me  complacen  las  observaciones  de  mi 
amigo,  y  estoy  en  un  todo  de  acuerdo  con  él  en  lo  que  ha  dicho  sobre 
el  progreso  de  Costa  Rica.  Es  un  país  pequeño,  pero  uno  de  los  más 
progresivos  de  la  América  Central.  Dice  que  estamos  aquí  para 
representar,  cada  uno,  á  un  solo  país,  y  entiendo  que  nos  sugiere 
que  debemos  limitarnos  al  Gobierno  que  representamos.  Yo  no  lo 
veo  de  esta  manera.  No  he  venido  aquí  para  hablar  de  Costa  Rica, 
porque  no  tengo  derecho  á  ello,  sino  porque,  siendo  miembros  de  un 
congreso  sanitario  internacional,  en  caso  de  que  opinemos  que  una 
medida  que  se  adoptara  beneficiaría  á  toda  aquella  región,  tenemos 
perfecto  derecho  para  proponerla.  Si  ha  de  ser  aceptada  ó  no  es 
cuestión  aparte.  Mi  proposición  es  que,  de  una  manera  ú  otra,  haga 
uso  esta  Conferencia  de  su  valiosa  influencia  para  conseguir  uniformi- 
dad de  acción  por  parte  de  estas  cinco  pequeñas  repúblicas  para  que  así 
sus  juntas  de  sanidad  puedan  obrar  de  acuerdo  con  el  fin  de  que 
ninguna  de  ellas  destruya  ó  perjudique  el  bien  que  un  país  como  Costa 
Rica  está  haciendo.  Esta  es  la  razón  por  qué  hice  la  proposición  del 
otro  día.  Por  último,  deseo  manifestar  mi  conformidad  con  todo  lo 
dicho  por  el  Doctor  Ulloa  sobre  el  progreso  de  Costa  Rica. 

Doctor  Ulloa.  Considero  terminado  el  incidente,  aún  cuando 
disentimos  un  poco  en  los  detalles. 

El  Doctor  Guiteras  pidió  que  no  se  leyeran  en  su  totalidad  las 
observaciones  de  los  demás  oradores. 

La  propuesta  fué  aceptada. 

El  Secretario  reanudó  y  terminó  la  lectura  del  acta. 

A  propuesta,  el  acta  fué  aprobada  conforme  se  leyó  y  modificó. 

El  Presidente.  Deseo  leerles  ahora  una  carta  del  Doctor  Kennedy, 
uno  de  los  delegados  de  los  Estados  Unidos.     Es  como  sigue: 

Siento  en  al  alma  tener  que  ausentarme  esta  mañana.  Tendré  que  estar  dos  días  en  Nueva 
York,  y  hacer  aljíunos  exámenes  en  Des  Moines  el  próximo  miércoles.  Tengo  los  partes 
periodísticos  de  las  sesiones  celebradas  hasta  aliora  por  nuestra  Convención.  Si  Vd. 
tuviera  la  amabilidad  de  enviarme  copias  que  contengan  las  últimas  noticias,  le  agradecería 
mucho.  He  gozado  y  sacado  provecho  de  las  sesiones  á  que  he  asistido,  y  mi  único  deseo 
es  poder  estar  presente  hasta  la  clausura  de  la  Conferencia. 

Muy  respetuosamente,  ,   J.  A.  F.  Kennedy. 


SEGUNDA    (K)NFKKIíN(;iA    SANITARIA    INTERNACIONAL.  251 

El  PiíESiDKNTK.  Ahora  leerá  el  Secireiario  algunas  cartas. 
El  Secretario  leyó  las  siguientes: 

Dei'ak'jamento  de  Sanidad  ¡>\;í.  DrsxRrro  de  Columiua, 

WáfiliÁnf/ton,  D.  C,  11  de  octubre  de  lí)Oó. 
Al  Dr.  Juan  Ulloa,  Secretario  de  la  Conferencia  Sanitaria  InlerrMciorud. 

Muy  Señoe  Mío:  Tongo  el  honoi'  do  acusar  rooibo  do  su  cai'ta  del  10  del  pr(!sente  en  la 
que  ino  informa  en  la  ,s('<funda  .ses'n'ín  de  la  (Jonfereneia  Sanitaria  Intei-nacional,  se  me  han 
concedido  los  pi¡vile<í¡os  do  la  Coiivonción.  D(!hoo  expresar  mi  a])i(!CÍo  por  esta  cortesía, 
así  corno  el  sontiinieni.o  de  no  poder  asistir  á  todas  las  sesiones  de;  la  Convenci(')n  á  causa  de 
la  cantidad  del  tiabajo  oficial  que  tengo. 

Muy  respetuosamente»  William  C.  Woodwaud,  M.  D., 

FuncioTUirio  de  Sauida/l. 

Departamento  de  Guerra, 
Oficina  del  Círu.jano  General, 
Museo  y  Biblioteca  de  Medicina  del  Ejícrcito, 

Washington,  D.  C. 
Hon.  Juan  J.  Ulloa, 

Secretario  de  la  Conferencia  Sanitaria  Internacional, 

Washington,  D.  C. 
Muy  Señor  Mío:  Tongo  el  honor  de  acusar  recibo  do  su  carta  del  10  del  corrientc,  en  la 
que  me  invita  á  asistir  á  las  sesiones  de  la  Convención  y  me  concede  los  privilegios  do  la 
misma.     Me  apresuro  á  expresarle  la  seguridad  de  mi  alto  aprecio  por  este  lionor  y  la  acep- 
tación del  mismo. 

De  Vd.  afectuosamente,  James  Carroll. 

El  Presidente.  Señores,  dentro  de  pocos  momentos  será  necesario 
que  partamos  para  la  Casa  Blanca  con  el  fin  de  presentar  nuestros 
respetos  al  Presidente  de  los  Estados  Unidos.  Antes  de  marcliarnos 
deseo  hacerles  una  breve  alocución  sobre  el  interés  que  el  rresidente 
Roosevelt  ha  demostrado  siempre  por  la  profesión  médica  y  la  higiene. 

Deseo  asegurarles  que  se  les  dará  en  la  Casa  Blanca  una  recepción 
cordial,  y  que  seréis,  indudablemente,  felicitados  con  palabras  de 
estímulo  sobre  los  fines  de  esta  Convención.  Ningún  otro  Presidente 
de  los  Estados  ha  demostrado  tan  elocuente  y  frecuentemente  un 
aprecio  por  la  conducta  y  los  trabajos  del  médico  con  respecto  á  su 
sagrada  relación  con  sus  enfermos,  por  sus  deberes  cívicos,  y  por  sus 
labores  como  higienista.  En  el  discurso  que  pronunció  ante  la  Aso- 
ciación de  Cirujanos  Militares  de  los  Estados  Unidos,  en  la  alocución 
que  dirigió  al  descubrirse  el  monumento  del  Dr.  Benjamín  Rush  en 
Washington,  en  la  que  pronunció  en  la  colocación  de  la  primera 
piedra  de  la  Escuela  Médica  Naval,  j  hace  poco  en  la  que  hizo  ante 
la  Asociación  de  Médicos  de  Long  Island,  sus  palabras  fueron  de 
estímulo  y  sabiduría.  Ha  declarado  que  en  la  vida  militar  el  chujano 
lleva  consigo  las  penalidades  del  soldado  y  las  responsabilidades  de 
un  administrador.  Ha  declarado  que  el  médico  que  se  mantiene  en 
las  alturas  de  la  profesión  es  considerado  en  cualquiera  ciudad  como 
uno  de  los  factores  más  importantes  de  la  labor  cívica  de  la  misma,  y 
que  ningún  médico  puede  ser  bueno,  ó  buen  ciudadano,  á  menos  que 
trabaje  pro  hono  público,  y  que  los  médicos  deben  poner  su  atención 
personal  en  los  deberes  cívicos,  porque  "lo  que  concierne  á  todos  con- 
cierne á  nadie."  "Los  asuntos  de  estado  no  deben  dejarse  enco- 
mendados á  cualquiera,  sino  que  individualmente  el  médico  debe 
interesarse  por  ellos." 

Ha  demostrado  su  manera  de  apreciar  los  sentimientos  que  para 
nosotros,  los  médicos  é  higienistas,  son  tan  caros,  diciendo  que  nues- 
tros trabajos  son  sumamente  esenciales  tanto  para  el  bien  del  estado 
como  para  el  individual.     Para  explicar  esto  demostró  un  grande 


252  SEGUNDA    CONFERENCIA    SANITAKIA    INTERNACIONAL. 

interés  y  confianza  por  los  trabajos  de  los  higienistas  en  la  Zona  del 
Canal  de  Panamá,  y  ha  tomado  la  iniciativa,  cuyos  buenos  resultados 
son  incaculables  en  la  obra  higiénica  que  se  ha  comenzado  y  se  está 
llevando  á  cabo  en  Nueva  Orleans  contra  la  epidemia  de  fiebre 
amarilla. 

Al  expresar  este  aprecio  de  nuestro  Presidente  me  hago  eco  de  las 
declaraciones  -voluntarias  que  he  oído  en  muchas  partes  y  especial- 
mente en  la  reciente  reunión  de  la  Gran  Sociedad  Médica  Americana, 
celebrada  en  Portland,  Oregon,  se  hacían  con  frecuencia  comentarios 
de  esta  naturaleza  motivados  puramente  por  la  manera  de  apreciar 
la  profesión  médica  los  sentimientos  j  el  apoyo  de  nuestro  Presidente 
en  k)s  asuntos  relativos  á  la  salud  pública  é  individual. 

A  propuesta  del  Doctor  Guiteras,  se  levantó  la  sesión  para  con- 
tinuarse á  las  2.30  de  la  tarde. 

SESIÓN    DE    LA    TARDE. 

La  sesión  se  declaró  abierta  por  el  Presidente  á  las  2.30  de  la  tarde. 

Doctor  Guiteras.  Señor  Presidente,  tengo  el  honor  de  presentar 
la  siguiente  resolución  relativa  á  la  Farmacopea  de  los  Estados 
Unidos : 

Por  cuanto  la  Junta  de  Fideicomisarios  dé  la  Convención  de  Farmacéuticos  de  los  Estados 
Unidos,  nombrada  por  la  Asociación  Farmacéutica  Americana,  acaba  de  publicar  la  edi- 
ción decenal  de  La  Farmacopea  de  los  Estados  Unidos;  y 

Por  cuanto  esta  farmacopea  revisada  comprende  muchas  nuevas  fórmulas  de  valor, 
tanto  para  uso  terapéutico  como  para  prevenir  enfermedades  epidémicas,  y  representa  la 
mejor  idea  y  labor  de  los  peritos  en  estas  materias; 

Por  lo  tanto  se  resuelve  que  una  versión  castellana  de  esta  farmacopea  de  los  Estados 
Unidos  sería  de  gran  provecho  para  las  profesiones  médica  y  farmacéutica  de  cada  una  de  las 
Repúblicas  representadas  en  esta  Convención;  y  además, 

Se  resuelve,  Que  se  someta  dicha  farmacopea  á  los  respectivos  Gobiernos  para  que  la 
comenten  en  la  próxima  Convencic5n  que  se  celebrará  en  Méjico,  con  el  objeto  de  adoptar  una 
farmacopea  internacional  para  las  Repúblicas  Americanas;  y 

Se  resuelve,  además,  Que  se  i-uegue  á  la  Oficina  Sanitaria  Internacional  que  averigüe  si  se 
pueden  sufragar  los  gastos  de  dicha  traducción  y  la  publicación  de  una  edición  de  5,000 
ejemplares,  del  fondo  provisto  en  el  artículo  7  de  las  resoluciones  adoptadas  por  la  Segunda 
Conferencia  Internacional  de  las  Repúblicas  Americanas,  celebrada  en  Méjico  en  el  invierno 
de  1901-2;  y  ^ 

Se  resuelve,  además,  Que  si  resulta  que  los  gastos  de  dicha  traducción  y  publicación  no 
pueden  sufragarse  del  fondo  provisto  en  el  mencionado  artículo  7,  se  remita  el  asunto  á 
la  Oficina  de  las  Repúblicas  Americanas  con  la  súplica  de  que  se  haga  dicha  traducción  y 
pubhcación  en  la  citada  oficina.^ 

El  Presidente.  Habéis  oído  las  resoluciones,  las  cuales  serán 
sometidas  á  la  junta  consultora.  Entre  tanto,  Vds.  recordarán  que 
los  privilegios  de  la  Convención  fueron  concedidos  al  Dr.  H.  C.  Wood, 
de  Filádelña.  Este  señor  se  halla  muy  interesado  en  este  asunto  y  ha 
sido  invitado  especialmente  para  que  hable  sobre  él.  vSu  nombre 
goza  de  una  reputación  nacional  é  internacional,  y  él  ha  estudiado 
muy  atentamente  las  cuestiones  de  materia  médica  y  farmacia;  por 
lo  tanto,  con  el  permiso  de  Vds.,  tengo  el  honor  de  presentarles  al  Dr. 
H.  C.  Wood,  de  Filadelfia,  que  hablará  sobre  el  asunto. 

Doctor  Wood.  A  pesar  del  hecho  de  que  casi  todos  los  miembros 
de  esta  Convención  son  médicos,  daré  comienzo  á  mis  observaciones 
explicando  lo  que  es  la  farmacopea. 

La  farmacopea  es  una  lista  de  medicinas  con  los  ensayos  para 
probar  su  pureza  y  los  métodos  para  hacer  preparaciones  con  las 
sustancias  químicas  crudas  para  el  uso  de  los  médicos.     La  farma- 


SEGUNDA    CONFERENCIA    SANJ'I'AHIA     IN  TEKNAÍJIOKAI..  258 

copea  tiene,  sin  embargo,  otro  objeto  más  amplio  que  la  mera  práctica 
de  la  medicina,  porque  sobre  ella  están  basadas  mucbas  de  las  leyes 
que  rigen  las  costumbres  de  los  distintos  países,  y  las  llamadas  leyes 
sobre  alimentos  puros  y  porijue  con  frecuencia  se  sirven  los  tribunales 
de  ella  como  norma  kigai. 

En  casi  todos  los  países  la  farmacopea  se  deriva  directamente  del 
Gobierno.  En  los  países  anglo  sajones  una  necesidad  ha  producido 
con  frecuencia  medios  po])ulares  para  hacerla  frente,  fuera  de  la 
inspección  gubernamental,  ó  sin  ella,  como  en  Inglaterra,  precisa- 
mentCj  donde  todo  el  servicio  de  faros  se  halla  en  manos  de  los  Her- 
manos de  la  Trinidad  y  no  bajo  el  dominio  del  Gobierno,  porque  fueron 
los  comerciantes  de  Inglaterra  los  que  originalmente  establecieron 
los  faros  en  su  país. 

Del  mismo  modo,  en  los  Estados  Unidos  la  farmacopea  fué  origi- 
nada por  convenciones  cond^inudas  de  las  dos  profesiones  interesadas, 
y  así  ha  continuado  siéndolo  por  más  que  los  estatutos  del  Gobierno 
la  han  reconocido  como  la  ley  del  país. 

Antes  de  que  exista  la  farmacopea  en  un  país,  la  práctica  de  la 
medicina  en  el  mismo  debe  hallarse  en  un  estado  más  ó  menos  caótico. 
La  farmacia  no  tiene  una  norma  oficial,  así  es  que  si  uno  quiere  por 
ejemplo  una  tintura  especial  la  consigue  en  la  botica  de-vm  lado  de  la 
calle  distinta  en  fuerza  ,á  la  que  conseguiría  en  la  farmacia  del  otro 
lado.  Ahora,  desde  que  la  costumbre  de  viajar  ha  puesto  á  las 
naciones  en  comunicación  continua,  la  diferencia  entre  las  varias 
farmacopeas  ha  llegado  á  ser  grande  en  sus  resultados  prácticos.  Por 
esta  razón  se  convocó,  á  iniciativa  del  Gobierno  Belga,  la  llamada 
Conferencia  sobre  los  remedios  fuertes  ó  poderosos  que  se  celebró  en 
Bruselas,  en  la  cual  se  adoptaron  ciertas  normas  para  la  preparación 
de  dichos  remedios.  La  Farmacopea  de  los  Estados  Unidos  es  la 
primera  que  está  de  acuerdo  con  la  norma  internacional,  y  ha  hecho, 
por  lo  tanto,  un  gran  adelanto  en  la  historia  de  la  práctica  de  la  medi- 
cina del  mundo.  Por  una  casualidad  fui  presidente  de  la  llamada 
Farmacopea  de  los  Estados  Unidos,  y  creo  que  por  esta  razón  se  me  ha 
llamado  para  hablar  ante  Vds.  El  movimiento  para  que  se  publique 
una  edición  española  de  la  Farmacopea  de  los  Estados  Unidos,  no  se 
originó  de  la  Convención  Farmacéutica  de  éstos.  Mucho  antes  de  que 
se  publicara  la  Farmacopea,  desde  Cuba,  primeramente,  yo  creo, 
pidieron  una  traducción  española  de  la  obra,  después  de  Panamá  y 
por  último  de  Filipinas.  La  necesidad  de  esta  traducción  en  las  pose- 
siones americanas  y  los  países  en  donde  se  liabla  el  español  es,  natural- 
mente, imperiosa,  y  cuando  vemos  el  estado  de  las  Repúblicas  Sur- 
Americanas  en  general  resulta  la  no  menos  imperiosa  necesidad  de  una 
norma  común.  Creo  que  Méjico  es  la  única  República  que  tiene  una 
farmacopea  oficial.  En  Cuba  se  usan  tres  farmacopeas,  la  de  los 
Estados  Unidos,  la  española  y  la  francesa,  y  siempre  existe  una  con- 
fusión perpetua;  supongo  que  el  resultado  de  esta  confusión  hizo  que 
los  cubanos  fueran  los  primeros  en  pedir  una  traducción  de  la  Farma- 
copea de  los  Estados  Unidos. 

En  casi  todos  los  países  españoles  se  usa  el  códice  francés.  En 
Chile  usan  el  alemán.  Actualmente  no  existe  ninguna  traducción 
castellana  del  códice  francés,  de  modo  que  ninguno  de  los  vastos  terri- 
torios al  sur  de  los  Estados  Unidos  y  Méjico  tiene  una  farmacopea  en 
el  idioma  del  pueblo,  que  sea  reconocida  por  los  gobiernos  como  una 
norma  oficial.     Si  existe  alguna  verdad  fundamental  en  la  Doctrina  de 


254  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Monroe  es  la  de  que  los  pueblos  de  América  sean  independientes,  no 
solamente  en  lo  político,  sino  también  en  lo  científico  y  profesional. 
En  las  condiciones  actuales  se  ve  que  las  Repúblicas  Sur- Americanas  no 
lo  son.  Con  respecto  á  este  asunto  copian  sus  instituciones  ó  leyes  de 
los  países  extranjeros.  Por  ahora  la  Farmacopea  de  los  Estados 
Unidos  no  es  internacional,  pero  se  espera  que  cuando  se  hao;a  la  tra- 
ducción española,  y  si  se  usa,  como  casi  seguramente  lo  será,  extensa^ 
mente,  tendremos  una  especie  de  Farmacopea  Americana  ó  Pan- 
Americana,  si  así  queréis  llamarla.  Esto  puede  suceder  de  varias 
maneras.  Bien  puede  ocurrir  que  finalmente  se  nombre  un  cuerpo 
internacional  para  que  prepare  una  nueva  farmacopea  basada  en  la 
más  completa  que  exista  en  el  mundo.  También  puede  suceder  que  la 
llamada  Convención  de  la  Farmacopea  de  los  Estados  Unidos  sea  modi- 
ficada en  su  naturaleza,  de  modo  que  se  convierta  en  Pan-Americana 
mediante  la  admisión  de  deleitados  de  todas  partes  de  Sur-América. 
Nadie  sabe  cuál  de  estos  dos  modos  será  el  que  se  lleve  á  cabo,  porque 
ésta  es  sólo  la  iniciativa  para  un  movimiento  que  á  mi  juicio  es  de  la 
mayor  importancia  y  que  es  estrictamente  de  la  incumbencia  de  esta 
Convención,  y  entonces,  dentro  de  dos  años  en  la  Convención  de 
Méjico,  ó  de  otra  manera,  podremos  seguramente  fundar  una  Farma- 
copea Pan-AiHericana. 

Doctor  LicÉAGA.  En  Méjico  hay  una  junta  especial  para  la  farma- 
copea, que  estudia  las  distintas  farmacopeas  j  hace  una  publicación 
especial,  ó  bien  adopta  alguna  particularmente  j  la  traduce  al  caste- 
llano con  la  aprobación  oficial  de  la  nación. 

Doctor  Wood.  En  mis  observaciones  generales  luce  excepción 
expresa  de  Méjico  conociendo  bien  el  hecho  que  el  Doctor  Licéaga  acaba 
de  mencionar. 

Doctor  Licéaga.  Es  que  no  entendí  bien  lo  que  dijo  el  Doctor  Wood 
en  este  respecto. 

Doctor  MooEE.  En  Chile  han  adoptado  la  Farmacopea  alemana  y  la 
publicación  nacional  es  casi  toda  una  copia  de  la  alemana,  traducida  al 
castellano.  Estoy  del  todo  conforme  con  la  solución  propuesta  por  el 
Doctor  Guiteras,  y  considero  de  importancia  el  que  se  adopte  una 
farmacopea  de  carácter  internacional  para  las  Reptíblicas  Americanas. 
Según  tengo  entendido,  la  Farmacopea  americana  es  mucho  mejor  que 
las  otras  que  se  usan  en  las  Repúblicas  Hispano- Americanas. 

Doctor  Ulloa.  Como  representante  de  Costa  Rica,  no  tengo  mucho 
cpie  añadir  á  lo  dicho  por  el  Doctor  Moore.  Hago  mías  sus  palabras, 
con  la  excepción  de  cpie  nosotros  no  tenemos,  ni  nunca  hemos  tenido, 
una  farmacopea  nacional.  En  Costa  Rica  son  varias  las  farmacopeas 
que  se  hallan  en  uso.  Hacemos  uso  principalmente  de  la  Farmacopea 
de  los  Estados  Unidos,  porcjue  la  mayoría  de  los  médicos  de  Costa  Rica 
han  estudiado  en  los  Estados  Unidos.  Usamos  ésa  j  también  la 
alemana  y  la  francesa.  Convengo  en  todas  las  declaraciones  hechas 
por  los  anteriores  oradores,  y  con  placer  daré  mi  conformidad  á  la 
proposición  hecha  por  el  Doctor  Guiteras. 

Doctor  Baenet.  Me  hallo  conforme  con  las  manifestaciones 
hechas.  El  Gobierno  de  Cuba  ha  nombrado  una  comisión  especial 
para  la  preparación  de  una  farmacopea  nacional,  pero  que  después  de 
celebrar  varias  reuniones  encontró  c[ue  el  trabajo  que  tenía  entre 
manos  era  harto  difícil,  y  que  tenía  que  tropezar  con  muchas  difi- 
cultades, por  lo  que  se  decidió,  después  de  consultarlo  y  discutirlo,  que 


SEGUNDA    CONI^^EKENCIA    SANITARIA    INTEKNACK/NAJ..  205 

lo  mejor  era  adoptar  la  Farmacopea  de  los  Estados  Unidos,  traducida, 
como  es  claro,  al  castellano.  Habiéndose  acordado  ésto,  se  díicidió 
que  el  Doctor  Guiteras,  en  nombre  de  Cuba,  propusiera  á  esta  Confe- 
rencia la  adopción  de  las  resoluciones  cpie  lia  presentado  al  efecto. 

El  FuKSiDiíN'i'E.  ¿  Desea  al,'i;íin  otro  caballero  hacer  más  observa- 
ciones sobre  este  tema'í  Si  nó,  estas  resoluciíjnes  serán  devueltas  por 
la  junta  consultora  en  luia  de  las  sesiones  de  la  Convención.  Deseo 
prep;untar  al  presidente  de  esa  junta  si  tiene  ([ue  someter  alj^o  de 
la  misma. 

Doctor  MooRE.  Pon^o  en  conocimiento  del  Coní^reso  que  la  junta 
consultora,  después  de  discutir  el  asunto,  ha  decidido  recomendar  la 
adopción  de  la  Convención  de  París  de  1903,  omitiendo,  como  es  natu- 
ral, todos  los  artículos  que  no  son  de  aplicación  en  América.  Hay 
algunos  artículos  que  se  refieren  al  Mar  Rojo  y  á  otros  asuntos,  los 
cuales  no  son  de  importancia  ó  interés  para  este  lado  del  Atlántico. 
También  se  hizo  una  excepción  al  efecto  de  que  no  de1)ía  perniitirse  á 
los  pasajeros  desembarcar  después  de  la  llegada  de  un  buque  inf(!ctado, 
sino  que  fueran  puestos  bajo  observación  en  alojamientos  adecuados. 
Además  se  han  añadido  á  esa  convención  todos  los  artículos  relativos 
á  la  fiebre  8.marilla  que  han  sido  adoptados  en  la  última  reunión  de 
esta  conferencia,  y  se  propone  que  se  lean  uno  por  uno  los  artículos 
de  la  mencionada  convención,  para  la  aprobación  de  esta  reunión. 

El  Secretario.  Se  hará  una  copia  oficial,  en  pergainino,  de  esta 
convención,  para  que  esté  lista  para  ser  firm.ada  por  los  delegados. 

El  Doctor  Guiteras.  Cada  artículo  debe  ser  aprobado  antes  de  ser 
incluido.     Por  lo  tanto  debemos  leerlos  uno  por  uno. 

El  Presidente.  Tengo  entendido  que  hay  aquí  una  versión  inglesa 
y  otra  castellana.  Primero  se  leerá  el  artículo  en  inglés  y  después  en 
español,  de  modo  que,  cuando  se  lean  todos  y  se  aprueben,  estarán 
listos  para  ser  firmados  mañana.  Cada  artículo  debe  ser  presentado  á 
la  Convención  para  su  voto,  antes  de  que  los  delegados  lo  firmen. 
Ruego  al  Doctor  Guiteras  que  lea  la  versión  inglesa  y  al  Doctor  Moore 
que  lea  la  española. 

El  preámbulo  se  leyó  primero  en  inglés  y  después  en  español. 

El  Presidente.  Él  preámbulo,  conforme  se  ha  leido  en  inglés  y  en 
español,  se  halla  ante  la  Convención.  ¿Se  desean  hacer  observaciones 
sobre  él  ?  Se  ha  indicado  también,  y  con  razón,  que  éste  es  el  informe 
de  una  comisión  que  debía  someterlo  á  la  junta  consultora,  y  ésta,  á 
su  vez,  á  la  Convención.  Como  casi  todos  los  miembros  de  la  junta 
consulatora  han  expresado  la  opinión  de  que  debe  presentarse  ahora, 
me  hago  la  suposición,  á  menos  que  alguien  se  exprese  en  con- 
trario, que  es  con  el  fin  de  se  que  presente  como  proveniente  de  la  junta 
consultora  para  la  consideración  de  la  Conferencia.  Si  algún  miem- 
bro de  dicha  junta,  todos  los  cuales  están  aquí  presentes,  tiene  alguna 
objeción  contra  esto,  puede  manifestarla  ahora.  Dos  son  los  miem- 
bros de  la  junta  consultora  que  aún  no  han  hablado,  y  éstos  son  los 
representantes  del  Ejército  y  de  la  Armada  de  los  Estados  Unidos,  el 
Comandante  McCaw  y  el  Doctor  Gatewood.  Quisiera  que  hablen 
antes  que  sigamos  adelante.  ¿Están  estos  dos  caballeros  conformes 
con  el  orden  de  procedimiento? 

Comandante  McCaw.  Estoy  del  todo  conforme. 

Doctor  Gatewood.  Lo  mismo  yo. 

Doctor  Geddings.  Entre  los  nombres  de  los  delegados  de  los  Esta- 
dos Unidos  aparece  el  del  Dr.  A.  H.  Doty,  de  Nueva  York.     Este 


256  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

caballero  fué  debidamente  invitado  para  aue  representara  á  los  Esta- 
dos Unidos  en  la  presente  ocasión,  pero,  debido  al  exceso  de  trabajo 
en  el  puerto  de  Neuva  York,  se  ha  visto  privado  de  asistir.  Por  lo 
tanto  nunca  ha  sido  habilitado  debidamente  como  deleo;ado  de  los 
Estados  Unidos,  y  pido,  Señor  Presidente,  que  se  borre  el  nombre  del 
Doctor  Doty  de  loa  registros  de  esta  Convención. 

La  petición  fué  apoyada. 

El  Presidente.  Antes  de  dar  curso  á  esta  petición,  deseo  mani- 
festar c[ue  el  Doctor  Doty  ha  demostrado  gran  interés  por  esta  Con- 
vención, y  que  ha  aceptado  la  invitación  que  se  le  ha  hecho  caso  de 
serle  posible  el  asistir;  que  ha  enviado  muchos  telegramas  sobre  ello, 
esperando  que  podría  venir  de  un  día  para  otro,  pero,  encontrando 
que  el  trabajo  que  tiene  en  su  estación  de  cuarentena  es  excesivo,  no 
ha  podido  hacerlo.  Por  lo  que  esta  resolución  no  debe  considerarse 
como  una  censura  contra  el  Doctor  Doty.  Con  el  ñn  de  que  esto 
conste,  pido  que  se  tome  esta  acción.  El  Doctor  Doty  quiso  expresar 
ante  esta  Convención  su  grande  sentimiento  de  no  poder  estar  pre- 
sente, por  lo  que  he  creído  conveniente  hacer  esta  explicación  (véase 
el  Apéndice,  pág.  445). 

La  propuesta  fuá  aprobada. 

Doctor  Barnet.  Esta  Convención  debe  ser  firmada  por  los  repre- 
sentantes del  Gobierno  de  los  Estados  Unidos,  así  como  por  los  del 
Ejército  y  los  de  la  Armada.  Considerando  que  los  distintos  Estados 
de  la  Unión  Americana  tienen  reglamentos  diferentes  sobre  estas  mate- 
rias, sería  interesante  saber  en  qué  situación  se  encuentran  dichos 
Estados,  y  qué  actitud  tomarán  con  respecto  á  este  acuerdo. 

El  Presidente.  Esta  es  una  cuestión  muy  interesante,  j  Se  desean 
hacer  más  observaciones  ?  Si  nó,  sólo  queda  por  resolverse  la  adopción 
del  preámbulo. 

El  preámbulo  fué  aceptado. 
P^El  Doctor  Guiteras  dio  lectura  al  artículo  1  en  inglés  y  el  Doctor 
Moore  al  castellano. 

^-ílEl  Presidente.  ¿Desea  alguien  hacer  observaciones  sobre  el  arti- 
culo 1  ? 

Doctor  Guiteras.  Deseo  consultar  el  texto  francés.  Creo  que  se 
ha  empleado  una  palabra  equivocada  en  la  traducción  española. 
La  palabra  francesa  es  equivalente  á  la  inglesa  "confirmed."  La 
traducción  española  no  quiere  decir  lo  mismo  exactamente;  es  como 
sigue:  "casos  averiguados,"  que  tiene  un  significado  indefinido.  La 
mejor  traducción  sería  la  palabra  española  equivalente  á  la  inglesa 
^'confirmed." 

Doctor  Moore.  Se  ha  hecho  la  corrección  insertando  la  palabra 
española  equivalente. 

El  artículo  1  fué  aprobado. 

Se  dio  lectura  al  artículo  2. 

Doctor  Lavorería.  Propongo  que  los  distintos  «párrafos  de  este 
artículo  sean  discutidos  por  separado,  en  vez  de  serlo  todo  el  artículo 
á  un  tiempo. 

El  Presidente.  La  indicación  es  muy  buena. 

Se  leyó  el  siguiente  párrafo: 

Art.  2.  Esta  notificación  irá  acompañada,  6  muy  prontamente  seguida,  de  reseñas 
circunstanciadas  sobre: 
1°.  Lugar  en  donde  la  enfermedad  apareció. 


SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAL.  257 

El  Presidente.  ¿Se   desea   hacer   alguna  observación  soVjre  este 
párrafo?     Si  nó,  se  discutirá  su  aprobación. 
El  párrafo  precedente  fue  adoptado. 
Después  se  leyó  el  que  sigue: 

2°.  Fecha  de  su  aparición,  origen  y  forma. 

El  Presidente.  ]ra})6is  oído  la  lectura  del  2"  párrafo,  deseáis 
hacer  alguna  observación? 

Doctor  GuiTBRAS.  Se  presenta  la  cuestión  de  la  dificultad  que 
hay  algunas  veces  de  .descubrir  el  origen  de  la  enfermedad.  Así  es 
que  se  sugiere  que  no  se  puede  cumplir  siempre  con  el  requisito  de 
dar  el  origen  de  la' enfermedad.  Contestamos  á  ello  diciendo  que  si 
no  se  conoce  el  origen  de  la  enfermedad,  naturalmente  no  se  puede 
precisar  cuál  es. 

Este  párrafo  fué  aprobado. 

A  continuación  leyóse  el  siguiente: 

3°.  Número  de  casos  comprobados  y  de  defunciones. 

Este  párrafo  fué  aprobado. 
Luego  se  dio  lectura  al  siguiente: 

4",  Para  la  peste:  la  existencia  entre  las  ratas  y  ratones,  de  la  peste  ó  de  una  mortandad 
insólita;  para  la  fiebre  amarilla,  la  existencia  del  Stegomyia  Fasciata. 

Este  párrafo  quedó  aprobado. 
Después  se  leyó  el  siguiente: 

5°.  Las  medidas  tomadas  iimiediatamente  después  de  la  primera  aparición. 

El  Presidente.  Espero  que  los  miembros  que  hablan  el  inglés 
pongan  especial  atención  á  la  traducción  inglesa,  porque,  como  el 
Doctor  Guiteras  dice,  ha  sido  hecha  apuradamente  y  puede  tener 
errores.     El  Doctor  Guiteras  me  rogó  que  hiciera  esta  declaración. 

El  párrafo  precedente  quedó  aprobado. 

El  Presidente.  Creo  que  ahora  debemos  aprobar  el  artículo  2  por 
entero,  pues  aún  cuando  ha  sido  leído  por  párrafos,  ahora  debemos 
discutir  la  aprobación  del  mismo  en  su  totalidad.  Se  desea  que  la 
lectura  de  los  siguientes  artículos  se  haga  por  párrafos? 

El  Doctor  Guiteras.  Ya  se  ha  hecho  esa  petición. 

Se  dio  lectura  al  siguiente: 

Artículo  3.  La  notificación  y  las  reseñas  previstas  en  los  artículos  1  y  2  serán  dirigidas 
á  los  agentes  diplomáticos  ó  consulares  en  la  capital  del  país  contaminado. 

El  Presidente.  Esta  es  una  cuestión  muy  importante.  Entiendo 
que  nada  hay  en  esto  que  impida,  por  ejemplo,  al  Presidente  de  la 
Junta  Superior  de  Sanidad  de  México  para  que  telegrafíe  al  Cirujano 
General  del  Servicio  de  Sanidad  Pública  y  Hospitales  Marítimos  de 
los  Estados  Unidos. 

Doctor  Guiteras.  Creo  que  nada  hay  que  lo  prohiba,  pero  tampoco 
hay  nada  que  le  obligue  á  hacerlo. 

Dr.  H.  L.  E.  Johnson.  ¿No  se  podría  refomar  este  artículo  de 
manera  que  la  notificación  sea  enviada  al  Servicio  de  Sanidad  Pública 
y  Hospitales  Maritimos  de  los  Estados  Unidos  en  vez  del  Departa- 
mento de  Estado  de  los  mismos? 

El  Presidente.  La  obtendríamos  por  medio  del  Departamento  de 
Estado,  y  nada  hay  que  impida  que  se  envíe  directamente  al  Servicio. 
Por  ejemplo,  yo  telegrafío  con  frecuencia  al  Presidente  de  la  Junta 
1112a— 06— 17 


258  SEGUXDA    COÍÍFEE.EÍÍCIA    SAXITAEIA    INTERNACIONAL. 

Superior  de  Sanidad  de  Cuba  y  también  al  Presidente  Licéaga,  y 
ambos  hacen  lo  mismo  conmigo. 

Doctor  Barnet.  Pido  que  se  inserte  un  párrafo  en  ese  artículo 
que  comprenda  la  declaración  que  acaba  de  nacerse. 

Doctor  Gatewood.  Propongo  que  la  modificación  proyectada 
esté  concebida  en  los  siguientes  términos: 

Artículo  3.  La  notificación  y  las  reseñas  previstas  en  los  artículos  1  y  2  serán  dirigidas  á 
los  agentes  diplomáticos  6  consulares  en  la  capital  del  país  contaminado.  Entendiéndose 
que  esto  no  es  óbice  para  que  los  funcionarios  de  sanidad  pública  de  los  diversos  países 
puedan  comunicarse  directamente.  * 

Hago  esta  proposición  con  el  fin  de  evitar  las  objeciones  que  se 
hacen  en  contra  de  la  lentitud  con  que  las  informaciones  pasan  por  las 
vías  diplomáticas. 

El  Presidente.  Habéis  oído  el  párrafo  conforme  está  reformado. 
gSe  desea  hacer  más  observaciones? 

El  párrafo  fué  aprobado  con  la  modificación  propuesta. 

Después  se  leyó  el  párrafo  cpe  sigue: 

A  los  países  que  no  tengan  representación  diplomática  ó  consular  en  el  país  contami- 
nado, les  serán  transmitidas  directunente  por  telégrafo. 

Este  párrafo  fué  aprobado. 

A  continuación  se  dio  lectura  al  artículo  4 : 

Artículo  4.  La  notificación  y  las  reseñas  previstas  en  los  artículos  1  y  2  serán  seguidas 
de  comunicaciones  ulteriores,  dadas  de  un  modo  regular,  con  el  ñn  de  tener  á  los  Gobiernos 
al  corriente  del  curso  de  la  epidemia. 

Estas  comunicaciones,  que  se  harán  por  lo  menos  una  vez  á  la  semana  y  que  serán  tan 
completas  como  sea  posible,  indicarán  más  particularmente  las  precauciones  tomadas 
con  el  fin  de  combatir  la  propagación  de  la  enfermedad.  Deben  precisar  (1)  las  medidas 
profilácticas  tomadas  con  respecto  á  la  inspección  sanitaria  ó  la  visita  médica,  al  aisla- 
miento y  á  la  desinfección  y  (2)  las  medidas  tomadas  al  salir  los  buques  para  impedir  la 
exportación  del  mal,  y  especialmente,  en  el  caso  previsto  en  la  fracción  4"^  del  artículo  2 
arriba  mencionado,  las  medidas  tomadas  contra-las  ratas  y  los  mosquitos. 

El  Presidente.  ¿Doctor  Guiteras,  quiere  Vd.  hacer  el  favor  de 
decirnos  si  hemos  llegado  al  fin  del  artículo  4  ? 

Doctor  Guiteras.  Sí;  se  ha  leído  todo  el  artículo  4. 

El  Presidente.  El  artículo  4  ha  sido  leído  á  la  Convención,  en 
inglés  y  en  español,  conforme  ha  sido  reformado.  Debemos  resolver 
pues  la  aprobación  del  mismo  en  su  totalidad. 

El  artículo  fué  aprobado. 

El  Doctor  Moore  dijo  que  no  había  nada  especial  en  los  diversos 
párrafos  de  cada  artículo.  Que  creía  que  cada  artículo  debía  leerse 
en  su  totalidad  y  después  discutirse  todo  él  de  una  vez. 

Después  se  leyó  el  siguiente  artículo: 

Artículo  5.  El  pronto  y  sincero  cumplimiento  de  las  disposiciones  que  preceden  es  de 
importancia  primordial.  Las  notificaciones  no  tienen  valor  real  sino  cuando  cada  Gobierno 
es  prevenido  el  mismo,  á  tiempo,  de  los  casos  de  peste,  cólera  ó  fiebre  amarilla,  ó  de  los 
dudosos,  sobrevenidos  en  su  territorio.  Nunca  se  recomendará  demasiado  á  los  gobiernos 
que  hagan  obligatoria  la  declaración  de  los  casos  de  peste,  cólera  y  fiebre  amarilla  y  que 
den  aviso  de  toda  mortandad  insólita  comprobada  de  ratas  ó  ratones,  particularmente  en 
los  puertos. 

Doctor  Gatewood.  Señor  Presidente,  me  parece  que  la  palabra 
''sincero"  debe  ser  sustituida  por  ''franca,"  y  "cumplimiento"  por 
"consumación." 

Dr.  H.  L.  E.  Johnson.  ¿No  sería  mejor  dejar  las  palabras  que  se 
han  acordado?     ¿Cómo  está  esa  parte? 

Doctor  Guiteras.  Dice,  "el  pronto  y  sincero  cumplimiento." 
Esto  es  mejor  que  "consumación,"  no  cabe  la  menor  duda. 


SE(JUNDA    CONFERENCIA    SANITAlílA    JNTEKN ACIONAL.  259 

Doctor  Gatewood.  "El  pronto  y  fiel  cumplimiento," 

Doctor  GuiTEiiAS.  Sí,  "pronto  y  íicl." 

El  Presidente.  ¿  Está  esto  de  acuerdo  con  el  ori^rinal? 

Doctor  GuiTERAS.  El  original  dice:  "El  rápido  y  fiel  cumplimiento 
de  las  disposiciones  que  preceden  es  de  importancia  primordial." 
Después  dice  "casos  dudosos  sobrevenidos  en  su  territorio." 

El  PiiEsiDENTE.  "p, Casos  dudosos?" 

Doctor  GuiTERAS.  Sí,  "casos  dudosos." 

Doctor  Gatewood.  La  palabra  "sospechosos"  sería  mejor  (jue 
"dudosos." 

Doctor  GuiTERAS.  Sí,  lo  es. 

Doctor  Gatewood.  Quisiera  saber  qué  valor  tiene  la  palabra 
"insólito"  con  respecto  á  mortandad.  ¿No  sería  mejor  la  palabra 
"anormal?" 

Doctor  Guiteras.  Muy  bien.  Sustituyendo  esas  palabras,  el  artí- 
culo dice: 

El  pronto  y  fiel  cumplimiento  de  las  disposiciones  que  preceden  es  de  importancia  pri- 
mordial. Las  notificaciones  no  tienen  valor  real  sino  cuando  se  previene  cada  Gobierno,  á 
tiempo,  de  los  casos  de  peste,  cólera  y  fiebi-e  amarilla,  ó  de  los  sospechosos,  sobrevenidos  en 
su  territorio.  Nunca  se  recomendará  demasiado  á  los  Gobiernos  que  hagan  obligatoria  la 
declaración  de  los  casos  de  peste,  cólera  y  fiebre  amarilla,  y  que  den  aviso  de  toda  mortandad 
anormal  comprobada  de  ratas  ó  ratones,  especialmente  en  los  puertos. 

El  Presidente.  ¿Es  ese  todo  un  artículo,  ó  sólo  un  párrafo? 

Doctor  Guiteras.  Es  todo  el  artículo  5.  Deseo  hablar  sobre  este 
artículo,  Señor  Presidente,  únicamente  con  respecto  á  la  traducción 
española. 

Aquí  el  Doctor  Guiteras  habló  en  español. 

Doctor  Guiteras.  Eso  es  todo.  Señor  Presidente,  sólo  quise  men- 
cionar las  correcciones  verbales. 

El  Doctor  Moore  leyó  el  artículo  5  en  español  conforme  quedó 
corregido. 

El  Presidente.  Habéis  oído  el  artículo  5.  La  cuestión  está  ahora 
en  discutir  su  adopción. 

El  artículo  5  fué  aprobado. 

El  Presidente.  Antes  de  seguir  adelante,  deseo  preguntar  al 
Doctor  Guiteras  cómo  se  ha  de  firmar  la  convención,  en  pergamino  ó 
en  una  galerada,  ó  en  una  copia  mecanografiada.  Porque  si  ha  de  ser 
en  pergamino  ó  en  impreso,  tendremos  que  tomar  medidas  especiales 
para  que  se  haga  cuanto  antes.  Se  emplearía  algún  tiempo  en  pre- 
parar la  copia  en  pergamino  ó  impresa,  por  lo  que  sería  conveniente 
que  á  medida  que  terminemos  cada  una  de  estas  hojas,  las  vayamos 
entregando  al  representante  oficial  de  la  Oficina  de  las  Repúblicas 
Americanas  para  que  sean  transcritas  en  ella  y  de  este  modo  estarán 
listas  para  mañana.  Supongo  que  todos  los  delegados  querrán  firmar 
dicha  convención  antes  de  marcharse,  y  sería  muy  difícil  preparar  la 
copia  para  mañana  por  la  tarde. 

Doctor  Guiteras.  He  propuesto  que  tuviéramos  aquí  dos  personas 
que  escribieran  estos  artículos  á  medida  que  se  aprueban,  una  que 
escribiera  en  inglés  y  otra  en  español,  pero  me  parece  que  la  indicación 
de  Vd.  debe  ser  aceptada,  y  que  las  hojas  se  vayan  entregando  á 
medida  que  se  aprueban. 

El  Presidente.  ¿Desea  la  Convención  que  se  escriban  los  artículos 
en  pergamino  ? 


260  SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL. 

Doctor  GuiTERAS.  Creo  que  nó.  Desde  luego  que  si  pudiera 
hacerse  en  pergamino  sería  mejor,  pero  supongo  que  esto  no  es  fac- 
tible. 

El  Presidente.  Podría  serlo. 

En  esta  parte  los  Doctores  ülloa  y  Licéaga  liicieron  uso  de  la 
palabra. 

El  Presidente.  Si  Yds.  no  tienen  inconveniente,  las  hojas  en 
español  y  en  inglés  que  se  hayan  terminado  serán  entregadas  al 
Oficial  Mayor  de  la  Oficina  de  las  Repúblicas  Americanas  para  que 
sean  transcritas  en  pergamino.  Creo  que  hay  algunas  hojas  termi- 
nadas. 

Doctor  GuiTERAS.  Sí,  señor. 

El  Presidente.  (Después  de  una  conversación  en  privado  que 
sostuvieron  los  delegados).  lluego  al  Doctor  Culteras  que  haga 
alguna  indicación  sobre  la  parte  preliminar  de  este  documento,  porciue 
se  entregará  ahora  al  escribiente  para  que  la  copie.  Creo  que  esto 
está  muy  claro  ahora.  Sólo  queda  por  decidirse  si  se  ha  de  hacer  este 
documento  en  pergamino  ó  en  copias  mecanografiadas. 

En  esta  parte  los  delegados  sostuvieron  una  conversación  en 
privado. 

El  Presidente.  Vds.  comprenden  el  objeto,  y  no  será  necesario 
ponerlo  á  votación.  A  menos  que  haya  algún  inconveniente,  el  pro- 
cedimiento será  que  la  primera  parte  del  documento  presentado  por 
la  comisión  redactada  de  manera  satisfactoria  para  ésta  y  en  forma 
adecuada  para  ser  copiada  por  el  escribiente,  será  mecanografiada  en 
buen  papel  grueso,  haciéndose  una  copia  en  inglés  y  otra  en  caste- 
llano. También  se  acompañará  á  dicho  documento  un  certificado 
sobre  la  exactitud  de  las  traducciones. 

Ahora  se  dará  lectura  al  artículo  6. 

Este  artículo  fué  leído  en  inglés  por  el  Doctor  Culteras  y  en  caste- 
llano por  el  Doctor  Moore. 

Artículo  6.  Se  entenderá  que  los  países  vecinos  se  resen^an  el  derecho  de  hacer  arreglos 
especiales  con  el  fm  de  organizar  un  servicio  de  observaciones  directas  entre  los  jefes  de  las 
administraciones  de  las  fronteras. 

El  Doctor  Lavorería  hizo  uso  de  la  palabra. 

Este  artículo  fué  aprobado. 

Doctor  Guiteras.  Ahora  llegamos  á  la  sección  segunda.  Su  título 
es:  "Condiciones  que  permiten  considerar  una  circunscripción  terri- 
torial como  contaminada  ó  como  que  ha  vuelto  á  quedar  sana."  Esto 
no  significa  nada. 

Se  sostuvo  una  discusión  en  privado  entre  los  miembros. 

Doctor  Guiteras.  Hemos  modificado  este  título  de  manera  que  se 
lea  conio  sigue:  "Condiciones  que  permiten  que  un  territorio  deter- 
minado se  considere  como  contaminado,  ó  como  libre  ya  de  la 
enfirmedad. 

Artículo  7.  La  notificación  de  un  primer  caso  de  peste,  cólera  ó  fiebre  amarilla  no  impone, 
contra  la  circunscripción  territorial  donde  ha  ocurrido,  la  aplicación  de  las  medidas  previstas 
en  el  capítulo  que  sigue. 

El  Presidente.  Allí  se  usa  la  palabra  "capítulo,"  y  es  la  primera 
vez  que  la  oigo. 

Doctor  Gatewood.  Esta  es  la  sección  segunda  del  capítulo  primero. 


SEGUNDA   CONFERENCIA    SANITARIA   INTERNACIONAL.  201 

Doctor  GuiTERAS.  Eso  es.  Volveré  á  leer  este  artículo  hasta  el 
final: 

Artículo  7.  La  notificación  do  un  primer  caso  do  posto,  cólera  6  íiobro  amarilla  no  impone, 
contra  la  circunscripción  territorial  donde  lia  ocurrido,  la  aplicación  de  las  medidas  pre- 
vistas en  el  capítulo  (jue  sin;ue. 

Pero  al  ocurrir  muclios  casos  do  peste  ó  fiebre  amarilla,  no  irnpoitados,  ó  cuando  los  casos 
de  cólera  constituyen  un  foco,  la  circunscripción  se  declarará  contaminada. 

Doctor  GuiTERAS.  Deseo  hacer  uso  de  la  palabra.  Solamente 
quiero  hacer  notar  que  estamos  decidiendo  si  un  solo  caso  de  fiebre 
amarilla  no  importado  es  suficiente  para  declarar  una  circunscripción 
contaminada.  Siento  decir  que  no  tengo  una  opinión  positiva  sobre 
el  particular,  pero  quisiera  que  la  Conferencia  estudie  el  asunto  y 
decida  con  precisión  lo  que  sea  exacto.  Se  dice  que  es  preciso  que 
ocurran  varios  casos  de  peste  antes  de  que  se  declare  un  sitio  contami- 
nado. Se  dice  que  los  casos  de  cólera  deben  ser  bastantes  para  cons- 
tituir un  foco  antes  de  que  se  declare  un  lugar  infectado.  Vamos  á 
decidir  si  un  caso  de  fiebre  amarilla  es  bastante  para  que  el  lugar  en 
donde  ha  ocurrido  sea  declarado  contaminado.  Ciertamente  que,  si 
la  moderna  teoría  de  la  transmisión  de  la  fiebre  amarilla  se  entendiera 
generalmente,  y  todos  estuvieran  conformes  en  llevar  á  efecto  las 
medidas  contra  la  propagación  de  la  misma,  me  opondría  á  que  se 
declare  un  sitio  infectado  porque  en  él  ocurrió  un  solo  caso  no  impor- 
tado; pero  como  en  algunas  partes  se  duda  mucho  de  la  aplicación 
de  la  moderna  teoría  mencionada,  me  inclino  más  bien  á  apoyar  la 
adopción  de  esa  medida,  que  un  solo  caso  de  fiebre  amarilla  es  bas- 
tante para  declarar  un  sitio  como  contanfinado.  Quisiera  oh  la 
opinión  del  Doctor  Licéaga  sobre  el  particular. 

El  Doctor  Licéaga  manifestó  que  se  hallaba  en  favor  del  artículo  en 
cuestión,  tal  como  está  en  la  Convención,  porque  tiene  la  plena  con- 
vicción de  la  exactitud  de  la  doctrina  de  la  infección  de  la  fiebre 
amarilla  por  medio  del  mosquito,  y  cree  que  un  solo  caso  de  fiebre 
amarilla  es  suficiente  para  infectar  bastantes  mosquitos  que  pro- 
duzcan un  buen  número  de  casos  de  la  enfermxcdad.  El  opinaba  que, 
estando  nosotros  interesados  en  la  extinción  de  la  fiebre  amarilla  en  el 
continente  americano,  este  artículo  debía  dejarse  tal  como  está. 

El  Presidente.  Creo  que  no  se  menciona,  ó  aún  no  se  ha  men- 
cionado, la  extensión  del  area,  por  lo  que  se  debe  aclarar  este  punto,  y 
creo  que  lo  mejor  sería  leer  lo  que  viene  más  adelante  relativo  á  la 
extensión  del  area  contaminada,  y  después  volver  á  discutir  esta 
cuestión  y  ponerla  á  votación. 

Doctor  Guiteras.  Aquí  dice  "circunscripción  territorial,"  es  decir, 
cualquier  área  territorial. 

El  Presidente.  ¿Significa  eso  una  casa,  una  manzana  ó  un  acre? 

Doctor  Guiteras.  El  siguiente  artículo  lo  define.     Voy  á  leerlo. 

El  Presidente.  Lea  lo  que  dice  el  siguiente  artículo. 

Doctor  Guiteras.  Dice: 

Se  entiende  por  la  palabra  "circunscripción"  una  parte  del  territorio  bien  determinada  en 
las  reseñas  que  se  acompañen  ó  sigan  á  la  notificación,  así:  Una  provincia,  un  "gobierno," 
un  distrito,  un  departamento,  un  cantón,  una  isla,  una  com-una,  una  ciudad,  un  barrio  de  una 
ciudad,  una  aldea,  un  puerto,  un  polder,  una  aglomeración,  etc.,  cualesquiera  que  sean  la 
extensión  y  la  población  de  esas  porciones  de  territorio. 

El  Presidente.  Es  evidente,  pues,  de  esa  clausula  que  la  exten- 
sión de  la  circunscripción  contaminada  debe  ser  indicada  pronta- 
mente.    ¿Ha  terminado  Vd.  la  lectura  de  ese  artículo? 


262  SEGUNDA    CONFERENCIA   SANITARIA    INTERNACIONAL. 

Doctor  GuiTERAS.  Hemos  discutido  la  cuestión  de  si  un  caso  de 
fiebre  amarilla  es  suficiente  para  declarar  una  circunscripción  conta- 
minada, y  los  delegados  que  hablan  el  español  parecen  ser  de  la  opi- 
nión de  (|ue  un  caso  es  suliciente  para  que  se  declare  un  sitio  infectado. 

El  Presidente.  Creo  que  los  delegados  que  hablan  el  inglés  esta- 
rán de  acuerdo. 

Doctor  GuitERAS.  Entonces  el  artículo  7  queda  conforme  está. 

Dióse  lectura  de  nuevo  al  artículo  7,  como  sigue: 

Artículo  7.  La  notificación  de  un  primer  caso  de  peste,  cólera  ó  fiebre  amarilla  no 
impone,  contra  la  circunscripción  territorial  donde  ha  ocurrido,  la  aplicación  de  las  medidas 
provistas  en  el  artículo  que  sigue. 

Pero  al  ocurrir  muchos  casos  de  peste  ó  fiebre  amarilla,  no  importados,  ó  cuando  los  casos 
de  cólera  constituyen  un  foco,  la  circunscripción  se  declara  contaminada. 

El  Presidente.  Ahora  se  pone  á  votación  la  adopción  de  este 
artículo. 

Discutióse  la  cuestión  y  el  artículo  fué  aprobado. 
Doctor  GuiTERAS.  Ahora  sigue  el  artículo  8. 

Aktículo  8.  Para  limitar  las  medidas  á  las  regiones  atacadas  solamente,  los  Gobiernos 
no  deben  aplicarlas  más  que  á  las  procedencias  de  las  circunscripciones  contaminadas. 

"Se  entiende  por  'circunscripción'  una  parte  del  territorio  bien  determinada  en  las 
reseñas  que  acompañen  ó  sigan  á  la  notificación,  así:  una  provincia,  un  'gobierno,'  un 
distrito,  im  departamento,  un  cantón,  una  isla,  una  comuna,  una  ciudad,  un  barrio  de  una 
ciudad,  una  aldea,  un  puerto,  un  polder,  una  aglomeración,  etc.,  cualesquiera  que  sean  la 
extensión  y  la  población  de  esas  porciones  de  territorio." 

Pero  esta  restricción  limdtada  á  la  circunscripción  contaminada  no  debe  ser  aceptada, 
sino  con  la  condición  formal  de  que  el  Gobierno  del  país  contaminado,  tome  las  medidas 
necesarias:  Primero,  para  impedir,  á  menos  de  desinfección  previa,  la  exportación  de  los 
objetos  á  que  se  refieren  los  incisos  1  y  2  deKaríícuio  12,  procedentes  de  la  circunscripción 
contaminada. 

Doctor  Ulloa.  ¿Cómo  está  eso? 

Doctor  GuiTERAS.  ¿Cómo  se  pueden  impedir  los  artículos  pro- 
cedentes por  medio  de  la  desinfección? 

Doctor  Ulloa.  Eso  quiere  decir  que  se  impida  la  exportación  de 
los  aitículos  de  la  circunscripción  contaminada.  Lo  mejor  es  cam- 
biar la  palabra  inglesa  "articles"  por  "objects." 

Doctor  GuiTERAS.  ¿Se  impide  la  procedencia  mediante  la  desinfec- 
ción? Nó.  Dice  el  texto,  "impedir  la  procedencia  de  la  circuns- 
cripción mediante  la  desinfección."  Esto  no  es  exacto,  por  más 
que  está  así  en  el  texto  francés  también.  Este  dice,  "prevenir  la 
importación  de  artículos  por  medio  de  la  desinfección  preliminar  de 
los  mismos."     Esto  és  muy  extraño.     Evidentemente  hay  un  error. 

Los  delegados  sostuvieron  una  discusión  privada. 

Doctor  GuiTERAS.  Hemos  modificado  este  párrafo  de  manera  que 
se  lea  como  sigue : 

Pero  esta  restricción,  limitada  á  la  circunscripción  contaminada,  no  debe  ser  aceptada 
sino  con  la  condición  formal  de  que  el  Gobierno  del  país  contaminado  tome  las  medidas 
necesarias,  primero  para  impedir,  á  menos  que  se  hayan  desinfectado,  previamente,  la 
exportación  de  los  objetos  mencionados  en  los  incisos  1  y  2  del  artículo  12,  procedentes 
de  la  circunscripción  contaminada. 

Y  más  adelante: 

Y  segundo,  para  combatir  la  propagación  de  la  epidemia,  y  con  la  condición  de  que  no 
haya  duda  que  las  autoridades  sanitarias  han  cumplido  fielmente  con  el  artículo  1  de 
esta  Convención. 

Cuando  una  circunscripción  esté  contaminada,  no  se  tomará  medida  restrictiva  alguna 
contra  las  procedencias  de  esa  circunscripción,  si  dichas  procedencias  la  han  dejado  cinco 
días,  por  lo  menos,  antes  del  principio  de  la  epidemia. 


SEGUNDA    CDNFEEENCIA   SANITARIA   INTERNACIONAL.  263 

Se  volvió  á  leer  .el  artículo  8  desde  el  principio  hasta  el  íin.  El 
Doctor  Guiteras  lo  leyó  en  inglés  y  el  Doctor  Moorc  en  español. 

El  Presidente.  Habéis  oído  la  lectura  de  ese  artículo.  ¿Están 
Vds.  dispuestos  para  discutirlo? 

El  artículo  fue  aprobado  después  de  la  debida  discusión. 

Doctor  Geddinus.  Pido  la  palabra. 

El  Presidente.  El  Doctor  Geddings  tiene  la  palabra. 

Doctor  Geddinüs.  Señor  Presidente,  señores,  es  un  hecho  evi- 
dente el  de  que,  debido  á  la  prisa  en  que  este  proyecto  de  convención 
ha  sido  preparado,  hay  verdadera  necesidad  de  editarlo  en  forma  para 
perfeccionarlo,  y  estamos  sacrificando  todo  el  tiempo  de  esta  confe- 
rencia para  hacer  las  correcciones  que  la  comisión  debería  hacer.  Por 
lo  tanto,  tengo  el  honor  de  proponer  que  se  suspenda  la  sesión  y  que 
el  texto  de  esta  convención  sea  devuleto  á  dicha  comisión  para  que 
la  revise  esta  noche  y  la  presente  en  forma  corregida  en  la  sesión 
de  mañana. 

Y  pido  también,  señor  Presidente,  que  se  añada  el  nombre  del 
Doctor.  Moore,  el  delegado  de  Chile,  á  esa  comisión  para  el  objeto  que 
acabo  de  mencionar,  si  es  que  él  no  tiene  inconveniente  y  ello  le  place. 

El  Doctor  Moore  dio  su  consentimiento. 

El  Presidente.  ¿Se  desea  hacer  algunas  observaciones  sobre  la 
propuesta  del  Doctor  Geddings?     Si  nó,  la  daré  curso. 

Después  de  la  discusión  dehida,  la  propuesta  fué  aprobada. 

Por  lo  cj[ue  la  Convención  suspendió  la  sesión  á  las  5.25  p.  m.  para 
volverse  á  reunir  mañana,  13  de  octubre,  á  las  9.30  a.  m. 


CUAHTO  DÍA— VIERNES,  13  DE  OCTUBRE. 

Sesión  de  la  mañana. 

El  Presidente,  Cirujano  General  Wyman,  declaró  abierta  la  sesión 
á  las  10 :  30  de  la  mañana. 

El  acta  de  la  sesión  anterior,  del  12  de  octubre,  fué  leída  por  el 
secretario,  j  quedó  aprobada  sin  modificaciones. 

El  PEEsroENTE.  Ruego  al  presidente  de  la  junta  consultora  que  lea 
el  informe  que  tenga  preparado. 

Se  leyó  el  siguiente: 

La  junta  recomienda  que  los  vice-presidentes  de  la  última  convención  sigan  siéndolo  en 
ésta,  excepto  en  los  casos  en  que  los  representantes  sean  otros,  en  los  cuales  los  nuevos  dele- 
gados sustituií'án  á  los  anteriores. 

En  los  casos  de  las  repúblicas  que  estuvieron  representadas  en  la  última  conferencia  y 
no  lo  están  en  la  presente,  no  se  nombrarán  vicepresidentes. 

La  junta  recomienda  además  que  los  respectivos  delegados  de  los  países  que  están 
representados  en  esta  convención  por  la  primera  vez,  sean  nombrados  vicepresidentes 
también. 

2.  Que  continue  funcionando  la  Oficina  Sanitaria  Internacional  conforme  quedó  con- 
stituida en  la  última  conferencia. 

3.  Que  las  resoluciones  presentadas  por  el  Doctor  Guiteras  relativas  á  la  impresión  de 
5,090  copias  de  la  Farmacopea  de  los  Estados  Unidos,  sean  recomendadas  para  su 
aprobación. 

Doctor  Guiteras.  La  comisión  redactora  está  dispuesta  á  informar 
sobre  la  convención  proyectada. 

Doctor  Barnett.  Pido  que  el  informe  sea  aprobado. 

Esta  propuesta  fué  apoyada. 

El  Presidente.  ¿Hay  objeciones  contra  esta  propuesta?  Si  nó, 
la  daré  curso. 

Doctor  Guiteras.  Pido  la  palabra. 

El  Presidente.  El  Doctor  Guiteras  tiene  la  palabra. 

Doctor  Guiteras.  Deseo  someter  algunas  resoluciones  á  la  con- 
sideración de  la  conferencia. 

Por  cuanto  que  la  República  de  México  y  la  Zona  del  Canal  de  Panama,  mediante  la 
aplicación  de  la  doctrina  del  mosquito  al  saneamiento  público,  están  aprojcimándose 
rápidamente  á  la  consecución  del  extermiiúo  final  de  la  fiebre  amarilla; 

Por  cuanto  que  la  República  de  Cuba,  mediante  la  aplicación  de  los  imsmos  métodos,  ha 
conservado  su  territorio  libre  de  dicha  fiebre; 

Por  cuanto  que  la  falta  de  preparación  para  la  aplicación  perfecta  de  estos  métodos  ha 
sido  la  causa  de  la  propagación  de  la  fiebre  en  varios  territorios;  y 

Por  cuanto  que  gracias  á  la  aplicación  de  los  mismos  métodos  en  la  ciudad  de  Nueva 
Orleans  se  ha  combatido  y  se  está  reduciendo  gradualmente  la  epidemia  de  fiebre  amarilla, 
que  desgraciadamente  las  autoridades  permitieron  que  tomara  pie  fu'me  en  ella,  la  mayor 
de  las  poblaciones  propensas  que  hasta  ahora  se  han  expuesto  á  esta  fiebre;  por  lo  tanto, 

Se  resuelve:  1.  Que  esta  conferencia  considera  que  estos  resultados  son  más  pruebas  que 
confií-man  la  exactitud  de  la  doctrina  de  que  la  fiebre  amarilla  se  trasmite  solamente  por 
la  picadura  de  un  mosquito  infectado; 

2.  Que  la  conferencia  es  de  opinión  que  sobre  la  base  de  esta  doctrina  puede  establecerse 
fácilmente  un  plan  eficaz  de  defensa  contra  la  propagación  de  la  fiebre  amarilla  al  comienzo 
de  ima  epidemia; 

264 


SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAL.  265 

3.  Quo  el  éxito  de  este  plan  dependo  do  la  poife<;ta  comprenH¡(jn,  f^or  parte  del  pueblo, 
de  la  doctrina  citada,  y  del  apoyo  quo  presten  notificando  pronta  y  francamente  los  primeros 
casos  que  ocurran,  así  como  loa  sospechosos,  y  atendiéndolos  debidamente; 

4.  Quo  las  autoridades  que  no  ddn  aviso  inmediato  de  los  casos  de  fiebre  amarilla,  son 
merecedoras  de  las  censuras  do  esta  conferencia; 

5.  Que  esta  coni'ei'cncia  áó  la  enhoiabuena  á  las  Repúblicas  de  México  y  Cuba  y  á  la 
Zona  del  Canal  de  l'anamá  ])or  los  éxitf)s  ol>tcnidos,  así  como  también  al  Servicio  de  Sanidad 
Pública  y  Hospitales  Marítimos  de  los  Eslacios  Unidos  por  el  biillante  trabajo  realizado 
en  Nueva  Orleans; 

8e  resuelve  además,  que  esta  conferencia  opina  fjue  las  cuarentenas  marítimas  y  la 
dirección  de  las  campañas  contra  toda  clase  de  epidemias  que  amenacen  extenderse  á  los 
estados  y  países  vecinos,  sean  encomendadas  á  las  autoridades  nacionales  de  sanidad. 

El  Pres  DENTE.  Estas  resoluciones  serán  sometidas  á  la  junta 
consultora.  Se  desea  someter  alguna  otra  propuesta  á  la  considera- 
ción de  la  Conferencia  antes  de  que  continuemos  la  discusión  de  los 
artículos  de  la  proyectada  convención  que  estábamos  considerando 
al  suspender  la  sesión  de  ayer? 

De  ser  así  seguiremos  leyendo  los  artículos  de  la  Convención  de 
París,  que  espero  será  firmada  por  todos.  Creo  que  sería  conveniente 
empezar  con  el  artículo  siguiente  al  último  que  adóptameos,  y  el  pro- 
cedimiento será  el  mismo  que  antes,  leyéndose  los  artículos  en  inglés 
y  en  español. 

Doctor  GuiTERAS.  Pido  que  así  se  ordene. 

El  Presidente.  Entonces,  si  todos  están  dispuestos,  se  leerá  el 
artículo  9. 

Se  dio,  pues,  lectura  al  siguiente: 

Abtícixlo  9.  Para  que  una  circunscripción  deje  de  ser  considerada  como  contaminada, 
es  preciso  la  comprobación  oficial:  1°.  De  que  no  ha  habido  ni  defxmciones  ni  casos  nuevos 
de  peste  ó  cólera  durante  los  cinco  días  siguientes  al  aislamiento,  muerte  ó  curación  del 
último  pestoso  ó  colérico.  En  caso  de  fiebre  amarilla  el  período  será  de  dieciocho  días, 
entendiéndose  que  cada  Gobierno  se  reserva  el  derecho  de  prolongar  este  período. 

Doctor  GuiTERAS.  Aquí  hay  una  nota  que  define  la  palabra  "aisla- 
miento."    Dice  así: 

Nota. — La  palabra  "aislamiento"  significa  aislamiento  del  enfermo,  5^  de  las  personas 
que  lo  cuidan  constantemente,  y  prohibición  de  visitas  de  otras  personas,  excepto  el  médico. 

Señor  Presidente,  supongo  que  si  tengo  algunas  observaciones  que 
liacer,  las  puedo  exponer  ahora. 

El  Presidente.  Sí,  señor. 

Doctor  GuiTERAS.  Deseo  hacer  constar  que  hémeos  evitado  añadir 
nada  que  no  esté  en  la  Convención  de  París,  excepto  lo  relativo  á  la 
fiebre  amarilla,  lo  cual  es  de  la  incumbencia  exclusiva  del  continente 
americano.  Pero  en  este  caso  tenemos  algo  que  decir  con  respecto 
á  las  últimas  palabras  de  la  nota.  Estas  palabras  son  "''excepto  el 
médico."  La  definición  dada  en  la  nota  de  la  Convención  de  París 
prohibe,  realmente,  que  el  médico  visite  al  enfermo,  por  que  dice: 
''el  aislamiento  del  enfermo  y  de  las  personas  que  lo  cuidan  cons- 
tantemente y  prohibición  de  visitas  de  otras  personas."  Esto 
incluye  hasta  el  médico,  por  lo  que  hemos  añadido  las  palabras 
"excepto  el  médico." 

Dice  además  el  artículo  9: 

2°.  Que  todas  las  medidas  de  desinfección  se  han  aplicado ;  si  se  trata  de  los  casos  de  peste, 
que  se  han  ejecutado  las  medidas  contra  las  ratas,  y  en  los  casos  de  fiebre  amarilla  que 
se  han  puesto  en  práctica  las  medidas  contra  los  mosquitos. 

El  Presidente.  Ayer  acordamos  que  se  añadiera  algo  más  á  la 
definición  de  la  palabra  "aislamiento,"  lo  cual  no  se  incluyó  en  la 


266  SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL. 

copia  inglesa  pqr  una  inadvertencia,  por  lo  que  deseo  que^  se  añada 
ahora.  Se  refiere  especialmente  á  la  fiebre  amarilla.  Esta  es  la 
adición  propuesta: 

En  los  casos  de  fiebre  amarilla  se  entiende  por  "aislamiento"  la  incomunicación  del 
enfermo  en  una  habitación  resguardada  de  tal  manera  que  impida  el  acceso  á  los  mosquitos. 

Esta  adición  se  leyó  en  la  copia  española,  y  nos  olvidamos  ayer 
de  insertarla  én  la  copia  inglesa. 

El  Presidente.  Habéis  oído  la  lectura  de  esta  adición.  Hay 
albina  objeción  contra  ella? 

Doctor  CJlloa.  No  estoy  del  todo  conforme  con  este  artículo 
según  se  ha  leído,  j  al  efecto  propongo  que  con  relación  á  la  peste 
bubónica  se  deje  este  artículo  tal  como  está  en  el  original  francés, 
tal  como  fué  aprobado  por  el  Congreso  Higiénico  de  París.  Soy  de 
la  opinión  que  se  debe  excluir  al  médico  de  esas  visitas  porque  tanto 
como  cualquiera  otro  puede  llevar  la  infección. 

El  Presidente.  Apoya  alguien  la  propuesta  del  Doctor  Ulloa? 

Doctor   Guiteras.  La   apoyaré   para   los   fines   de   la   discusión. 

Aquí  hicieron  uso  de  la  palabra  los  Doctores  Guiteras  y  Licéaga. 

El  Presidente.  El  Doctor  Ulloa  interpretará  las  observaciones 
del  Doctor  Licéaga  al  inglés. 

Las  observaciones  del  Doctor  Licéaga  fueron  interpretadas  al 
inglés  por  el  Doctor  Ulloa. 

Doctor  Ulloa.  El  Doctor  Licéaga  ha  dicho  haciendo  referencia 
á  mi  propuesta,  que  cuando  un  médico  va  á  visitar  un  caso  de  peste, 
toma,  como  es  natural,  todas  las  precauciones  necesarias  para  la 
ocasión;  y  el  Doctor  Guiteras  añadió  que  sería  mejor  no  hacer 
la  alteración  propuesta  por  mí,  porque  los  médicos  son  llamados  y 
tienen  que  ser  llamados  para  hacer  el  diagnóstico  de  la  peste  en 
muchos  casos,  y,  como  es  claro,  se  les  permite  hacerlo.  En  contesta- 
ción á  estas  declaraciones  digo  que  la  Conferencia  de  París  tendría 
sus  motivos  para  dejar  el  artículo  tal  como  está,  y  no  veo  la  razón 
por  que  hayamos  de  alterarlo.  Claro  está  que  respeto  las  opiniones 
de  personas  como  el  Doctor  Licéaga  y  el  Doctor  Guiteras;  pero 
tratándose  de  la  peste  bubónica,  para  que  las  medidas  tengan  efecto 
en  la  América  Española,  creo  que  los  casos  deben  aislarse  perfecta- 
mente, y  el  médico  que  los  asiste  debe  quedarse  con  los  enfermos. 
En  caso  de  aislamiento,  naturalmente,  un  médico  podría  entrar  y 
desinfectarse  antes  de  ponerse  en  contacto  con  otras  personas. 

Doctor  Guiteras.  El  médico  no  podría  entrar  en  absoluto  de 
acuerdo  con  ese  artículo,  y  esto  és  lo  que  queremos  evitar.  Si  se  deja 
el  artículo  como  estaba,  no  podría  permitirse  ninguna  clase  de  visitas. 

El  Presidente.  Ruego  al  Doctor  Geddings,  que  exponga  su  opi- 
nión sobre  el  particular,  ya  que  él  estuvo  presente  en  la  Conferencia 
de  París. 

Doctor  Geddings.  Yo  estaba  presente  cuando  se  firmó  esa  Conven- 
ción y  creo  que  las  palabras  de  esa  nota,  que  no  es  más  que  una 
nota  al  pie,  se  dejaron  por  una  simple  inadvertencia.  Pero  aparte 
de  esto,  como  interesado  que  estoy  en  la  ciencia  higiénica,  objeto  y, 
como  médico,  protesto,  con  todo  el  respeto  debido  á  nuestro  estimado 
colega,  el  Doctor  Ulloa,  contra  esa  restricción  á  las  funciones  .pro- 
fesionales de  un  médico  que  implica  la  alteración  propuesta  por  el 
Doctor  Ulloa.  Por  espacio  de  años  y  más  años,  desde  el  comienzo 
de  la  medicina,  los  médicos  han  considerado,  no  sólo  como  un  sagrado 


SEGUNDA    CONFEEENCÍA    KANI'l'AItlA    INTEIINACÍONAL.  207 

deber,  sino  también  como  un  privilefjfio,  (5I  visitar  al  enfermo,  sin 
miramiento  al  mal  de  eme  esto  atacado  y  sin  temor  de  arriesgarse 
ellos  mismos,  y,  tomanao  las  precauciones  necesarias  con  respecto 
á  otros,  han  seguido  prestando  sus  servicios.  Y  ahora  pregunto  á 
esta  Conferencia,  compuesta  de  personas  de  experiencia,  si  sabe  de 
algún  caso  en  que  la  infección  de  una  enfermedad  contagiosa,  como 
viruela,  escarlatina,  peste  bubónica,  sarampión,  etc.,  haya  sido  comu- 
nicada por  el  médico  (jue  sale  del  cuarto  (leí  enfermo. 

Esjíero  sinceramente  cjue  esta  Convención  a))robará  esta  nota  al 
üie  taf  como  ha  sido  modiíicada  por  la  comisión  y  que  no  restringirá 
la  utilidad  y  eficacia  do  los  servicios  de  un  médico,  en  menoscabo 
de  su  dignidad,  haciendo  que  se  quede  con  el  enfermo  durante  el 
aislamiento,  y  exigiendo  de  este  modo  que  cada  caso  de  peste,  cólera, 
ó  fiebre  amarilla  tenga  un  facultativo  especial. 

El  Presidente.  Se  desean  hacer  más  observaciones  sobre  la 
propuesta  del  Doctor  Ulloa?     Si  no,  discutiremos  la  cuestión. 

Discutióse  la  propuesta  del  Doctor  Ulloa,  quedando  desaprobada. 

El  Doctor  Barnet  propuso  que  se  alterara  esta  nota  borrando  á 
palabra  "  constantemente." 

Doctor  GuiTEBAs.  A])oyo  la  propuesta  del  Doctor  Barnet. 

Aprobóse  esta  proposición  después  de  ser  discutida. 

El  Presidente.  Se  desean  hacer  más  observaciones  sobre  este 
articulo  ? 

Aquí  hizo  uso  de  la  palabra  el  Doctor  Lavorería. 

Doctor  GuiTERAS.  El  Doctor  Lavorería  ha  dicho  que  no  se  ha 
levantado  para  hacer  una  objeción,  sino  para  pedir  que  se  le  explique 
la  razón  por  qué  hemos  fijado  el  período  de  dieciocho  días  en  los  casos 
de  fiebre  amarilla.     Con  vuestro  permiso  le  daré  esta  explicación. 

El  Presidente.  El  Doctor  Guiteras  explicará  eso. 

El  Doctor  Guiteras  hizo  uso  de  la  palabra  en  castellano. 

El  Presidente.  Desgraciadamente  no  tenemos  en  esta  Conven- 
ción ningún  taquígrafo  español.  El  Señor  Fox,  Director  de  la 
Oficina  de  las  Repúblicas  Americanas,  ha  hecho  todo  lo  posible  por 
conseguir  uno,  así  como  también  algunos  de  nosotros,  pero  nuestros 
esfuerzos  no  han  tenido  éxito,  por  lo  que  los  discursos  en  castellano 
tendrán  que  ser  traducidos  al  inglés.  La  explicación  que  ha  hecho 
el  Doctor  Guiteras  debe  ser  muy  interesante  y  creo  que  debe  constar 
en  las  actas,  por  lo  que  debe  traducirse.  Me  hará  Vd.  el  favor, 
Doctor  Guiteras,  de  interpretar  lo  que  acaba  de  decir? 

Doctor  Guiteras.  Trataré  de  ser  todo  lo  breve  posible.  Se  ha 
fijado  el  período  de  diez  y  ocho  días,  sin  que  ocurra  ningún  caso  de 
fiebre  de  amarilla,  antes  de  que  pueda  considerarse  una  localidad 
libre  de  la  epidemia.  Este  período  se  ha  fijado  sobre  una  base 
científica,  tomando  en  consideración  los  períodos  intrínseco  y 
estrínseco  de  la  incubación,  es  decir,  se  pasan  doce  días  desde  que  el 
mosquito  ha  picado  á  la  última  persona  afectada  hasta  que  está 
dispuesto  á  producir  un  nuevo  caso.  Después  que  pica  á  una  persona 
sana  se  pasan  seis  días  antes  de  que  la  fiebre  se  desarrolle  en  esta 
persona.  Doce  j  seis  son  diez  y  ocho.  Así  pues,  después  del 
término  de  los  diez  y  ocho  días  se  puede  considerar  un  sitio  como 
libre  de  la  epidemia.  Desde  luego,  estamos  tratando  de  una  sola 
localidad.  Tomemos,  por  ejemplo,  el  caso  de  Tampa,  Florida.  Des- 
pués de  diez  y  ocho  días  se  declaró  Tampa  libre  de  la  fiebre  amarilla; 
estábamos  seguros  j  no  había  duda  sobre  ello. ' 


68  SEGUNDA   CONFEKENCIA   SANITAEIA   INTERNACIONAL. 

Ahora  hemos  añadido  aquí  la  disposición  de  que  las  autoridades 
podrán  prolongar  este  período  de  expectación,  antes  de  declarar  un 
sitio  libre  de  la  fiebre  amarilla,  que  puedan  extenderlo  ad  libitum, 
porque  hemos  considerado  que  en  los  sitios  en  que  la  fiebre  amarilla 

f)revalece  de  ordinario — mejor  dicho,  es  endémica — el  número  de 
as  personas  inmunes  es  tan  grande  que  puede  haber  un  número 
considerable,,  ó  bastante    considerable,  de    mosquitos    que    todavía 

E ululen  por  la  localidad  sin  comunicar  la  fiebre  amarilla,  á  causa  de 
i  inmunidad  de  los  habitantes  y  en  cualquier  tiempo  podríamos 
ser  sorprendidos  por  un  caso  de  fiebre,  liemos  concedido  por  lo 
tanto  esta  facultad  para  prolongar  el  período  de  la  expectación,  por 
todo  el  verano  si  así  lo  creen  conveniente  las  autoridades.  De 
todos  modos,  se  les  dá  libertad  para  que  extiendan  ese  período. 

El  Presidente.  Me  parece  que  esta  explicación  es  muy  clara. 
Sm  embargo,  deseo  hacer  una  pregunta  al  Doctor  Guiteras,  y  es 
sobre  si  el  hecho  de  la  entrada  del  invierno  se  debe  tener  en  cuenta 
en  este  particular.  Según  lo  entiendo  aquí. se  ha  fijado  el  período 
de  diez  y  ocho  días.  Es  costumbre  en  los  Estados  Unidos  suspender 
todas  las  medidas  de  precaución  en  cuanto  ha  entrado  el  invierno. 

Doctor  Guiteras.  Ese  período  puede  ser  menor  á  la  discreción 
de  las  autoridades.     La  disposición  está  en  esta  forma. 

El  Presidente.  Se  desean  hacer  más  observaciones  sobre  este 
artículo?     Si  no,  discutiremos  su  aprobación. 

El  artículo  fué  aprobado. 

El  Presidente.  Ha  quedado  adoptado  este  artículo.  Ahora  viene 
el  Capítulo  2. 

Capítulo  II.  Medidas  de  defensa  por  los  otros  países  contra  los  territorios  declarados 
contaminados. 

Sección  1.  Publicación  denlas  medidas  prescritas. 

AnTÍcuLO  10.  El  Gobierno  de  cada  país  está  obligado  á  publicar  inmediatamente  las 
medidas  que  crea  deber  prescribir  con  motivo  de  las  procedencias  de  un  país  ó  de  una 
circunscripción  contaminada. 

Comunicará  en  el  acto  esta  publicación  al  agente  diplomático  ó  consular  del  país  con- 
taminado, residente  en  su  capital,  así  como  á  los  consejos  sanitarios  internacionales. 

Está  igualmente  obligado  á  hacer  conocer,  por  las  mismas  vías  la  retirada  de  estas 
medidas  ó  las  modificaciones  de  que  liayan  sido  objeto.  A  falta  de  agente  diplomático  ó 
consular,  en  la  capital,  las  comunicaciones  se  harán  directamente  al  Gobierno  del  país 
interesado. 

El  Presidente.  Se  desean  hacer  comentarios  sobre  este  artículo? 
Estáis  dispuestos  para  discutir  su  adopción? 
El  artículo  fué  adoptado. 
Doctor  Guiteras.  Lo  siguiente  es  esto: 

Sección  2.  Mercancías,  desinfección,  importación  y  tránsito,  equipajes. 

Aktíc'ulo  11.  No  existen  mercancías  que  sean  por  sí  mismas  capaces  de  transmitir  la 
peste,  el  cólera,  ó  la  fiebre  amarilla.  No  son  peligrosas  sino  en  el  caso  en  que  hayan  sido 
ensuciadas  con  productos  pestosos  ó  coléricos,  6  en  el  caso  de  fiebre  amarilla,  cuando  sean 
criadero  de  mosquitos. 

El  Presidente.  Se  desean  hacer  observaciones  en  este  artículo? 
El  artículo  fué  adoptado. 

Artículo  12.  Las  mercancías  ó  efectos  no  serán  desinfectados  á  causa  de  la  fiebre  amarilla, 
sino  en  los  casos  previstos  en  el  artículo  anterior  en  los  que  el  vehículo  de  transmisión  podrá 
ser  fumigado  para  la  destrucción  de  los  mosquitos. 

En  los  casos  de  peste  ó  cólera,  la  disinfección  no  deberá  aplicarse  más  que  á  las  mercancías 
ú  objectos  que  la  autoridad  sanitaria  local  considere  como  contaminadas. 

Doctor  Guiteras.  Este  artículo  es  de  bastante  importancia,  y 
pido  que  sea  divido  en  párrafos.     Lo  volveré  á  leer. 


BEGUWDA    CÍUMFElíKNOlA    SANITAJilA    INTElíNAClONAL.  209 

El  Presidente.  Está  bien. 

Doctor  GuiTEiiAS.  Dico  parte  del  artículo  12: 

*    *     *     en  loa  casos  previstos  en  el  artículo  anterior 

Es  decir,  cuando  las  mercancías  sean  criadero  de  mosquitos 


©n  los  quo  el  voliículo  ue  traii,sniÍH¡(')n  podrá  ser  íuniigaílo  para  la  dísslruwiión  de  mosquitos. 
En  los  casos  de  pcíste  ó  cfílei'a,  la  cl(!siiircc(;idn  no  deljcrá  aplicarse  más  que  á  las  mercancías 
ú  objetos  que  la  autoridad  sanitaria  local  consirlcre  como  contaminadas. 

Este  párrafo  fué  leído  en  castellano  por  el  Doctor  Moore. 
El  Presidente.  Habéis   oido   la   lectura   de   estos   dos   párrafos. 
Deseáis  hacer  al<^una  observación  ?     Si  no  discutiremos  su  aprobación. 
Los  dos  párrafos  precedentes  del  artículo  12  fueron  aprobados. 
Doctor  GuiTEKAs.  El  siguiente  párrafo  es: 

Sin  embargo,  las  mercancías  y  objectos  enumerados  después,  pueden  ser  sometidos  á  la 
desinl'ección,  y  hasta  prohibirse  su  entrada,  independientemente  de  toda  comprobación, 
estén  ó  nó  contaminados: 

1.  La  ropa  interior,  las  prendas  «le  vestir,  en  uso,  y  la  ropa  de  cama  ya  usada.  Cuando 
estos  objectos  son  trasportados  como  equipaje  ó  á  consecuencia  do  un  cambio  de  domicilio 
(muebles),  no  podrán  ser  prohibidos  y  se  someterán  al  régimen  del  artículo  19.  Los  piaquetes 
dejados  por  los  soldados  ó  marinos  y  remitidos  á  su  patria,  después  de  la  defunción,  se 
asimilarán  á  los  objetos  comprendidos  en  el  párrafo  primero  del  inciso  primero. 

2.  Los  trapos  viejos,  con  excepción  hecha,  en  lo  relativo  á  los  casos  de  cólera,  de  los 
trapos  viejos  comprimidos  que  se  transportan,  en  gi-andes  cantidades  como  mercancía,  en 
fardos  afianzados  con  flejes.  No  deberán  ser  detenidos  los  desperdicios  nuevos  que  pro- 
vienen directamente  de  los  talleres  de  filatura,  de  fábricas  ó  de  tintorerías,  ni  tampoco  las 
lanas  artificalies  ó  resortes  de  papel  nuevo. 

El  Presidente.  Es  ese  el  final  del  artículo  12? 

Doctor  Gtjiteras.  Sí,  señor. 

Después  de  una  discusión  en  castellano,  se  hicieron  varios  cambios 
verbales  en  la  traducción  española,  y  el  Doctor  Moore  leyó  el  artículo 
otra  vez  conforme  quedó  corregido. 

El  Presidente.  Deseáis  hacer  algunas  observaciones?  Si  no, 
supongo  que  estaréis  dispuestos  para  la  discusión  de  este  artículo 
conforme  ha  sido  presentado  en  inglés  y  según  se  ha  corregido  en 
castellano. 

El  artículo  fué  aprobado. 

Doctor  Guiteras.  El  artículo  13  es  como  sigue: 

Ajbtículo  13.  En  caso  de  peste  ó  cólera  no  hay  razón  para  prohibir  el  tránsito  de  las 
mercancías  y  ef estos  enumerados  en  los,  incisos  1  y  2  del  artículo  precedente,  á  través 
de  un  distrito  contaminado,  si  están  embalados  de  tal  modo  que  no  puedan  ser  infectados 
durante  el  camino. 

De  la  misma  manera,  cuando  las  mercancías  ú  objetos  son  transportados  de  tal  forma  que 
durante  el  camino  no  lleguen  en  contacto  con  objetos  contaminados,  su  tránsito  á  través 
de  una  circunscripción  territorial  contaminada  no  será  obstáculo  para  su  entrada  en  el  país 
á  que  están  destinados. 

Doctor  Ulloa.  Propongo  que  se  cambie  la  palabra  ''embalados" 
por  "empacados."     No  todo  se  puede  embalar. 

Doctor  Guiteras.  Debemos  insertar  la  palabra  ''empacados"  en 
lugar  de  "embalados?"     Qué  le  parece.  Doctor  Geddings? 

Doctor  Geddings.  Creo  que  la  palabra  adecuada  es  "empacados." 
Así  lo  pensé  cuando  se  estaba  leyendo  el  artículo. 

Doctor  Guiteras.  La  comisión  aceptará  la  indicación  del  Doctor 
Ulloa,  haciendo  el  cambio  propuesto. 

El  artículo  fué  aprobado  con  el  cambio  introducido. 

Doctor  Guiteras.  Leeré  el  siguiente  artículo: 

AnTÍcuLO  14.  Las  mercancías  y  objetos  especificados  en  los  incisos  1  y  2  del  artículo  12 
no  caen  bajo  la  aplicación  de  las  medidas  de  prohibición  á  la  entrada,  si  se  demuestra  á  la 


270  SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAL. 

autoridad  del  país  de  destino  que  lian  sido  expedidos  cinco  días,  por  lo  menos,  antes  del 
principio  de  la  epidemia. 

Este  artículo  fué  aprobado. 

Doctor  GuiTEKAS.  El  artículo  15  es  como  sigue: 

Artículo  15.  El  modo  y  sitio  de  la  desinfección,  así  como  los  procedimientos  que  deberán 
emplearse  para  asegurar  la  destrucción  de  ratas,  se  fijarán  por  la  autoridad  del  país  de 
destino.  Éstas  operaciones  deberán  hacerse  en  tal  forma  que  los  objetos  se  deterioren  lo 
menos  posible. 

Corresponile  á  cada  Estado  arreglar  la  cuestión  relativa  al  pago  eventual  de  indemniza- 
ción por  los  daños  cjue  resulten  de  la  desinfección  ó  de  la  destrucción  de  ratas. 

Si  con  ocasión  de  las  medidas  tomadas  para  asegurar  la  destrucción  de  ratas  á  bordo  de 
los  buques,  la  autoridad  sanitaria  percibe  algunos  impuestos,  sea  directamente,  sea  por 
medio  de  una  compañía  por  medio  de  un  particular,  el  importe  de  este  impuesto  se  fijará 
en  una  tarifa  publicada  de  antemano  y  establecida  de  manera  que  no  pueda  resultar  de  su 
aplicación  una  fuente  de  beneficios  para  el  Estado  ó  para  la  Administración  Sanitaria. 

El  Presidente.  ¿Se  desean  hacer  comentarios  sobre  este  artículo? 

Entonces  se  sostuvo  una  discusión  en  castellano  entre  los  delegados. 

Doctor  Guiteras.  Traduciré  las  observaciones  que  el  delegado  del 
Ecuador,  Doctor  Alcivar,  ha  hecho.  Este  señor  sugiere  que  se  inserte 
en  este  artículo  la  palabra  "mosquitos."  Propone  la  adición  de  las 
palabras  ''y  mosquitos,"  de  modo  que  se  lea  como  sigue: 

Artículo  15.  El  modo  y  sitio  de  la  desinfección,  así  como  los  procedimientos  que  deberán 
emplearse  para  asegurar  la  destrucción  de  ratas  y  mosquitos,  se  fijarán  por  la  autoridad  del 
país  de  destino.  Estas  operaciones  deberán  hacerse  en  tal  forma  que  los  objetos  se  dete- 
rioren lo  menos  posible. 

El  Presidente.  Según  lo  entiendo,  esta  es  una  resolución  pro- 
puesta por  el  Doctor  Alcivar  para  que  el  artículo  quede  modificado 
en  esa  forma. 

Doctor  Guiteras.  Es  una  indicación  que  hace  el  Doctor  Alcivar. 
Propone  que  se  inserten  las  palabras  "j  mosquitos"  en  donde  aparez- 
can las  palabras  "la  destrucción  de  ratas,"  de  manera  que  se  lea 
"ratas  y  mosquitos,"  quedando  el  artículo  15  en  la  forma  siguiente: 

Artículo  15.  El  modo  y  sitio  de  la  desinfección,  así  como  los  procedimientos  que  deberán 
emplearse  para  asegurar  la  destrucción  de  ratas  y  mosquitos,  se  fijarán  por  la  autoridad  del 
país  de  destino.  Estas  operaciones  deberán  hacerse  en  tal  forma  que  los  objetos  se  dete- 
rioren lo  menos  posible. 

Corresponde  á  cada  Estado  arreglar  la  cuestión  relativa  al  pago  eventual  de  indemnización 
por  los  daños  que  resulten  de  la  desinfección  ó  de  la  destrucción  de  ratas  y  mosquitos. 

Si  con  ocasión  de  las  medidas  tomadas  para  asegurar  la  destrucción  de  ratas  y  moscjuitos  á 
bordo  de  los  buques,  la  autoridad  sanitaria  percibe  algunos  impuestos,  sea  directamente, 
sea  por  medio  de  una  compañía  ó  por  medio  de  un  particular,  el  importe  de  este  impuesto 
se  fijará  en  una  tarifa  publicada  de  antemano  y  establecida  de  manera  cpe  no'pueda  resultar 
de  su  aplicación  una  fuente  de  ingresos  para  el  Estado  ó  para  la  administración  sanitaria. 

El  Presidente.  ¿Están  Vds.  dispuestos  para  la  discusión? 

El  Doctor  Lavorería  hizo  uso  de  la  palabra  en  castellano,  inter- 
pretándole el  Doctor  Ulloa. 

El  Doctor  Lavorería  dijo  que  esta  era  una  cuestión  de  traducción, 
de  fijar  en  términos  claros  el  significado  del  artículo  en  español. 
Dijo  que  en  castellano  podrían  darse  dos  interpretaciones  á  éste 
artículo.  Algunos  podrían  entender  que  el  país  al  cual  van  destinadas 
las  mercancías  puede  autorizar  al  país  de  donde  provienen  para  hacer 
uso  de  ciertas  desinfecciones,  pero  lo  propio  sería  que  el  país  de  donde 
provienen  dichas  mercancías  sea  el  que  ponga  en  vigor  las  medidas 
para  desinfectar  esos  artículos.  Dijo  que  él  creía  era  principalmente 
una  cuestión  de  interpretación. 

Doctor  Guiteras.  La  cuestión  es  muy  delicada,  'j  con  el  fin  de 
aclararla  pondré  un  ejemplo:  Digamos  que  esto  significa  que  si  Perú 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  271 

tiene  una  epidemia  de  peste,  Chile  debería  decir  á  Perú  el  modo  cómo 
tiene  que  manejar  estas  cosas. 

El  Pre.sidente.  ¿Es  esa  su  manera  de  interpretarlo? 

Doctor  GuiTERAS.  Sí,  señor;  esa  es  la  interpretación  que  le  doy. 
Dice  el  artículo:  "El  modo  y  sitio  de  la  desinfección,  así  como  los 
procedimientos  que  deberán  emplearse  para  asej^urar  la  destrucción 
de  ratas  y  mosquitos,  se  lijarán  por  la  autoridad  del  país  de  destino." 
En  el  caso  de  artículos  destinados  á  los  Estados  Unidos  y  provenientes 
de  Cuba,  aquéllos  tendrán  que  decir  á  ésta  en  qué  forma  ha  de  desin- 
fectar esos  artículos,  y  creo  cjue  ésto  es  lo  propio.  Yds.  protestarían 
si  Cuba  no  desinfecta  sus  exportaciones  adecuadamente.  Os  nej^aríais 
á  admitir  esas  mercancías  si  es  que  no  han  sido  desinfectadas  de 
acuerdo  con  vuestros  métodos,  y  nosotros  liaríamos  lo  mismo.  Si  los 
artículos  provenientes  de  los  Estados  Unidos  con  destino  á  Cuba  no 
han  sido  desinfectados  de  conformidad  con  nuestros  métodos,  nos- 
otros objetaríamos,  y  por  lo  tanto  les  obligaríamos  á  hacer  la  desinfec- 
ción en  la  forma  debida'. 

Estoy  tratando  de  aclarar  la  cuestión.  Aún  no  la  discuto,  simple- 
mente trato  de  aclararla.  No  he  dado  mi  opinión  y  no  sé  si  podré 
darla. 

Aquí  sostuvieron  una  discusión  en  castellano  los  Doctores  Licéaga, 
Medina,  Guiteras  y  Moore. 

El  Secretario.  Aquí  tengo  una  traducción  de  esta  convención, 
concebida  en  estos  términos:  Incumbe  á  las  autoridades  del  país  al 
cual  van  consignadas  las  mercancías  determinar  la  forma  en  que  se 
ha  de  efectuar  la  desinfección  y  el  sitio  en  donde  se  ha  de  llevar  á 
cabo,  etc.  Creo  que  añadiendo  simplemente  las  palabras  "de  este 
país"  queda  todo  arreglado. 

Doctor  Guiteras.  "Á  la  llegada."  Quiero  decir  que  el  país  que 
recibe  las  mercancías  decidirá  la  forma  en  que  han  de  ser  tratadas,  así 
es  que  creo  necesario  añadir  las  palabras  "á  la  llegada." 

El  Presidente.  ¿Se  ha  hecho  alguna  propuesta  sobre  el  particular? 

Doctor  Guiteras.  No,  señor. 

En  esta  parte  se  sostuvo  otra  discusión  en  castellano. 

El  Doctor  Guiteras  leyó  el  artículo  15  en  inglés  como  quedó  refor- 
mado. 

El  Doctor  Moore  leyó  el  artículo  reformado  en  español. 

Doctor  Guiteras.  Ahora  está  claro  el  artículo. 

El  artículo  15  fué  aprobado. 

Doctor  Guiteras.  El  artículo  16  es  como  sigue: 

Artículo  16.  Las  cartas  y  correspondencia,  impresos,  libros,  papeles  de  negocios,  etc. 
(á  excepción  de  los  paquetes  postales)  no  se  someterán  á  ninguna  restricción,  ni  desinfec- 
ción. 

Este  artículo  fué  aprobado. 

Doctor  Guiteras.  El  artículo  17  dice: 

Artículo  17.  Las  mercancías  que  lleguen  por  tierra  ó  por  mar  no  podi'án  ser  detenidas 
en  las  fronteras  ni  en  los  puertos. 

Las  únicas  medidas  que  se  permitirá  prescribir  respecto  de  aquéllas  quedan  especificadas 
en  el  artículo  12. 

Sin  embargo,  si  las  mercancías  llegando  por  mar  en  "vrac"  ó  en  empaques  defectuosos, 
han  sido,  durante  la  traveía  contaminadas  por  ratas  que  se  reconozcan  como  apestadas,  y  si 
no  pueden  aquéllas  ser  desinfectadas,  la  destrucción  de  los  gérmenes  puede  asegurarse 
depositando  las  mercancías. 

Se  entiende  que  la  aplicación  de  esta  última  medida  no  deberá  traer  consigo  ni  detención 
para  el  navio  ni  gastes  extraordinarios  que  resulten  de  la  falta  de  almacenes  en  los  puertos. 


272  SEGUXDA    CONFERENCIA   SANITAEIA   INTERNACIONAL. 

El  artículo  17  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  Presidente.  ¿Se  desea  hacer  observaciones  sobre  este  artículo? 

El  Doctor  Lavorería  hizo  uso  de  la  palabra. 

Doctor  GuiTERAS.  ¿Sabe  alguno  de  los  presentes  qué  quiere  decir  la 
palabra  "vrac"?  En  la  versión  española  la  han  puesto  tal  como 
estaba  en  el  original  francés. 

Doctor  Geddings.  Quiere  decir  "á  granel." 

Doctor  GuiTERAS.  Dice  ''en  'vrac'  ó  en  empaques  defectuosos." 

Doctor  Geddings.  Eso  significa  sin  empacar  ó  mal  empacados. 

Doctor  GuiTERAS.  "A  granel  ó  en  embalajes  defectuosos." 

Doctor  Geddings.  Debía  ser  "empaques  defectuosos." 

Doctor  GuiTERAS  (leyendo) : 

Artículo  13.  Las  mercancías  que  lleguen  por  tierra  6  por  mar  no  podi'án  ser  retenidas 
en  las  fronteras  ni  en  los  puertos. 

El  Presidente.  Permítame  que  le  interrumpa  para  preguntarle 
qué  diferencia  ha.j  entre  "detenidas"  y  "retenidas." 

Doctor  GuiTERAs.  A  mi  juicio  "retenidas"  quiere  decir  de  una 
manera  permanente,  mientras  que  "detenidas"  es  temporalmente. 
No  sé  si  esta  interpretación  es  correcta.  Nos  hemos  basado  en  la 
interpretación  que  dan  los  franceses  á  las  palabras  "retenue"  y 
^'détenue."  Emplean  la  primera  como  en  este  artículo  cuando 
quieren  significar  una  duración  permanente,  y  la  segunda  cuando  es 
un  espacio  de  tiempo  limitado. 

El  Presidente.  Esa  palabra  sola  no  es  suficiente  en  inglés,  si  esa 
es  la  idea. 

El  Doctor  Stiles  dice  que  en  francés  significa  realmente  "embargo." 

Doctor  GuiTERAS.  Entonces  diremos  "retenidas  permanente- 
mente." 

El  Presidente.  Creo  que  eso  sería  mejor. 

Doctor  GuiTERAS.  Muy  bien,  se  pondrá  así.  Volveré  á  leer  el 
artículo  17. 

Artículo  17.  Las  mercancías  que  lleguen  por  tierra  ó  por  mar  no  podrán  ser  retenidas 
permanentemente  en  las  fronteras  ni  en  los  puertos. 

Las  únicas  medidas  que  se  permitirá  prescribir  respecto  de  aquéllas  quedan  especificadas 
en  el  artículo  12. 

Sin  embargo,  si  las  mercancías  llegando  por  mar  a  granel  ó  en  empaques  defectuosos  han 
sido,  durante  la  travesía,  contaminadas  por  ratas  que  se  reconozcan  como  apestadas,  y  si 
no  pueden  aquéllas  ser  desinfectadas,  la  destrucción  de  los  gérmenes  puede  asegurarse 
depositando  las  mercancías  en  un  almacén  durante  un  espacio  de  tiempo  que  fijarán  las 
autoridades  del  puerto  de  llegada. 

Se  entiende  que  la  aplicación  de  esta  última  medida  no  deberá  traer  consigo  ni  detención 
para  el  navio  ni  gastos  extraordinarios  que  resulten  de  la  falta  de  almacenes  en  los  puertos. 

El  artículo  precedente  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  17  quedó  aprobado. 

Doctor  GuiTERAS.  En  la  versión  española  se  ha  dejado  la  palabra 
"  vrac"  entre  paréntesis.  Para  que  se  sepa  que  es  la  palabra  francesa 
deseo  insertarla  en  el  inglés. 

El  artículo  18  es  como  sigue: 

Artículo  18.  Cuando  las  mercancías  han  sido  desinfectadas,  por  la  aplicación  de  las 
prescripciones  del  artículo  12,  ó  depositadas  temporalmente  ^n  un  almacén  de  acuerdo  con  el 
párrafo  3°  del  artículo  17,  el  propietario  ó  su  representante  tiene  el  derecho  de  reclamar 
de  la  autoridad  sanitaria  que  ha  ordenado  la  desinfección  ó  el  deposito  un  certificado  que 
indique  las  medidas  tomadas. 

El  artículo  18  fué  leído  en  castellano  por  el  Doctor  Moore. 
El  Presidente.  Habéis  oído  la  lectura  del  artículo.     Si  no     se 
desean  hacer  observaciones  discutiremos  su  aprobación. 


SEGUNJM    (1()NFKRKN(!IA    SANI'I'AIUA    INTKRNACIONA  f..  273 

El  artículo  IS  fué  aprobado. 

Doctor  (Ikddings.  Señor  Presidente-,  (¡uisiera  hablar  sobre  el 
artículo  18.     Este  artículo  dice — 

Cuando  las  mercancías  han  üido  dosinl'cctadas,  por  aplicación  de  las  prcscripcioncH  del 
artículo  12,  ó  depositadas  temporalmente  en  un  almacén,  de  acuerdo  con  el  párrafo  3° 
del  ai'tícuJo  17,  ol  pr()j)i(íturio  ó  su  representante  tiene  el  deroclu^  de  leclatiíai-  de  la  autoridad 
sanitaria  que  lia  ordenado  la  dcsinfeccicjii  un  certificado  que  indi()ue  las  ineflidas  toniaílas. 

Sugiero  que  se  lea  "la  desiiifíicción  6  el  depósito." 
Doctor  GuiTKRAS.  Veo  que  eso  ya  está  en  la  versión  castellana. 
Se  discutió  la  cuestión,  y  se  hizo  la  reforma  indicada  por  el  Doctor 
Geddings. 

El  Doctor  Guiteras  leyó  desj^ués  el  artículo  19. 

Artículo  19.  Ecjuipagos.  La  desinfección  de  la  ropa  sucia,  rofja  de  cama,  y  objetos  que 
forman  parte  de  equipr.ges  ó  muebles,  los  cuales  provengan  de  una  circunscripción  territorial 
declarada  contaminada,  no  so  haiá  efectiva  mas  que  en  los  casos  eu  que  la  autoridad  sani- 
taria los  considei'e  como  contaminados.  En  caso  de  í'iehro.  atnarilla  no  se  desinfectarán 
los  equipages. 

El  Presidente.  Antes  de  que  se  lea  el  artículo  en  castellano  qui- 
siera llamar  la  atención  del  Doctor  Geddings,  que  es  el  representante 
de  esa  comisión,  á  la  traducción  francesa — que,  dicho  sea  de  paso,  es 
muy  buena — en  donde  se  usan  las  palabras  "'área  local." 

Doctor  Gatewood.  La  palabra  "área"  es  definida.  ¿Porqué  no 
la  hemos  de  sustituir  por  las  palabras  ' '  área  territorial ' '  ?  Estas  pala- 
bras no  son  definidas. 

Doctor  Guiteras.  Dice  "área  territorial."  La  definición  dice  que 
un  área  es  un  territorio. 

Doctor  Gatewood.  ¿Se  ha  definido  la  palabra  "área"  ? 

Doctor  Guiteras.  Fué  definida  como  un  territorio,  un  área,  una 
villa,  ó  lo  que  pudiera  ser.  Entre  otras  cosas  estaba  incluida  la 
palabra  "territorio." 

Doctor  Gatewood.  ¿Porqué  no  se  usa  la  palabra  "área"  ? 

Doctor  Guiteras.  ¿Volveré  á leerlo? 

El  Presidente.  Léalo  otra  vez. 

Doctor  Guiteras  (leyendo) : 

La  desinfección  de  la  ropa  sucia,  ropa  de  cama,  y  objetos  que  forman  parte  de  equipages 
ó  muebles,  los  cuales  provengan  de  una  circunscripción  temtorial  declarada  contaminada, 
no  se  hará  efectiva  mas  que  en  los  casos  en  que  la  autoridad  sanitaria  los  considere  como 
•contaminados.     En  caso  de  fiebre  amarilla  no  se  desinfectarán  los  equipages. 

El  artículo  19  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  Presidente.  Quisiera  preguntar  al  Doctor  Geddings  si  está  satis- 
fecho con  la  redacción  de  est-e  artículo. 

Doctor  Geddings.  Me  parece  que  están  bien  las  palabras  "cir- 
cunscripción territorial." 

El  Doctor  Guiteras  dio  continuación  á  la  lectura. 

Sección  tercera.  iNÍedidas  que  se  tomarán  en  los  puertos  y  en  las  fronteras  marítimas. 

Artículo  20.  Clasificación  de  los  buques.  Se  considera  infectado  el  buque  que  tenga 
la  peste,  el  cólera  ó  la  fiebre  amarilla  á  su  bordo,  ó  que  ha  presentado  uno  ó  muchos  casos 
de  peste  ó  cólera  á  su  bordo,  durante  los  últimos  siete  días,  ó  de  fiebre  amarilla  en  cualquier 
tiempo  durante  el  viaje. 

Este  párrafo  fué  leído  en  castellano  por  el  Doctor  Moore. 
Después  los  delegados  sostuvieron  una  discusión  en  español. 
Doctor  Guiteras.  Hemos  estado  discutiendo  solamente  una  correc- 
ción verbal  relativa  á  la  versión  española. 

El  párrafo  que  precede  fué  leído  otra  vez  en  castellano. 
1112a— 06 18 


274  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

El  párrafo  leído  del  artículo  20  quedó  aprobado. 
El  Doctor  Guiteras  continuó  leyendo : 

Se  considera  como  sospechoso  el  buque  á,  bordo  del  cual  ha  habido  casos  de  peste  6  cólera 
en  el  momento  de  la  partida  ó  duvante  la  travesía,  poro  en  el  cual  no  se  ha  declarado  ningún 
caso  por  unos  siete  días;  serán  también  sospechosos,  tratándose  de  la  fiebre  amarilla,  los 
buques  que  hayan  estado  anclados  á  tal  proximidad  de  la  orilla  contaminada  que  haya 
hecho  factible  el  acceso  de  mosquitos. 

Este  párrafo  fué  leído  en  castellano  por  el  Doctor  Moore. 
Esta  parte  del  artículo  20,  conforme  fué  leída  en  castellano  é  inglés, 
quedó  aprobada. 

Doctor  Guiteras.  El  último  párrafo  del  artículo  20  es  como  sigue: 

Se  considera  como  indemne  el  buque  que,  aún  cuando  provenga  de  un  puerto  contami- 
nado, no  ha  tenido  dcñmciones  ni  casos  de  peste,  colera  ó  liebre  amarilla  á  bordo,  antes  de 
la  partida,  durante  la  travesía  ó  en  el  momento  de  la  llegada,  y  que,  tratándose  de  la  fiebre 
amarilla  no  haya  estado  anclado  á  tal  proximidad  de  la  orilla  contaminada  que  haya  hecho 
factible  el  acceso  de  mosquitos. 

Creo  que  esta  última  parte  debía  estar  concebida  en  estos 
términos — 

á  tal  proximidad  de  la  orilla  contaminada  que  haya  hecho  factible,  á  opinión  de  las  autori- 
dades, el  acceso  de  mosquitos. 

Los  delegados  de  la  Convención  sostuvieron  una  discusión  en 
castellano. 

Doctor  Guiteras.  El  delegado  del  Ecuador  no  está  conforme  con 
este  último  párrafo.  Es  decir,  quiere  discutir  la  cuestión  relativa  á 
los  buques  indemnes. 

El  Presidente.  En  ese  caso  tendrá  que  hacer  una  propuesta. 

Doctor  Guiteras.  Pide  una  explicación  que  yo  no  le  puedo  dar. 
Pregunta  si  debe  considerarse  indemne  un  buque  que,  por  ejemplo, 
lisija  hecho  un  viaje  de  un  día  desde  un  puerto  de  Méjico  á  otro  de 
Texas,  ó  vice  versa — muy  próximos  el  uno  al  otro — uno  de  cuyos 
puertos  de  salida  está  contaminado;  ¿se  consideraría  ese  buque 
indemne  porque  no  ha  ocurrido  ningún  caso  de  peste,  cólera  ó  fiebre 
amarilla  á  su  bordo  ?  Como  Vds.  verán,  no  habrá  habido  más  tiempo 
que  un  día  para  que  se  desarrolle  cualquier  enfermedad. 

El  Presidente.  Evidentemente  no  se  ha  tenido  eso  en  cuenta. 

Doctor  Guiteras.  Diría  que  no  se  ha  tenido  eso  en  consideración 
en  la  Conferencia  de  París. 

Se  sostuvo  una  discusión  en  castellano. 

Doctor  Guiteras.  Estamos  dispuestos  á  votar  sobref  el  último 
párrafo  del  artículo  20. 

El  último  párrafo  del  artículo  20  fué  aprobado. 

El  Presidente.  Habiéndose  terminado  la  lectura  de  todo  el  artí- 
culo 20,  debemos  ahora  votar  sobre  la  aprobación  del  artículo  en 
co]ijunto,"  según  se  ha  leído  y  aprobado  por  párrafos. 

El  artículo  20  en  conjunto  fué  aprobado. 

Doctor  Guiteras.  El  artículo  21  es  como  sigue: 

Artículo  21.  Los  buques  infectados  de  peste  serán  sometidos  al  siguiente  régimen: 

1.  Visita  médica  (inspección). 

2.  Los  enfermos  serán  inmediatamente  desembarcados  y  aislados. 

3.  Las  demás  personas  deben  ser  igualmente  desembarcadas,  si  es  posible,  y  sometidas  á 
una  observación  (1),  que  no  debe  exceder  de  cinco  días  á  contar  desde  la  fecha  de  la  llegada. 

Después  de  la  palabra  "observación"  hay  una  llamada  hacia  una 
nota  al  pie  que  explica  lo  que  esa  palabra  quiere  decir,  y  es  como  sigue : 

F   La  palabra  "observación"  significa  aislamiento  de  los  viajeros,  bien  sea  á  bordo  de  un 
buque,  ó  bien  en  una  estación  sanitaria,  antes  de  dárseles  entrada  libre. 


SEGUNDA    CONFERENCIA    SANT'I'AKTA    INTERNACIONAL.  275 

Continúa  diciendo  el  artículo  2 1 : 

4.  La  ropa  sucia,  los  efectos  de  uso  y  los  objetos  de  la  tripulación  (2)  y  de  los  paHajcros 

3ue,  segíin  el  paroror  do  la  autoridad  sanitaria,  sean  considerados  como  contaminados, 
eben  sor  dcsinl'cctados. 

Después  de  la  palabra  "tripulación"  hay  una  llamada  hacia  una 
nota  al  pie  que  dice: 

La  palabra  "tripulación"  se  aplica  á  las  personas  que  forman  parte  de  la  dotación  del 
buque,  ó  dol  personal  de  servicio,  comprendiendo  los  mayordomas  criados,  caíedji,  etc., 
Esta  palabra  se  interpretará,  en  este  sentido  siempre  que  aparezca  en  esta  Convención. 

El  resto  del  artículo  21  es  como  sigue: 

5.  Las  partes  del  buque  que  han  sido  habitadas  por  apestados  ó  que,  según  el  parecer  de 
la  autoridad  sanitaria,  se  considoian  como  contaminadas  deben  ser  dcsinícctadas. 

6.  La  dcstTucción  de  las  ratas  del  buque  debe  efoctuarse,  antes  ó  después  de  la  descarga, 
lo  más  rápidamente  posible,  y,  en  todo  caso,  en  un  plazo  máximo  de  cuarenta  y  ocho  horas, 
evitando  deteriorar  las  mercancías,  el  buque  ó  las  máquinas. 

Para  los  buques  en  lastre  esta  operación  debe  hacerse  lo  más  pronto  posible  antes  de  la 
descarga. 

Se  sostuvo  una  discusión  en  español. 

El  artíciüo  21  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  mismo  articulo  quedó  aprobado. 

El  artículo  22  fué  leído  por  el  Doctor  Guiteras  y  es  como  sigue: 

Aktículo  22.  Los  buques  sospechosos  de  peste  se  sometarán  á  las  medidas  indicadas  en 
los  números  1,  4,  y  5  del  artículo  21 . 

Además,  la  tripulación  y  los  pasajeros  pueden  ser  sometidos  á  una  observación  que  no 
excederá  de  cinco  días,  á  partir  de  la  llegada  del  buque.  Se  puede,  durante  el  mismo 
tiempo,  impedir  el  desembarque  de  la  tripulación,  siempre  que  no  lo  exija  el  servicio.  Se 
recomienda  destruir  las  ratas  del  buque.  Esta  operación  se  efectuará  antes  ó  después  de 
la  descarga,  lo  más  rápidamente  posible,  y  en  todo  caso,  en  una  dilación  máxima  de  cua- 
renta y  ocho  horas,  evitando  deteriorar  las  mercancías,  el  buque  ó  las  máquinas. 

Para  los  buques  en  lastre  esta  operación  se  hará,  si  hay  lugar,  lo  más  pronto  posible,  y 
en  todo  caso  antes  de  la  carga. 

El  artículo  22  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  mismo  artículo  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  23  tal  como  está  en  la  Conven- 
ción. 

Después  ñié  leído  en  castellano  por  el  Doctor  Moore. 

Sostúvose  una  discusión  en  castellano. 

Doctor  Guiteras.  He  llamado,  simplemente,  la  atención  al  hecho 
de  aquí  se  ha  usado  la  palabra  "observación"  en  vez  de  "vigilancia," 
y  debíamos  haber  convenido  qua  en  este  caso  podríamos  usar  esta 
última  palabra. 

Los  delegados  volvieron  á  sostener  otra  discusión  en  español. 

Doctor  Guiteras.  Estamos  dispuestos  para  votar,  Señor  Presi- 
dente. 

El  artículo  23  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  24,  como  sigue: 

Artículo  24.  Cuando  en  una  nave  indemne,  después  de  examen  bacteriológico,  se  ha 
averiguado  que  hay  á  bordo  ratas  apestadas,  ó  bien  cuando  se  compnieba  una  mortandad 
insólita  en  estos  roedores,  habrá  que  aplicar  las  siguientes  medidas: 

1 .  Naves  con  ratas  apestadas : 

(a)  Visita  médica  (inspección). 

(b)  Las  ratas  deberán  ser  destruidas  antes  ó  después  de  la  descarga,  lo  más  rápidamente 
posible,  y,  en  todo  caso,  en  un  plazo  máximo  de  cuarenta  y  ocho  horas,  evitando  deteriorar 
las  mercancías,  los  buques  ó  las  máquinas.  Los  buques  en  lastre  sufrirán  esta  operación 
lo  más  pronto  posible,  y,  en  todo  caso,  antes  de  hacerse  la  carga. 

(c)  Las  partes  del  buque  y  los  objetos  que  la  autoridad  sanitaria  considere  contaminados 
serán  desinfectados. 


270  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

(d)  Ijos  pasajo.'os  y  la  tripulación  pueden  ser  sometidos  á  observación  que  no  exceda 
de  cinco  días,  contados  desde  la  fecha  de  llegada,  salvo  en  casos  excepcionales  en  los  que 
la  autoridad  sanitaria  puede  prolongar  la  \igilancia  hasta  un  máximum  de  diez  días. 

Lo  precedente  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  Secretario.  Aquí  hay  la  misma  diferencia  otra  vez.  En  la 
versión  inglesa  se  usa  la  palabra  "observación,"  y  en  la  española 
"viirilencia.".    Está  en  el  párrafo  (d). 

Doctor  GuiTERAS.  Sí,  hay  que  hacer  una  corrección  aquí,  una  sola. 
Es  una  corrección  verbal.  El  Doctor  McCaw  propone  que  se  cambie 
la  palabra  "especial"  por  "excepcional"  en  el  párrafo  (d).  Ahora 
estamos  dispuestos  á  votar  en  el  primer  párrafo  del  artículo  24. 

El  párrafo  1  del  artículo  24  fué  aprobado. 

El  Doctor  Guiteras  dio  lectura  al  párrafo  2  del  artículo  24,  como 
sigue : 

2.  Buques  en  los  que  se  ha  comprobado  una  mortandad  insólita  de  ratas: 

(a)  Visita  médica  (inspección). 

(b)  El  examen  de  las  ratas  desde  el  punió  de  vista  de  la  peste,  que  se  hará  tan  pronto 
como  sea  posible. 

(c)  Si  la  destrucción  de  ratas  se  juzga  necesaria,  se  hará  en  las  condiciones  antes  indicadas, 
con  respecto  á  los  buques  con  ratas  apestadas. 

(d)  Hasta  que  toda  sospecha  se  haya  disipado,  los  pasajeros  y  la  tripulación  pueden  ser 
sometidos  á  una  observación  que  no  exceda  de  cinco  días,  contados  á  partir  de  la  fecha  de 
llegada,  salvo  en  casos  excepcionales  en  los  que  la  sanidad  sanitaria  puede  prolongar  la 
observación  hasta  un  máximum  de  diez  días. 

El  párrafo  2  del  artículo  24  fué  aprobado. 

El  Presidente.  Ahora  debemos  aprobar  todo  el  artículo. 

Todo  el  artículo  24  fué  aprobado. 

El  Doctor  Guiteras  dio  lectura  al  artículo  25,  como  sigue: 

Aetículo  25.  La  autoridad  sanitaria  del  puerto  entregará  al  capitán,  al  armador  ó  á  su 
agente,  siempre  que  se  le  pida,  un  certificado  en  el  que  conste  que  las  medidas  de  destruc- 
ción de  ratas  han  sido  efectuadas  y  cjue  indique  las  razones  por  las  cuales  estas  medidas  han 
sido  aplicadas. 

Este  artículo  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  25  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  26,  c[ue  es  como  sigue: 

AnTicuLO  26.  Los  buques  infectados  de  cólera  serán  sometidos  al  régimen  siguiente: 

1.  Visita  médica  (inspección). 

2.  Los  enfermos  serán  desembarcados  y  aislados  inmediatamente. 

3.  Las  otras  personas  se  desembarcarán  también,  si  es  posible,  y  se  someterán,  desde  la 
llegada  del  buque,  á  una  observación  cuya  duración  no  excédela  de  cinco  días. 

Doctor  Guiteras.  En  la  versión  española  se  incluyen  las  palabras 
"cuya  duración  variará  según  el  estado  sanitario  del  buque  y  la  fecha 
del  último  caso." 

El  Presidente.  ¿Ha  sido  introducido  ese  cambio  por  nuestra  comi- 
sión? Según  tengo  entendido,  hemos  tomado  ese  convenio  de  París 
y  lo  hemos  de  adaptar  á  nuestras  necesidades.  Si  ese  cambio  ha  sido 
iiecho  por  la  comisión,  debe  aparecer  también  en  la  versión  inglesa. 

Doctor  Guiteras.  No  me  acuerdo  cómo  se  originó  la  diferencia. 

El  Presidente.  Existe  una  discrepancia  entre  el  texto  inglés  y 
el  español.     ¿Se  liizo  esto  á  propósito? 

Doctor  Guiteras.  En  el  español  se  han  suprimido  las  palabras 
"variará  según  el  estado  sanitario."  ¿Qué  necesidad  hay  de  decir 
esto  cuando  ya  se  dice  que  el  período  de  la  observación  no  ha  de 
exceder  de  cinco  días?  Las  suprimeremos  también  de  la  versión 
inglesa  con  el  fin  de  que  ambos  textos  estén  acordos. 

El  Presidente.  Está  bien;  hágase,  pues,  el  cambio. 


SEGUNDA    CONFKKIONCÍA    SANl'I'MilA    INTERN  ACTON' AL.  277 

El  Doctor  Guiteras  continuó  la  lectura  del  artículo  26: 

4.  La  ropa  sucia,  los  efectos  de  uso  y  los  objetos  de  los  tripulantes  y  de  los  pasajeros 
que,  conforme  al  parecer  de  la  autoridad  sanitaria  del  puerto,  se  consideren  como  contami- 
nados, serán  diainfííctudos. 

5.  Ijas  partes  del  l)ii(|iie  (hk!  hayan  estado  habitadas  por  enfermos  de  cólera  6  que  las 
autori(hxd(iH  sanitarias  ccjn.sideron  como  contaminadas,  serán  disinfectadas. 

6.  El  afilia  do  la  cala  será  evacuada  después  de  la  disinfección. 

La  autoridad  sanitai'ia  puede  ordenar  la  substitución  del  agua  que  está,  almacenada  á 
bordo  por  otia  buena  potable. 

Se  prohibirá  derramar  las  deyecciones  humanas  ó  dejarlas  escurrir  en  las  aguas  del  puerto, 
é  menos  que  se  hayan  desinfectado  previamente. 

Este  artículo  fue  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  26  fué  a])robado. 

El  Doctor  Guiteras  leyó  el  artículo  27,  como  sigue: 

Aktículo  27.  Los  buques  so.spechosüs  de  cólera  serán  sometidos  á  las  medidas  prescritas 
en  los  incisos  1,  4,  5,  y  6  del  artículo  26. 

La  tripulación  y  los  pasajeros  pueden  ser  sometidos  á  una  observación  que  no  excederá 
de  cinco  días  después  de  la  llegada  del  buque.  Se  recomienda  impedir,  durante  el  mismo 
tiempo,  el  desembarque  de  los  tripulantes,  salvo  por  razones  del  servicio. 

El  Doctor  Moore  leyó  el  artículo  en  español. 

Este  artículo  fué  aprobado. 

El  Doctor  Guiteras  dio  lectura  al  artículo  28,  que  es  como  sigue: 

Artículo  28.  Los  buques  indemnes  de  cólera  serán  admitidos  á  libre  plática  inmediata^ 
mente,  cualquiera  que  sea  la  naturaleza  de  su  patente. 

El  único  régimen  que  puede  establecer  la  autoridad  sanitaria  de  un  puerto  de  llegada, 
consistii'á  en  las  medidas  indicadas  en  los  números  1,  4  y  6  del  artículo  26. 

La  tripulación  y  los  pasajeros  pueden  ser  sometidos,  desde  el  punto  de  vi.sta  del  estado 
de  salud,  á  una  observación  que  no  excederá  de.cinco  días  contados  desde  la  fecha  en  que 
el  buque  salió  del  puerto  contaminado. 

Es  de  recomendarse  que  se  impida,  durante  el  mismo  espacio  de  tiempo,  el  desembarque 
de  la  tripulación,  salvo  por  razones  del  servicio. 

La  autoridad  competente  del  puerto  de  llegada  puede  siempre  exigir,  bajo  juramento, 
un  certificado  del  médico  de  á  bordo,  ó,  en  su  defecto,  del  capitán,  en  el  que  se  haga  constar 
que  no  ha  habido  caso  de  cólera  en  el  buque  después  de  su  partida.. 

Este  artículo  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  28  quedó  aprobado. 

El  Doctor  Guiteras  le^^ó  el  artículo  29 : 

Artículo  29.  La  autoridad  competente  tendrá  en  cuenta,  para  la  aplicación  de  las 
medidas  indicadas  en  los  artículos  21  á  28,  la  presencia  de  un  médico  y  de  aparatos  de 
desinfección  (estufas)  á  bordo  de  los  buques  de  las  tres  clases  arriba  mencionadas. 

En  lo  que  se  refiere  á  la  peste  tendrá  también  en  cuenta  la  instalación  á  bordo,  de 
aparatos  destinados  á  la  destrucción  de  ratas. 

.  Las  autoridades  sanitarias  de  los  países  á  los  cuales  convenga  entenderse  sobre  este  punto, 
podrán  dispensar  de  la  visita  médica  y  de  las  otras  medidas  á  los  buques  indemnes  que 
tuvieren  á.  bordo  un  médico  comisionado  por  su  país. 

El  artículo  29  fué  leído  en  español  por  el  Doctor  Moore. 

Este  artículo  ñié  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  30,  como  sigue: 

Artículo  30.  Pueden  prescribirse  medidas  especiales  para  los  buques  en  que  haya  aglo- 
meración, particularmeníe  para  las  naves  de  emigrantes  ó  para  cualquier  otro  buque  que 
tenga  malas  condiciones  higiénicas. 

Doctor  Guiteras.  ¿Está  bien  ''malas  condiciones  higiénicas"? 

Dr.  Geddings.  Está  bien. 

Doctor  Gatewood.  El  Doctor  Stiles  propone  que  se  cambie  por 
"condiciones  higiénicas  deficientes,"  que  suena  algo  mejor.  O  si  no, 
¿qué  tal  sería  "condiciones  anti-higiénicas"  ? 

El  artículo  30  fué  leído  en  castellano  por  el  Doctor  Moore. 


278  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

El  artículo  30,  conforme  fué  leído  en  inglés  y  en  español,  quedó 
aprobado. 

El  Doctor  Guiteras  dio  lectura  al  artículo  31 : 

Artículo  31.  Todo  buque  que  no  quiera  somettrse  á  las  obligaciones  impuestas  por  la 
autoridad  del  puerto  en  virtud  de  las  estipulaciones  de  la  presente  Convención,  queda  en 
libertad  de  volverse  á  la  mar. 

Puede  ser  autorizada  á  desembarcar  sus  mercancías  después  de  haber  tomado  las 
siguientes  precauciones: 

1.  Aislamiento  del  buque,  de  la  tripulacidn  y  de  los  pasajeros. 

2.  En  lo  que  concierne  A  la  peste,  pedir  informaciones  relativas  á.  la  existencia  de  una 
mortandad  insólita  entre  las  ratas. 

3.  En  lo  que  concierne  al  cólera  hacer  la  evacuación  del  agua  de  la  cala,  después  de  su 
desinfección  3'^  substitución  del  agua  que  esté  almacenada  á  bordo  por  otra  buena  potable. 

Puede  igualmente  ser  autorizado  á  desembarcar  á  los  pasajeros  que  lo  soliciten,  á 
condición  de  que  estos  se  sujeten  á  las  medidas  prescritas  por  la  autoridad  local. 

El  artículo  31  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  31  quedó  aprobado. 

El  Doctor  Guiteras  dio  lectura  al  artículo  32,  que  es  como  sigue: 

Artículo  32.  Los  buques  procedentes  de  un  puerto  contaminado,  que  han  sido  desin- 
fecta'dos  y  han  sido  objeto  de  medidas  sanitarias  aplicadas  de  una  manera  suficiente,  no 
sufrirán  por  segunda  vez  estas  medidas  á  su  llegada  á  un  puerto  nuevo,  á  condición  de  que 
no  haya  ocurrido  ningún  caso  después  que  se  efectuó  la  desinfección,  y  que  no  hayan  hecho 
escala  en  un  puerto  contaminado. 

Cuando  un  buque  desembarque  solamente  pasajeros  y  sus  equipajes  y  los  sacos  de  la 
correspondencia,  sin  haber  estado  en  comunicación  con  la  costa,  no  debe  considerársele 
como  que  ha  tocado  el  puerto,  y,  en  el  caso  de  fiebre  amarilla,  cuando  no  se  haya  aproxi- 
mado suficientemente  á  la  costa  para  recibir  mosquitos  á  bordo. 

Este  artículo  fué  leído  en  castellano  por  el  Doctor  Moore. 

Sotúvose  una  discusión  en  castellano. 

El  Presidente.  ¿Se  ha  introducido  algún  cambio  en  el  texto? 

Doctor  Guiteras.  No;  solamente  en  las  palabras. 

El  artículo  32  fué  aprobado. 

El  Doctor  Guiteras  dio  lectura  al  artículo  33,  como  sigue: 

Artículo  33.  Los  pa,sajeros  llegados  en  una  nave  infectada,  tienen  la  facultad  de  pedir  á 
la  autoridad  sanitaria  del  puerto  un  certificado  que  indique  la  fecha  de  su  llegada  y  las 
medidas  á  las  cuales  han  sido  sometidos  ellos  y  sus  equipages. 

El  artículo  que  precede  fué  leído  en  castellano  por  el  Doctor  Moore. 
El  artículo  33  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  34,  que  se  halla  concebido  en 
los  siguientes  términos: 

Artículo  34.  Los  vapores  correos  serán  objeto  de  un  régimen  especial  que  se  establecerá 
de  común  acuerdo  entre  los  países  interesados. 

Este  artículo  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  34  fué  aprobado. 

El  Doctor  Guiteras  dio  lectura  al  artículo  35: 

Artículo  3.5.  Sin  perjuicio  del  derecho  que  tienen  los  Gobiernos  de  ponerse  de  acuerdo 
para  organizar  estaciones  sanitarias  comunes,  cada  país  debe  proveer  uno  de  los  puertos, 
por  lo  menos,  del  litoral  de  cada  uno  de  sus  mares,  de  una  instalación  y  de  materiales  sufi- 
cientes para  recibir  un  buque,  cualquiera  que  sea  su  estado  sanitario. 

Cuando  un  buque  indemne  pi'ocedente  de  un  puerto  contaminado  llegue  á  un  gran  puerto 
de  navegación  marítima,  se  recomienda  no  enviarlo  á  otro  puerto  con  el  objeto  de  que  se 
someta  á  las  medidas  sanitarias  prescritas. 

En  cada  país,  los  puertos  abiertos  á  las  procedencias  de  otros,  contaminados  de  cólera, 
peste  ó  fiebre  amarilla,  deben  estar  provistos  de  tal  manera  que  los  buques  indemnes  puedan 
someterse  allí,  desde  el  momento  de  su  llegada,  á  las  medidas  prescritas  y  no  tengan  que  ir  á 
otro  puerto  con  este  objeto. 

Los  Goljiernos  harán  conocer  los  puertos  que  hayan  abierto  á  las  procedencias  de  otros, 
infectados  de  peste,  cólera  ó  fiebre  amarilla. 


SEGUNDA    GONFEKEISICÍA    tíANITAJilA    JNTEliN  AGIO  NAL.  279 

El  Doctor  Moore  leyó  este  artículo  en  castellano. 

Sostúvose  una  discusión  en  español. 

El  artículo  85  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  36,  que  es  como  sigue: 

Artículo  36.  So  rocomionda  que  cu  los  grandes  puíirtos  de  navegación  marítima  se 
establezca: 

(a)  Un  servicio  módico  regular  y  una  vigilancia  médica  permanente  del  estado  sanitario 
de  las  tripulaciones  y  de  la  población  del  puerto. 

(b)  Locales  apropiados  para  el  aislamiento  de  los  enfennos  y  la  observación  de  las  per- 
sonv^  sospechosas,  iín  los  lugares  donde  existe  Stegomyia  fasciata  deberá  haber  edificios 
ó  partes;de  ellos  que  tengan  las  puertas  y  ventanas  protcjidas  con  mallas  do  alambre,  y  una 
lancha  y  una  ambulancia  protcjidas  do  la  misma  manera. 

(c)  Las  instalaciones  netesarias  para  una  desinfección  eficaz  y  laboratorios  bacterio- 
lógicos. 

(d)  Un  servicio  de  aguas  potables,  no  sospechoso  para  el  uso  del  puerto,  y  la  aplicación 
de  un  sistema  que  presente  toda  la  seguridad  posible  para  la  extracción  de  los  desechos  y 
basuras. 

Este  artículo  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  36  fué  aprobado. 

El  Doctor  Guiteras  leyó  lo  siguiente : 

Sección  4.  Medidas  en  las  fronteras  terrestres,  viajeros,  ferrocarriles,  zonas  fronterizas, 
vías  fluviales. 

Aetículo  37.  No  se  deben  establecer  cuarentenas  terrestres,  pero  los  Gobiernos  se 
reservan  el  derecho  de  establecer  campamentos  de  observación,  si  los  consideran  necesarios, 
para  la  detención  temporal  de  los  sospechosos. 

Solamente  las  personas  que  presenten  síntomas  de  peste,  cólera  ó  fiebre  amarilla  pueden 
ser  retividas  en  las  fronteras. 

Este  principio  no  excluye  el  derecho  de  cada  Estado  de  cerrar,  cuando  lo  necesite,  una 
parte  de  sus  fronteras. 

El  Presidente.  ¿No  sería  mejor  cambiar  la  palabra  ''Estado"? 
Se  podría  creer  que  significa  un  Estado  de  los  Estados  Unidos. 

Doctor  Guiteras.  ¿No  tienen  Vds.  incoveniente  en  que  se  cambie 
esa  palabra  por  "Gobierno"? 

El  Presidente.  No. 

Un  Delegado.  Sustituirla  por  la  palabra  "país." 

Doctor  Guiteras.  "País,"  sí,  está  bien.  Entonces  con  este 
cambio  el  último  párrafo  de  este  artículo  dirá: 

í-  Este  principio' no  excluye  el  derecho  de  cada  país  de  cerrar,  cuando  lo  necesite,  una  parte 
de  sus  fronteras.j 

El  Doctor  Moore  leyó  este  artículo  en  español. 
Doctor  Guiteras.  Señor  presidente,  propongo  que  se  suprima  el 
segundo  párrafo  de  este  artículo,  á  saber,  aquella  parte  que  dice: 

Solamente  las  personas  que  presenten  síntomas  de  peste,  cólera  ó  fiebre  amarilla  pueden 
ser  retenidas  en  las  fronteras. 

Doctor  Geddings.  Apo57^o  la  petición. 

Doctor  Guiteras.  Hago  esta  proposición  porque  considero  que 
este  segundo  párrafo  está  en  contradicción  con  el  primero  del  mismo 
artículo.     El  primer  párrafo  dice: 

No  se  deben  establecer  cuarentenas  terrestres,  pero  los  Gobiernos  se  reservan  el  derecho 
de  establecer  campamentos  de  observación,  si  los  consideran  necesarios,  para  la  detención 
temporal  de  los  sospechosos. 

Y  después  de  decir  que  estos  campamentos  de  observación  pueden 
ser  establecidos  si  se  consideran  necesarios,  declara  que  solamente 
las  personas  enfermas  podrán  ser  detenidas,  siendo  el  texto  del 
segundo  párrafo,  "solamente  las  personas  que  presenten  síntomas  de 
peste,  cólera  ó  fiebre  amarilla  pueden  ser  detenidas  en  las  fronteras." 


28C  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

El  Presidente.  ¿Están  Vds.  dispuestos  para  discutir  la  proposi- 
ción del  Doctor  Guiteras? 

Doctor  Medina.  Quisiéramos  C[ue  se  vuelva  á  leer  el  artículo  en 
castellano. 

El  Doctor  Moore  leyó  el  artículo  con  la  reforma  propuesta  en 
castellano. 

Doctor  Medina.  Está  bien. 

La  correción  propuesta  por  el  Doctor  Guiteras  fué  aprobada. 

El  Presidente.  Habiéndose  adoptado  la  reforma,  queda  .por 
discutirse  ahora  la  aprobación  del  artículo. 

El  artículo  37  según  quedó  reformado  fué  aprobado. 
•     El  Doctor  Guiteras  dio  lectura  al  artículo  38. 

Aetículo  38.  Es  importante  que  los  viajeros  sean  sometidos,  desde  el  puto  de  vista  de 
su  estado  de  salud,  á  una  vigilancia  por  parte  del  personal  de  ferrocarriles. 

Este  artículo  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  38  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  39,  como  sigue: 

Artículo  39.  La  intervención  médica  se  limitará  á  una  visita  á  los  pasajeros,  tomándoles 
la  temperatura,  y  á  los  cuidados  que  se  han  de  dar  á  los  enfermos.  Si  esta  visita  se  hace,  se 
combinará,  hasta  donde  fuera  posible,  con  la  visita  adiianera,  de  modo  que  los  pasajeros 
sean  detenidos  el  menor  tiempo  posible.  Las  personas  visiblemente  enfei-mas  serán  las 
únicas  que  se  someterán  á  un  examen  médico  completo. 

El  artículo  39  fué  leído  en  español  por  el  Doctor  Moore. 

Se  sostuvo  una  discusión  en  español,  en  la  que  tornearon  parte  los 
Doctores  Lavorería,  Licéaga  y  Alcivar.  * 

Doctor  Guiteras.  La  cuestión  es.  Señor  Presidente,  sobre  la  toma 
de  la  temperatura.  El  artículo  39  dice  que  la  intervención  médica 
se  limitará  á  una  visita  á  los  pasajeros,  tomándoles  la  temperatura, 
y  al  socorro  que  se  ha  de  prestar  á  los  que  están  realmente  enfermos. 
El  delegado  de  Perú  dice  cpie  sería  mejor  limitar  la  toma  de  la  tem- 
peratura en  los  casos  en  que  sea  necesario  solamente.  El  Doctor 
Licéaga  insiste  en  que  se  debe  conceder  facultad  al  médico  para  que 
tome  la  temperatura  á  todos,  y  yo  soy  de  la  misma  opinión. 

El  Presidente.  El  médico  puede  hacerlo  ó  no. 

Doctor  Guiteras.  Sí,  señor,  pero  para  ello  tiene  que  estar  facul- 
tado. 

Volvióse  á  sostener  otra  discusión  en  español. 

Doctor  Guiteras.  Se  ha  retirado  la  reforma  propuesta.  Estamos 
dispuestos  para  votar. 

El  artículo  39  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  40,  que  es  como  sigue: 

Aktículo  40.  Cuando  los  viajeros  procedentes  de  un  lugar  contaminado  han  llegado  á 
su  destino,  sería  de  la  mayor  utilidad  someterlos  á  una  vigilancia  que  no  exceda  de  diez  ó 
cinco  días  á  contar  de  la  fecha  de  partida,  según  que  se  trate  respectivamente  de  peste  6  de 
cólera,  y  de  seis  días  en  caso  de  fiebre  amarilla. 

El  artículo  40  fué  leído  en  castellano  por  el  Doctor  Moore. 

Este  artículo  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  41,  que  es  como  sigue: 

Artículo  4L  Los  Gobiernos  se  reservan  el  derecho  de  tomar  medidas  particulares  en 
relación  con  determinadas  categorías  de  personas,  particularmente  con  los  vagabundos,  los 
emigrantes  ó  los  que  atraviesan  la  frontera  en  grandes  grupos. 

Este  artículo  fué  leído  en  español  por  el  Doctor  Moore. 
Doctor  Gatewood.  ¿En  "grupos?" 


SEGUNDA    CONFERENCIA    SANITARIA     INTERNACIONAL.  281 

Doctor  Ullo A.  "Gniy)os,"  está  bien. 

Dr.  H.  1j.  K.  JojiNKON.  ¿Nose  refiere  esa  palabra  á  las  bandas 
errantes  de  gitanos  y  vagabundos? 

Doctor  Gatewood.  ¿Y  porífué  no  poner  ambas  palabras,  "grupos 
y  bandas" ? 

El  Presidente,  lluego  al  Doctor  Geddings  que  explique  ésto. 

Doctor  Geddings.  Esa  palabra  se  refiere  á  los  vagabundos  que 
viajan  en  partidas.  Se  refiere  á  los  gitanos  y  vagos  cjue  pasan  la 
frontera  en  cuadrillas  (troops),  no  en  un  sentido  militar. 

El  Presidente.  ¿Vd.  quiere  decir  compañías  teatrales? 

Doctor  Geddings.  Sí,  señor.;  "bandas  ó  grupos"  estaría  bien. 

Doctor  Guiteras.  ¿No  podría  interpretarse  esa  palabra  como  refe- 
rente á  lo  militar — escuadrones  (troops)  de  caballería,  por  ejemiplo? 

Doctor  Ulloa.  Entonces  dejar  la  palabra  "grupos." 

Doctor  Guiteras.  No,  porque  "grupos"  no' es  bastante.  Creo 
que  "bandas"  sería  mejor. 

Doctor  Geddings.  Propongo  que  sustituya  la  palabra  "grupos." 
""'  Dr.  H.  L.  E.  Johnson.  Creo  que  usando  ambas  palabras,  "grupos 
y  bandas;"  todo  quedaría  incluido.     Con  esto  la  idea  quedaría  pro- 
piamente expresada  en  inglés.     No  lo  sé  con  respecto  al  español. 

Doctor  Guiteras.  Yo  creo  que  grupos  tiene  un  sentido  tan  ge- 
neral que  podría  aplicarse,  del  mismo  modo,  á  grupos  muy  redu- 
cidos— un  grupo  de  cinco  personas,  por  ejemplo — é  indudablemente 
no  es  la  intención  el  aplicar  esta  medida  á  un  número  tan  reducido 
de  personas.  Se  refiere  á  bandas  tan  grandes  de  personas  que 
resulte  difícil  reglamentarlas,  disciplinarlas  y  seguirlas.  Pero  en  el 
caso  de  bandas  pequeñas  creo  que  no  es  la  intención  el  aplicarlas 
esta  medida.     Un  pequeño  grupo;  un  coche  con  varias  personas. 

Cierta-mente  que  no  se  intenta  aplicarlas  esa  medida.  La  palabra 
"bandas"  significa  grandes  grupos  que  van  sin  disciplina.  No  veo 
la  necesidad  para  que  se  use  el  vocable  "grupos." 

El  Presidente.  Se  ha  hecho  una  indicación  para  que  se  cambie  la 
palabra  "grupos"  por  "bandas."  Creo  que  el  Doctor  Johnson  tiene 
que  hacer  una  proposición. 

Doctor  Johnson.  Nó,  señor;  retiro  la  proposición  que  he  hecho. 

El  Presidente.  Entonces  la  cuestión  que  queda  por  resolverse 
es  la  propuesta  del  Doctor  Geddings. 

La  proposición  del  Doctor  Geddings  fué  discutida,  resultando 
aprobada. 

El  artículo  41  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  42,  que  es  como  sigue: 

Artículo  42.  Los  coches  que  hacen  el  trasporte  de  pasajeros,  del  correo  y  de  equipajes, 
no  pueden  ser  detenidos  en  las  fronteras.  A  fin  de  que  los  coches  que  trasportan  los  via- 
jeros y  el  correo  no  puedan  ser  detenidos,  se  hará  que  los  que  llegan  de  la  circunscripción 
inl'ectada  se  detengan  en  la  frontera  j  que  los  pasajeros  se  trasborden  á  los  coches  que 
llegan  á  la  frontera  del  oti'o  lado. 

Si  sucediera  que  uno  de  esos  coches  se  hubiera  contaminado  6  hubiere  sido  ocupado  por 
un  enfermo  atacado  de  peste,  de  cólera  ó  de  fiebre  amarilla 

Doctor  Guiteras.  Nó,  no  acepto  el  que  se  usen  las  palabras  "fie- 
bre amarilla"  en  este  caso,  nó,  nó.  Pero,  sin  embargo,  suponiendo 
que  ocurre  un  caso  de  fiebre  amarilla  en  un  tren,  ¿no  debe  desinfec- 
tarse el  coche  en  donde  ha  ocurrido?  Sí,  un  mosquito  puede  haber 
picado  al  individuo.     Sí,  está  bien. 


282  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

(Continuando  la  lectura :) 

Si  sucediera  que  uno  de  esos  coches  se  hubiere  contaminado  ó  hubiere  sido  ocupado  por 
un  enfermo  atacado  de  peste,  colera  ó  fiebre  amariUa,  será  desprendido  del  tren  para  ser 
desinfectado  lo  más  pronto  posible. 

Este  artículo  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  42  fué  adoptado. 

El  Doctor  Guiteras  leyó  el  siguiente: 

Artículo  43.  Las  medidas  concernientes  al  ps/so  por  las  ftonteras  del  personal  de  los 
ferrocarriles  y  del  correo  son  de  la  competencia  de  las  administraciones  interesadas.  Se 
combinaián  de  modo  que  no  estorben  el  servicio. 

Este  artículo  fué  leído  en  castellano  -por  el  Doctor  Moore. 

El  artículo  43  quedó  aprobado. 

Doctor  Gatewood.  ¿Qué  quiere  decir  en  ese  cí^so  la  palabra  "ad- 
ministraciones"? ¿Quiere  decir  la  administración  de  los  ferroca- 
rriles ó  de  los  países? 

Doctor  Guiteras.  Dice,  "personal  de  los  ferrocarriles  y  del  correo." 

Doctor  Gatewood.  Entonces,  si  es  así,  en  los  casos  en  que  los 
ferrocarriles  no  están  bajo  el  dominio  gubernamental  pueden 
prescribir  esas  medidas  por  sí  mismos. 

Dr.  H.  L.  E.  Johnson.  ¿No  sería  mejor  decir  "los  países  intere- 
sados" ? 

El  Presidente.  Realmente,  debía  ser  "las  autoridades  sanitarias. " 

Dr.  H.  L.  E.  Johnson.  Dice,  "administraciones interesadas"  donde 
yo  creo  que  debe  decir  "países  interesados." 

El  Secretario.  Creo  que  debe  decir  "autoridades  sanitarias." 

El  Presidente.  Ya  hemos  aprobado  el  artículo  43  sin  esta  reforma. 

Dr.  H.  L.  E.  Johnson.  Con  el  fin  de  que  podamos  discutirla,  pido 
que  se  vuelva  á  considerar  la  adopción  del  artículo  43. 

Esta  proposición  fué  apoyada,  discutida  j  aprobada. 

El  Presidente.  La  propuesta  para  que  se  vuelvará  discutir  el 
artículo  43  ha  sido  aprobada.     Empecemos  pues. 

Dr.  H.  L.  E.  Johnson.  Pido  que  se  reforme  el  artículo  43  en  la 
forma  aprobada  y  que  ésta  sea  leída. 

El  Doctor  Guiteras  leyó  el  artículo  43  con  la  reforma  propuesta: 

Artículo  43.  Las  medidas  concernientes  al  paso  por  las  fronteras  del  personal  de  los 
ferrocarriles  y  del  correo  son  de  la  competencia  de  las  autoridades  sanitai'ias  interesadas. 
Se  combinarán  de  modo  de  no  estorbar  el  servicio. 

El  Doctor  Moore  leyó  este  artículo  en  español. 
A  propuesta  del  Dr.  H.  L.  E.  Johnson,  debidamente  apoyada,  el 
artículo  43  quedó  aprobado  con  la  reforma  introducida. 
El  Doctor  Guiteras  leyó  el  artículo  44,  que  es  como  sigue : 

Artículo  44.  La  reglamentación  del  tráfico  fronterizo  y  de  las  cuestiones  inherentes  al 
mismo,  así  como  la  adopción  de  las  medidas  excepcionales  de  vigilancia,  deberán  sujetarse 
á  arreglos  especiales  entre  los  Estados  limítrofes. 

El  Secretario.  La  palabra  "Estados"  debía  cambiarse  por  "nacio- 
nes." 

Doctor  Guiteras.  Sí. 

El  Presidente.  Cambíese  por  "naciones." 

El  Doctor  Moore  leyó  el  artículo  44  con  la  reforma  introducida. 

El  artículo  44  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  45,  que  es  como  sigue: 

Artículo  45.  Corresponde  á  los  Gobiernos  de  los  países  ribereños  arreglar  por  medio  de 
acuerdos  especiales  el  régimen  sanitario  de  las  vías  fluviales. 


SEGUNDA    CONFEKENOIA    SAW  J'I'AJUA    I NTEKis  AUIONAL.  283 

Este  artículo  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  45  fué  aprobado. 

Doctor  GuiTERAS.  Señor  Presidente,  aquí  hay  otro  artículo  que 
supongo  no  será  orillen  de  discusión,  pero  la  cuestión  (|ue  deseo 
someter  es  respecto  al  título  del  mismo. 

El  Presidente.  Hemos  terminado  la  discusión  de  todos  los  artí- 
culos que  había  ])reparados,  y  ahora  susjxiJideremos  la  sesión  hasta 
las  3  de  esta  tarde. 

La  sesión  se  suspendió  para  volverse  á  abrir  á  las  3  de  la  tarde 

del  mismo  día. 

Sesión  de  la  tarde. 

El  Presidente,  Cirujano  General  Wyman,  declaró  abierta  la  sesión 
á  las  3  de  la  tarde. 

El  Presidente.  Si  los  señores  delegados  no  tienen  inconveniente, 
antes  de  que  continuemos  con  la  discusión  de  los  artículos  que  que- 
dan por  aprobarse,  y  mientras  tanto  llegan  uno  ó  más  miembros  que 
están  ausentes,  el  Doctor  Howard  hablará  sobre  la  distribución  del 
Stegomyia  fasciata. 

El  Doctor  Howard.  Señor  Presidente,  Señores  Delegados  de  la 
Convención,  considerando  que  están  Vds.  muy  ocupados  y  que  tie- 
nen que  despachar  muchos  asuntos,  seré  todo  lo  breve  que  pueda. 

Deseo  manifestar  que  he  ayudado  á  varias  personas  en  el  estudio 
del  mosquito  de  la  fiebre  amarilla.  Los  estudios  que  yo  he  hecho 
por  mi  cuenta  me  llevaron  a  Méjico,  en  donde  el  Doctor  Licéaga  me 
recibió  con  la  mayor  cortesía  posible,  dándome  cartas  de  presenta- 
ción para  las  personas  con  quienes  yo  deseaba  entrevistarme,  casi 
todas  ellas  residentes  en  Méjico,  y  me  prestó  su  valiosa  a3n,ida  en  todos 
los  sentidos.  También  deseo  dar  públicamente  las  gracias  al  Doctor 
Guiteras  por  la  oportunidad  que  me  dio  para  poder  ver  todo  el  Hos- 
pital de  Las  Ánimas  de  la  Habana,  y  creo  que  debido  á  la  cortés 
intervención  de  este  señor  pude  desembarcar  en  la  capital  mencio- 
nada, porque  llegué  en  un  vapor  procedente  de  Vera  Cruz  y  no  se  per- 
mitió á  ningún  otro  pasajero  que  bajara  á  tierra;  todo  lo  que  tuve 
que  hacer  fué  presentar  mi  tarjeta  al  inspector  médico  diciéndole. 
** Sírvase  entregarla  al  Doctor  Guiteras,"  no  habiendo  más  formali- 
dades y  siendo  yo  la  única  persona  á  quien  se  permitió  desembarcar. 

Con  el  fin  de  ser  todo  lo  más  breve  posible,  lo  mejor  es  que  yo  les 
lea  un  extracto  de  lo  que  les  iba  á  decir,  el  cual  es  muy  corto  y  espero 
que  sea  exacto.  Deseo  advertirles  que  hablaré  de  mí  mismo  en  la 
tercera  persona. 

El  Doctor  Howard  leyó  su  extracto  (véase  el  apéndice,  pág.  438). 

El  Presidente  Tenemos  en  nuestro  programa  un  documento 
muy  breve  del  Dr.  H.  L.  E.  Johnson,  y  tendremos  el  gusto  de  oir  su 
lectura  ahora  (véase  el  apéndice,  pág.  441). 

El  Presidente:  El  Doctor  McCaw,  del  Ejército  de  los  Estados 
Unidos,  desea  poner  en  vuestro  conocimiento  un  asunto  que  será  de 
interés  para  todos. 

Doctor  McCAW^  Únicamente  deseo  anunciar  á  la  Convención  que 
la  Oficina  del  Cirujano  General  ha  publicado  durante  el  año  pasado 
los  resultados  de  las  investigaciones  de  la  junta  de  oficiales  del 
ejército  en  la  guerra  hispano-americana,  sobre  la  propagación  de  la 
fiebre  tifoidea  en  los  campamentos.  Esta  obra  ha  sido  editada  y 
•publicada  por  el  último  miembro  superviviente  de  dicha  junta,  el 


284  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL, 

Dr.  Victor  C.  Vaughan.  Es  una  obra  voluminosa  y  pesada,  com- 
puesta de  dos  tomos,  uno  de  los  cuales  contiene  un  atlas  y  diagramas, 
y  el  otro  estadísticas.  La  obra  no  es  de  mucho  valor  para  el  médico 
y  es  demasiado  voluminosa  para  una  biblioteca  ordinaria,  pero  tiene 
mucha  importancia  para  los  que  están  interesados  en  la  higiene 
pública.  En  nombre  del  Cirujano  General  del  Ejército,  deseo  com- 
municarles  que  se  regalará  un  ejemplar  de  esta  obra  á  todos  los 
miembros  de  esta  Conferencia  si  cada  uno  de  ellos  me  hace  el  favor 
de  darme  su  dirección.  Podré  enviarlos  por  correo  mientras  estén 
en  los  Estados  Unidos,  bien  á  las  legaciones,  ó  bien  á  cualquier  otra 
dirección.  Temo  que,  si  se  envían  los  ejemplares  por  correo  á  los 
países  sur-americanos,  se  pierdan  en  el  camino.  Agradeceré  á  todo 
aquél  que  desee  un  ejemplar  que  míe  lo  diga. 

El  aviso  del  Doctor  McCaw  fué  interpretado  al  castellano  por  el 
secretario. 

Doctor  GuiTERAS :  Propongo  que  se  envíen  las  gracias  de  la  Confe- 
rencia al  Cirujano  General  del  Ejército  de  los  Estados  Unidos  por 
esta  cortés  oferta. 

La  proposición  fué  apoyada  5^  quedó  aprobada. 

Doctor  GuiTERAS.  ¿Podemos  discutir  las  observaciones  hechas  por 
el  Doctor  Howard  ó  hacer  comentarios  sobre  ellas? 

El  Presidente.  Sería  conveniente  hacer  comentarios  sobre  ellas. 

Doctor  GuiTERAS.  Con  respecto  á  la  opinión  de  que  el  mosquito 
pica  con  más  frecuencia  cuando  la  tarde  está  avanzada  ó  durante  las 
horas  calurosas  del  día,  quizás  atraído  por  el  olor  del  sudor,  deseo 
manifestar  que  hay  una  razón  poderosa  en  contra  de  esta  teoría, 
sustentada  por  uno  de  los  señores  mencionados  por  el  Doctor  Howard, 
y  es  la  de  que  los  mosquitos  eluden  á  los  negros,  y  si  es  que  hay  algún 
sudor  que  apeste  de  una  manera  verdaderam.ente  violenta,  es  el  sudor 
de  los  negros.  Así  pues,  no  creo  que  el  olor  del  sudor  atraiga  á  los 
mosquitos. 

Con  respecto  al  tiempo  que  transcurre  de  picadura  á  picadura, 
indudablemente  el  período  de  cinco  ó  siete  días  que  fija  uno  de  esos 
señores  es  demasiado  largo.  El  otro  cálculo  de  cuarenta  y  ocho  horas 
es  exacto.  La  hembra  del  Stegomyia  puede  picar  cada  cuarenta  y 
ocho  horas. 

Pero  la  cuestión  de  que  voy  á  tratar  ahora,  no  se  menciona  en  el 
documento  del  Doctor  Howard,  sino  que  está  íntimamente  relacio- 
nada con  la  distribución  del  Stegomyia.  Queremos  saber  cuál  es  la 
distribución  geográfica  del  Stegomyia,  y  estudiarla  minuciosamente, 
porque  suponemos  que  el  área  en  donde  existe  el  Stegomyia  corres- 
ponde con  aquella  en  la  cual  predomina  la  fiebra  amarilla,  pudiéndose 
hacer,  por  consiguiente,  la  deducción  de  que  la  fiebre  amarilla  no  se 
extenderá  fuera  de  ese  área.  Quiero  hacer  la  declaración  de  que  esto 
no  es  así;  que  creo  que  existe  fiebre  amarilla  en  regiones  que  están 
fuera  del  área  en  donde  existe  el  Stegomyia  fasciata,  por  lo  menos 
fuera  de  la  distribución  ordinaria.  Creo,  en  otras  palabras,  que  la 
fiebre  amarilla  puede  ser  propagada  y  llevada — quizás  nó  en  grandes 
epidemias,  pero  sí  propagada — en  donde  no  se  encuentra  el  Stegomyia. 
Es  decir,  el  Stegomyia  puede  ser  llevado  á  un  sitio  como  Atlanta  en  la 
primavera  y  el  verano,  ó  bien  más  al  norte,  cuando  hace  bastante 
calor  que  el  insecto  pueda  propagarse.  Dos  ó  tres  hembras  llenas  de 
huevos  pueden  ser  llevadas  en  un  tren  á  estos  sitios,  las  cuales  pueden 
criar  suficientes  mosquitos  hacia  el  final  del  verano,  en  agosto  por 


SEGUNDA    CONFEJliCNCIA    SANITARIA    INTEKNAOIONAL.  2i^5 

ejemplo,  para  hacer  (jue  se  produzca  una  epidemia  de  fiebre  amarilla. 
Creo  (pie  al<i;()  por  el  estilo  ocurrió  en  Madrid  no  hace  mucho,  en  donde 
una  licml)ra  del  Htego'tnyia  \nu\o  criarlo  suíiciente  para  provocar  una 
pecjueña  epidemia.  Creo  que  en  alf^unos  puertos  hay  consideraljle 
peligro  de  cpie  se  propa<;ue  en  ellos  una  pe(jueña  c[)¡demia,  y  que 
ninguno  de  ellos  está  del  todo  exento  de  dicho  jícligio.  Creo  que 
esta  innumidad  es  solamente  relativa,  y  puedo  añadir  que  el 
Doctor  Finlay  es  de  la  misma  opinión. 

El  Secretario.  Deseo  hacer  algunas  observaciones  en  corrobo- 
ración ;de  lo  que  el  Doctor  Guiteras  acaba  de  decir.  Hace  algunos 
años  hubo  una  epidemia  en  Alajuela,  que  está  á  una  distancia  de  unas* 
doce  millas  de  San  José,  Costa  Rica,  y  que  es  casi  tan  alto  como 
es  este  último  punto.  San  José  tiene  una  altura  de  3,868  ))ies  y 
Alajuela  3,001,  sobre  el  nivel  del  mar.  Naturalmente,  antes  de  que 
la  teoría  do  la  trasmisión  del  mal  por  medio  del  mosquito  cjuedara 
sentada  como  doctrina,  creíamos  (jue  la  fiebre  amarilla  no  podía 
desarrollarse  en  las  altitudes  elevadas;  pero,  sin  embargo,  hubo  una 
fuerte  epidemia  en  la  ciudad  mencionada,  y  el  Gobierno  pasó  nmcho 
trabajo  para  poder  exterminarla.  Creo,  como  el  Doctor  Guiteras 
opina,  que  la  epidemia  fué  causada  por  algunos  mosquitos  que  quizás 
fueron  importados  de  Punta  Arenas,  que  es  un  puerto  situado  en  el 
Pacífico,  durante  el  verano,  cuando  se  lleva  el  café  del  interior  á  los 
puertos  del  Pacífico,  desde  donde  es  posible  que  se  hayan  importado 
los  mosquitos  en  carros  ó  vehículos  de  carga.  Algunas  personas 
procedentes  del  puerto  mencionado  fueron  á  Alajuela  enfermas, 
introdujeron  la  fiebre  amarilla  y  los  mosquitos  que  quizás  habían  allí  se 
contaminaron,  provocando  de  esta  manera  la  epidemia. 

El  Presidente.  ¿Se  desean  hacer  más  observaciones?  Este  es  un 
tema  de  mucho  interés  é  importancia. 

Doctor  Medina.  Deseo  manifestar  que  tengo  noticias  de  que  hemos 
tenido  dos  casos  en  Managua,  que  está  á  una  distancia  bastante  larga 
de  Corinto,  unas  ciento  cincuenta  millas  Tuvinas  dos  casos,  pero 
ambos  eran  pasajeros  procedentes  de  Panamá.  La  fiebre  se  desarrolló 
en  ellos  y  murieron  en  Managua;  pero  no  se  produjo  infección  alguna, 
siendo  los  dos  únicos  casos  que  tuvimos. 

El  Doctor  Licéaga  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  El  Doctor  Licéaga  ha  dicho  que  desea  hacer  la 
siguiente  explicación  sobre  el  objeto  de  la  discusión.  Dice  que  en 
Méjico,  á  una  altura  de  2,000  pies,  en  donde  está  situada  la  Ciudad 
de  Méjico,  hicieron  el  siguiente  experimento:  Llevaron  algunos 
mosquitos  de  Vera  Cruz,  que  como  todos  sabemos  ha  sido  un  gran 
foco  de  la  fiebre  amarilla  desde  hace  algunos  años,  y  consiguieron 
criar  tres  generaciones  de  los  mosquitos  de  la  especie  Stegomyia 
fasciata,  con  la  única  diferencia  de  que  los  mosquitos  criados  en  la 
Ciudad  de  Méjico  no  vivieron  tanto  como  los  criados  en  Vera  Cruz. 

El  Doctor  Licéaga  terminó  diciendo,  con  mucha  razón,  que  esto 
demuestra  de  que  la  fiebre  amarilla  se  desarrollaría  en  una  ciudad  de 
esa  altura  si  las  autoridades  no  tienen  cuidado  en  la  manera  en  que  se 
debe  tratar  á  nuestro  amigo  el  Stegomyia. 

El  Doctor  Licéaga  dijo  además  que  deseaba  dar  las  gracias  al  Doctor 
Howard  por  las  manifestaciones  que  liizo  concernientes  al  trato  que 
recibió  en  Méjico. 

Doctor  Howard.  Pido  la  palabra. 

El  Presidente.  El  Doctor  Howard  tiene  la  palabra. 


280  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL, 

Doctor  Howard.  He  tomado  particular  interés  en  los  ejemplos 
que  han  dado  los  Doctores  Ulloa  y  Licéaga  y  en  las  generalizaciones 
hechas  por  el  Doctor  Guiteras.  En  él  folleto  distribuido  entre  los 
delegados  en  las  sesiones  del  primer  día,  se  trata  de  lleno  de  esa 
cuestión,  en  la  página  4,  y  en  ella  habló  del  peligro  de  que  estos 
mosquitos  se  introduzcan  por  los  ríos  Misisipí  y  Ohio  en  vapores  y 
trenes,  y  de  la  posibilidad  de  que  se  produzcan  epidemias  de  este 
modo. 

Durante  el  viaje  del  cual  ya  he  hablado,  y  en  el  que  se  facilitaron 
_mis  trabajos  gracias  á  la  cortés  ayuda  que  recibí  del  Doqtor  Licéaga, 
el  punto  más  elevado  en  donde  encontré  el  Stegomyia — estuve  allí  en 
ma3^o;  quizás  el  mosquito  fué  importado — fué  Orizaba  que  está  á  una 
altura  de  4,500  pies  sobre  el  nivel  del  mar,  y  esta  especie  no  se  ha 
criado  originalmente  en  este  punto  como  sucede  con  los  de  las  costas. 
Pero  cuando  se  consruyeron  ferrocarriles  en  el  interior  de  Méjico  fué 
llevado  más  adentro  hasta  que  finalmente  se  estableció  en  Córdoba  y 
por  último  en  Orizaba.  Los  primeros  casos  ocurrieron  entre  personas 
que  vivían  dentro  de  un  radio  alrededor  de  la  estación  del  ferrocarril. 
En  la  siguiente  epidemia  se  propagó  la  enfermedad  á  unos  cientos  de 
yardas  más  afuera  y  tomó  otra  manzana  de  casas,  un  poco  más  lejos  de 
la  estación  del  ferrocarril  como  centro,  y  puede  ser  que  con  el  tiempo 
el  Stegomyia  se  establezca  permanentemente  un  poco  más  lejos  aún 
de  la  estación  mencionada.  Pero  de  todos  modos  ese  punto,  Orizaba, 
es  el  más  elevado  de  Méjico  en  donde  he  observado  que  el  mosquito 
en  cuestión  se  cria  permanentemente. 

El  secretario  tradujo  al  castellano  lo  dicho  por  el  Doctor  Howard. 

El  Presidente.  ¿Se  desea  hacer  más  comentarios  sobre  el  docu- 
mento del  Doctor  Howard? 

El  Doctor  Lavorería  hizo  uso  de  la  palabra  en  castellano,  siendo 
interpretado  por  el  secretario. 

El  Secretario.  El  Doctor  Lavorería  dice  que  en  el  Perú  no  tienen 
la  fiebre  amarilla,  bajo  ningún  aspecto,  y  que  por  consiguiente  no  sabe 
mucho  acerca  del  Stegomyia  fasciata,  por  lo  que  desearía  saber  qué 
temperatura  es  necesaria  para  el  desarrollo  de  este  mosquito. 

Doctor  Howard.  ¿Me  hace  Vd.  el  favor  de  preguntarle  si  no  ocurren 
casos  de  fiebre  amarilla  en  Callao  ? 

El  secretario  hizo  esta  pregunta  en  castellano  al  Doctor  Lavorería. 

El  Secretario.  Dice  que  no  sabe;  que  han  ocurrido  casos  en  la 
costa  pero  que  no  se  ha  registrado  ninguno  desde  1868. 

El  Presidente.  Si  no  hay  inconveniente  continuaremos  discu- 
tiendo los  artículos  de  la  convención. 

Doctor  Guiteras.  El  último  artículo  será  denominado  "Disposi- 
ción transitoria,"  si  es  que  este  título  recibe  la  aprobación  de  los  dele- 
gados. Es  un  término  oficial  y  se  usa  en  los  tratados  oficiales;  por 
esto  lo  hémeos  adoptado  para  este  último  artículo,  el  cual  es  como 
sigue : 

DISPOSICIÓN   TRANSITORIA. 

Los  Gobiernos  que  no  han  firmado  la  presente  convención  pueden  adherirse  á  ella,  si  así 
lo  desean,  dirig'éndose  por  la  vía  diplomática  al  Gobierno  de  los  Estados  Unidos  de  América,. 
á  fin  de  que  é=;te  lo  comunique  á  los  demás  poderes  firmantes. 

Este  párrafo  fué  leído  en  castellano  por  el  Doctor  Moore,  y  c[uedó  aprobado. 

El  Doctor  Guiteras  leyó  el  siguiente  párrafo : 

Hecha  y  firmada  en  la  Ciudad  de  Washington,  el  día  catorce  de  Octubre  de  mil  novecientos 
cinco,  en  dos  ejemplares,  en  español  'y  en  inglés  respectivamente,  que  se  depositarán  en  el 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIftNAL.  287 

Dopartanionto  de  Estado  dol  Gobierno  do  los  Estados  Unidos  do  América,  con  el  propósito 

de  quo  so,  rciniian  pof  la  vín  diplomátifa  roj)¡aa  en  ambos  idiocias  á  cada  uno  do  Iok  |)aíge8 
signatarios. 

Doctor  GuiTEiiAS.  Creo  quo  dclxíiiios  añadir  al  íiiial  í|ii(!  on  caso  de 
duda  ó  desacuerdo  en  la  interpretación  de  esta  convención  prevale- 
cerá el  texto  inolós. 

El  PuESiDENTE.  ¿Doctqr  Geddíngs,  recuerda  Vd.  alguna  clausula 
por  este  estilo  ? 

Doctor  Geddíngs.  No,  señor. 

Doctor  GuiTERAS.  Esta  clausula  ha  sido  usada  con  respecto  al  texto 
francés.  Se  estipuló  que  en  caso  de  duda  el  texto  francés  regiría  la 
interpretación. 

Desde  el  momento  en  que  esta  convención  está  redactada  en  dos 
idiomas,  de])emos  usar  uno  de  los  dds  como  guía,  y  la  comisión  ha  ele- 
gido el  inglés  con  este  fin. 

Se  sostuvo  una  discusión  sobre  el  particular. 

El  Doctor  Guiteras  volvió  á  leer  la  disposición  transitoria  en  inglés 
y  el  Doctor  Moore  leyó  el  castellano. 

La  disposición  transitoria  fué  aprobada. 

El  Doctor  Moore  hizo  algunas  observaciones  en  español  sobre  la  dis- 
posición transitoria. 

El  Secretario.  El  Doctor  Moore  propone  que  se  firma  la  conven- 
ción hoy  en  vez  de  mañana. 

Doctor  Guiteras.  Entonces  debemos  cambiar  la  fecha,  haciéndola 
13  en  vez  de  14. 

El  Presidente.  Creo  que  sería  m.uy  conveniente  que  la  firmáramos 
hoy,  pero  esto  depende  de  que  los  mecanógrafos  la  terminen  este  día. 

El  Doctor  Moore  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  El  Doctor  Moore  dice  que  la  comisión  acordó  que 
se  firmará  la  convención  hoy,  y  que  si  es  imposible  que  la  hagamos 
este  día  que  se  ponga  la  fecha  13,  aunque  no  se  firme  hasta  mañana. 
Siento  decirle  al  Doctor  Moore  que  esto  no  puede  hacerse,  porque  el 
tratado  que  se  ha  de  firmar  es  un  acuerdo  internacional  3^  debe  estar 
hecho  exactamente  como  dice  su  texto.  No  podemos  firmarlo 
mañana  diciendo  que  fué  firmado  hoy  porque  esto  podría  invalidar  el 
tratado.  Podemos  terminar  su  discusión  hoy  y  aprobarlo  en  su  tota- 
lidad, pero  si  no  podemos  firmarlo  hoy  de  hecho  no  podemos  poner  la 
fecha  de  hoy. 

El  Doctor  Moore  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  El  Doctor  Moore  dice  que  retira  su  propuesta. 

El  Presidente.  Habiéndose  retirado  la  objeción,  discutiremos  la 
aprobación  de  la  disposición  transitoria. 

Después  de  discutida  la  disposición  transitoria  fué  aprobada. 

El  Presidente.  Alguien  ha  indicado  que  se  proponga  que  haya  un 
editor  para  el  texto  inglés  y  otro  para  el  español,  con  el  fin  de  com- 

Earar  ambos  textos,  y  que  se  autorice  á  los  dos  editores  para  que 
agan  los  cambios  necesarios  sin  alterar  el  sentido. 
Doctor  Guiteras.  Entonces  tendría  que  escribirse  de  nuevo  todo. 
El  Presidente.  Nó,  no  es  necesario. 

Doctor  Guiteras.  Propongo  que  se  nombre  una  comisión  com- 
puesta de  dos  individuos  para  que  hagan  la  revisión  final  de  los  dos 
textos,  los  comparen  y  hagan  las  correcciones  que  crean  necesarias  en 
la  redacción  de  ambos  textos. 

El  Presidente.  ¿Qué  correcciones? 


1288  SEGUNDA    CÜÍÍFERENCIA    SAN  IT.ARIA    INTERNACIONAL. 

Doctor  GuiTEBAS.  Correcciones  gramaticaies. 

El  Presidente.  Sin  alterar  el  sentido. 

Doctor  GuiTERAS.  Sí,  señor,  sin  alterar  el  sentido. 

El  Presidente.  Plabéís  oído  la  propuesta;  ¿hay  quien  la  apoye? 

La  proposición  fué  secundada. 

El  Doctor  Ulloa  la  tradujo  al  castellano. 

Después  de  discutida  quedó  aprobada  la  propuesta. 

El  Presidente.  Ha  sido  aprobada  la  proposición.  ¿Cómo  se  han 
de  nombrar  los  individuos  de  la  comisión? 

Varios  Delegados.  Por  el  Presidente. 

El  Presidente.  Nombro  al  Doctor  Lavorería,  delegado  del  Perú,  y 
a.1  Doctor  Gatewood,  del  Ejército  de  los  Estados  Unidos,  como  editores 
español  é  inglés  respectivamente,  é  individuos  de  la  comisión. 

Doctor  Gatewood.  Señor  Presidente,  como  el  caballero  que  va  á 
ser  mi  compañero  en  la  comisión  no  habla  el  inglés  será  casi  imposible 
que.  podemos  comparar  los  textos  inglés  y  español,  consistiendo  la 
comisión  de  dos  miembros,  uno  que  habla  el  inglés  solamente  y  otro 
que  no  habla  más  que  el  español. 

El  Secretario.  No  es  verdaderamente  el  objeto  comparar  los  dos 
textos.  Simplemente  repasarlos  y  hacer  algunas  ligeras  modifica- 
ciones sin  alterar  el  sentido  de  ningún  artículo. 

Doctor  Gatewood.  La  proposición  para  que  se  nombre  la  comi- 
sión dice,  entre  otras  cosas,  "comparar".  Me  parece  que  debe 
haber  un  individuo  más,  por  lo  menos,  en  esta  comisión,  que  habla 
ambos  idiomas.     ¿No  podría  servir  el  Doctor  Guiteras? 

Doctor  Guiteras.  Muy  bien,  señor;  cambiaré  mi  proposición  pi- 
diendo que  sean  tres  los  miembros  de  la  comisión  en  vez  de  dos. 

La  propuesta  fué  secundada  y  aprobada. 

El  Presidente.  Nombro  al  Doctor  Guiteras  como  tercer  miembro 
de  la  comisión. 

Los  delegados  sostuvieron  una  discusión  en  privado. 

¿Hay  otros  asuntos  c|ue  se  han  de  someter  á  la  Convención  esta 
tarde? 

Doctor  Guiteras.  La  continuación  del  programa  es  el  único 
asunto  que  tenemos  ahora. 

El  Presidente.  Ya  se  ha  ejecutado  casi  todo  el  programa  pro- 
visional de  esta  Convención.  Ya  hemos  dispuestos  de  los  asuntos 
sobre  diagnósticos,  cuarentenas  marítimas  y  terrestres  y  las  medidas 
locales  para  el  exterminio  de  enfermedades.  Quedan  por  discutirse 
los  números  tres  y  cuatro.     Son  los  siguientes : 

3.  La  relación  del  mosquito  con  la  fiebre  amarilla  y  la  palúdica.  Precauciones  contra  la 
propa2;ación  de  la  fiebre  amarilla  mediante  la  destmcción  y  el  exteiTainio  del  mosquito. 

4.  Discusiones  sobre  el  saneamiento  de  ciudades,  particularmente  con  respecto  á  la 
ventilación  de  habitaciones  y  la  disposición  de  las  basuras  de  las  casas. 

Creo  que  si  la  comisión  de  editores  estuviera  con  los  mecano- 
grafistas  al  mismo  tiempo  que  trabajan  éstos,  se  haría  el  trabajo  más 
rápidamente. 

Doctor  Guiteras.  Hay  algunos  documentos  relativos  á  la  peste  y 
á  la  fiebre  amarilla.  El  último  número  del  programa  se  refiere  en 
sí  á  la  fiebre  amarilla  y  á  su  trasmisión  por  medio  del  mosquito. 

El  Presidente.  Entonces  estudiaremos  esos  documentos.  Segui- 
remos con  el  programa  hasta  donde  se  pueda.  Este  es  un  programa 
provisional  solamente,  y  nos  hemos  apartado  de  él  muy  extensamente. 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  289 

Doctor  Medina.  Deseo  Kotnot,er  una  resol ik- ion  ante  la  Conferencia. 
Como  las  Jiepúbliíías  de  vSan  vSalvador  y  Honduras  no  están  represen- 
tadas aquí,  se  enviará  una  copia  de  la  convención  á  cada  uno  de  sus 
Gobiernos,  expresándoles  al  mismo  tiempo  el  placer  que  tendría  esta 
Conferencia  de  que  se  unan  á  nosotros  para  hacer  efectivas  las  medidas 
prescritas,  lie  hablado  de  esto  con  el  Doctor  Ulloa  y  el  representante 
de  Guatemala,  y  ambos  señores  están  en  favor  de  mi  idea.  Estas 
repúblicas  no  están  representadas,  y  de  acuerdo  con  la  convención  se 
enviarán  copias  á  los  poderes  signatarios  solamente,  así  pues,  para 
que  se  puedan  enviar  copias  á  dichas  repú})licas,  proj)ongo  que  se 
haga  lina  .resolución  con  este  fin  y  expresándoles  el  placer  que  tendría 
la  Conferencia  de  que  ambos  países  se  adhieran  á  la  convención. 

El  Secretario.  Deseo  hacer  unas  cuantas  observaciones  sólo, 
con  respecto  á  la  intención  del  Doctor  Medina,  conforme  me  la 
expresó.  Aún  cuando  á  mí  no  me  parece  que  debe  hacerse  una  excep- 
ción en  estos  casos,  sin  embargo  las  intenciones  del  Doctor  Medina 
son  buenas,  según  él  me  las  ha  explicado.  Como  estas  Repúblicas 
están  tan  próximas  á  nosotros,  y  Honduras  está  en  Golfo  de  Méjico  y 
San  Salvador  está  situado  entre  Guatemala  y  Nicaragua,  si  no  obser- 
varan los  reglamentos  que  hemos  acordado,  podrían  causar  un  retraso 
en  el  cumplimiento  de  las  medidas  por  los  otros  países  de  la  América 
Central,  porque  todas  ellas  se  comunican  entre  sí  por  las  mismas 
líneas  de  vapores,  y  el  Doctor  Medina  dice  que  á  menos  que  se  haga 
una  excepción  de  estos  dos  países,  tal  vez  no  interpretarían  adecuada- 
mente lo  que  se  ha  convenido,  y  que  no  firmen  tan  pronto  como 
desearía  esta  Convención.  Cuando  me  explicó  su  idea  en  esta  forma 
asentí  á  ella.  Claro  está  que  es  de  la  incumbencia  de  la  Convención 
el  aprobarla. 

Doctor  Guiteras.  Propongo  que  se  reforme  esa  resolución'  de 
manera  que  cuando  se  publiquen  los  trabajos  de  la  Convención  se 
envíe  un  ejemplar  á  cada  uno  de  los  países  del  Continente  Occidental. 
Yo  no  me  explicó  porqué  se  ha  de  escoger  á  dos  países  particular- 
mente para  presentarles  los  trabajos  de  esta  Convención,  dejando  á 
las  demás  repúblicas. 

El  Presidente.  No  los  trabajos  de  la  Convención,  sino  el  tratado 
que  acordemos. 

Doctor  Guiteras.  Lo  que  sea;  pero  yo  no  veo  el  por  qué  se  ha  de 
enviar  á  estas  repúblicas  solamente  y  no  á  las  otras.  Son  nueve  las 
repúblicas  que  no  están  representadas  en  esta  Conferencia. 

Doctor  Medina.  M  idea  al  mencionar  estas  dos  repúblicas  sola- 
mente fué  porque  están  más  interesadas  que  las  otras,  hallándose 
situadas  en  medio  de  la  América  Central.  Si  las  otras  repúblicas  no 
se  adhieren  al  tratado  yo  lo  sentiría  mucho,  pero  no  tanto  como  en 
el  caso  de  estas  dos  repúblicas,  porque  si  no  lo  aceptan,  nuestros  esfuer- 
zos resultarían  vanos. 

Doctor  Guiteras.  Propongo  que  se  envíe  un  ejemplar  á  todos  los 
países  del  Continente  Occidental.  Hago  esta  propuesta  como  una 
modificación  á  la  resolución  presentada. 

La  propuesta  del  Doctor  Guiteras  fué  interpretada  por  el  secretario. 

Doctor  Medina.  Acepto  esa  reforma. 

El  Secretario.  La   propuesta  es   que  se  envíe  una  copia   de  la 
Convención  á  cada  una  de  las  repúblicas  que  no  están  representadas 
en  esa  Conferencia. 
1112a— 06 19 


29C  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Doctor  Gatewood.  ¿No  hay  otros  países  interesados  además  de  las 
Repúblicas  de  la  América  del  Sur?  Tenemos  las  Islas  de  las  Indias 
Occidentales  que  podrían  estar  interesadas. 

El  Presidente.  Esta  es  una  Conferencia  de  Repúblicas  Americanas. 

Doctor  Gateavood.  Lo  sé;  ¿pero  habría  algún  inconveniente  en 
enviar  ejemplares  de  la  Convención  á  los  demás  países? 

El  Presidente.  Si  desea  \d.  proponer  que  se  reforme  la  reso- 
lución en  ese  sentido  puede  A"d.  hacerlo. 

Doctor  Gatewood.  No  quisiera  hacerlo  si  está  fuera  de  la  cuestión. 

Doctor  Medina.  Creo  que  no  es  facible  enviar  ejemplares  á  las 
Islas  de  las  Indias  Occidentales,  porque  pertenecen  á  países  extran- 
jeros. Lo  propio  es  enviar  los  ejemplares  á  las  Repúblicas  Ameri- 
canas solamente,  porque  son  las  únicas  interesadas. 

El  Presidente.  La  cuestión  que  se  ha  de  discutir  es  la  propuesta 
del  Doctor  Medina  reformada  por  el  Doctor  Guiteras. 

Doctor  Medina.  Modificaré  esa  propuesta  de  manera  que  se  envíen 
ejemplares  de  la  Convención  á  todas  las  repúblicas  que  no  están 
representadas  aquí,  en  vez  de  ser  solamente  las  dos  repúblicas  men- 
cionadas, diciéndoles  al  mismo  tiempo  que  veríamos  con  placer  su 
adhesión  á  ese  tratado. 

El  Presidente.  Mejor  sería  que  leyera  Vd.  esa  resolución  según 
está  reformada. 

Doctor  Medina.  Entonces  es  como  sigue: 

El  Doctor  Medina,  delegado  de  Nicaragua,  presenta  una  resolución,  reformada  por  el 
Doctor  Guiteras,  disponiendo  que  esta  Conferencia  se  dirija  oficialmente  á  los  Gobiernos  que 
no  están  representados  en  ella,  enviándoles  un  ejemplar  de  la  Convención  y  diciéndoles  que 
tendríamos  mucho  placer  si  se  adhieren  á  nuestro  tratado. 

El  Secretario.  Creo  que  sería  mejor  que  se  someta  esta  resolución 
á  la  junta  consultora  y  que  la  presente  mañana  á  la  Conferencia. 

Doctor  Medina.  Muy  bien. 

El  Presidente.  ¿Se  desea  someter  más  propuestas  ó  hay  algún 
documento  que  se  ha  de  leer? 

Doctor  Guiteras.  En  el  programa  se  habla  de  la  peste  bubónica 
primero,  pero  si  no  hay  ningún  documento  sobre  ella  leeré  uno  rela- 
tivo á  la  fiebre  amarilla  en  Cuba. 

El  Doctor  Licéagá  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  El  Doctor  Licéaga  quiere  que  ponga  en  vuestro 
conocimiento  que  en  vez  de  leer  el  documento  impreso  que  se  ha 
repartido  entre  Vds.,  el  cual  trata  de  la  peste  bubónica,  hará  sola- 
mente algunas  observaciones  sobre  él. 

El  Doctor  Licéaga  pronunció  un  discurso  improvisado  en  castellano 
relativo  á  la  peste  bubónica. 

El  Doctor  Lavorería  hizo  uso  de  la  palabra  en  castellano. 

El  Doctor  Licéaga  contestó  al  Doctor  Lavorería. 

Doctor  Guiteras.  Como  desgraciadamente  no  tenemos  taquígrafo 
en  español,  ruego  al  Doctor  Lavorería  que  escriba  sus  observaciones 
para  que  puedan  publicarse  en  los  trabajos  de  la  Conferencia.  El 
Doctor  Licéaga  tiene  su  documento  impreso  en  ambos  idiomas,  pero 
nada  nos  quedará  de  las  observaciones  del  Doctor  Lavorería  á  menos 
que  las  presente  por  escrito. 

El  Presidente.  ¿Tendría  el  Doctor  Lavorería  la  bondad  de  escribir 
sus  observaciones  y  de  enviarlas  al  secretario  ? 

El  Doctor  Lavorería  habló  en  castellano. 


SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL.  291 

Doctor  GuiTERAS.  Kctin;  mi  ruG<^o.  El  Doctor  Jjavorcría  dice 
que  en  la  memoria  que  ha  presentado  están  incluidas  sus  o})servaciones. 

El  Presidente.  Doctor  Moore,  ¿desea  Vd.  hacer  algunas  observa- 
ciones sobre  el  particular? 

El  Doctor  Moore  hizo  uso  de  la  palabra  en  castellano. 

El  Presidente.  Doctor  Moore,  ¿tendría  Vd.  la  bondad  de  escribir 
sus  observaciones  y  entregarlas  al  secretario? 

Doctor  Moore.  Sí,  señor,  lo  liare. 

El  Presidente.  ¿8e  desea  hacer  más  observaciones  sobre  el  asunto 
de  la  peste  bubónica?  wSi  no,  el  J^octor  Guiteras  dará  lectura  á  un 
documento  relativo  á  la  fiebre  amarilla. 

Doctor  Guiteras.  Aquí  tengo  una  memoria  sobre  la  fiebre  amarilla 
en  Cuba,  desde  la  fecha  de  la  última  Conferencia.  Siento  haber 
tenido  que  redactar  esta  memoria  en  forma  de  argumento  en  apoyo 
de  la  doctrina  de  la  trasmisión  de  la  fiebre  amarilla  por  medio  del 
mosquito.  Por  más  que  esta  Conferencia  la  ha  aceptado  como  un 
hecho  positivo,  existen  algunos  países  en  América  en  donde  no  se  ha 
intentado  aceptarla  como  tal  y  en  los  que  hay  gente  que  aún  no  está 
preparada  para  recibirla.  Así  es  que  me  alegro  de  tener  esta  ocasión 
para  repetir  los  argumentos  en  apoyo  de  esta  doctrina. 

El  Doctor  Guiteras  dio  lectura  á  su  documento  (véase  el  apéndice, 
pág.  441). 

El  Presidente.  Estoy  seguro  que  todos  debemos  estar  agradecidos 
al  Doctor  Guiteras  por  este  documento  tan  interesante.  Lo  considero 
•como  trabajo  de  mucho  valor,  ¿Se  desea  hacer  algunos  comentarios 
sobre  el  particular  ? 

Doctor  Gatewood.  Pido  que  se  suspenda  la  sesión. 

A  las  6  p.  m.  se  suspendió  la  sesión  hasta  el  día  siguiente,  sábado,  14 
de  octubre  de  1905^  á  las  10.30  de  la  mañana. 


QUINTO  BIA— SÁBADO,  14  DE  OCTUBRE. 
Sesión  de  la  Mañana. 

El  Presidente,  Cirujano  General  Wyman,  declaró  abierta  la  sesión 
á  las  10.30  a.  m. 

El  Presidente.  El  secretario  dará  lectura  al  acta  de  la  sesión  de 
ayer. 

El  acta  referida  fué  leída  por  el  secretario. 

El  Secretario.  Este  es  un  extracto  solamente  del  acta  de  la 
sesión  de  ayer.  Las  actas  de  todas  las  sesiones  serán  copiadas  en  su 
totalidad  y  se  publicarán. 

Se  propuso  que  fueran  aprobadas  las  actas,  y,  una  vez  apoyada,  la 
propuesta  quedó  aprobada. 

El  Presidente.  Ahora  sigue  el  informe  de  la  junta  consultora 
sobre  la  resolución  del  Doctor  Medina  que  tenía  que  poner  en  forma. 

Doctor  Guiteras.  En  nombre  de  la  Junta,  les  manifiesto  que  ésta 
recomienda  á  la  Conferencia  la  adopción  de  la  resolución  propuesta 
por  el  Doctor  Medina,  en  la  inteligencia  de  que  la  Oficina  de  las 
Repúblicas  Americanas  enviará  copias  de  la  Convención  á  todos  los 
poderes  del  Hemisferio  Occidental. 

El  Presidente.  Habéis  oído  la  proposición  según  la  presenta  la 
junta  consultora,  al  efecto  de  que  la  convención  que  estamos  prepa- 
rando, relativa  á  cuarentenas  y  enfermedades  contagiosas,  sea  tras- 
mitida por  la  Oficina  de  las  Repúblicas  Americanas  á  todos  los  países 
del  Centro  y  Sur  América,  hayan  estado  ó  no  en  esta  Conferencia,  i  Se 
desea  hacer  alguna  observación  ? 

La  resolución  propuesta  fué  aprobada. 

El  Presidente.  Como  se  hallan  aún  ausentes  algunos  de  los 
delegados  que  están  muy  interesados  en  los  asuntos  que  se  han  de 
discutir  relativos  á  la  terminación  del  convenio,  concedo  la  palabra 
al  Doctor  Geddings  que  tiene  algunas  breves  observaciones  que  hacer 
y  una  resolución  que  presentar. 

Doctor  Geddings.  Señor  Presidente,  se  ha  llamado  la  atención  de 
la  Conferencia  al  hecho  de  que  en  las  "Comptes  Rendus,  Société  de 
Biologie  de  Paris,"  de  agosto  de  1905,  según  creo,  existe  una  preten- 
sión de  los  Señores  Marchoux  y  Simon,  de  la  Comisión  Francesa  del 
Instituto  Pasteur  de  Paris,  cuyos  trabajos  en  Río  de  Janeiro  han  sido 
muy  notorios,  en  la  que  dicen  que  han  demostrado  que  el  stegomyia 
infectado  produce  descendencia  infectada.  Una  alegación  de  este 
género  es  sorprendente,  por  más  que  la  prensa  diaria  de  Nueva 
Orleans  hizo  una  declaración  similar  como  una  explicación  de  los 
casos  leves  que  ocurrieron  en  aquella  ciudad.  He  tenido  el  placer  de 
hablar  con  nuestro  estimado  colega,  el  Doctor  Guiteras,  á  quien  todos 
consideramos  como  el  más  versado  en  el  asunto,  por  lo  que  le  rogaría 
si  es  que  él  no  tiene  inconveniente  alguno,  ni  la  convención,  que  haga 
algunas    observaciones  sobre   el   particular   para    que  sepamos   su 

292 


SEGUNDA    CONFEKENOIA   SANITABIA   INTERNACIONAL.  293 

opinión  si  es  que  está  dispuesto  á  expresar  alguna  sobre  este  punto, 
y  también  le  rogaría  que  profigiire  por  el  profur)do  estudio  que  ha 
dado  á  estos  asuntos,  el  efecto  sobre  la  integridad  de  la  doctrina  de  la 
trasmisión  de  la  fiebre  atnarilla  por  el  mosquito,  y  el  efecto  posible 
sobre  las  medidas  do  sanidad  i)ública,  por  lo  que  pido  cjue  el  Doctor 
Guitcras  liable  sobre  el  particular,  si  es  que  ni  él  ni  la  Convención 
tienen  incoveniente. 

La  proposición  del  Doctor  Geddings  fué  traducida  al  castellano  por 
el  secretario. 

Doctor  GuiTERAS.  Mucho  sería  mi  placer,  en  verdad,  si  lo  que  yo 
diga  pueda  servir  de  ayuda  en  la  obra  en  que  todos  estamos  mtere- 
sados.  Tuve  noticia  de  la  publicación  que  hizo  de  este  descubrimiento 
la  Comisión  Francesa  del  Instituto  Pasteur.  En  su  última  memoria 
dicen  que  han  descubierto  dos  nuevos  medios  de  trasmisión  de  la 
fiebre,  á  los  cuales  creen  que  se  debe  dar  importancia.  Estos  nuevos 
medios  consisten  en  la  infección  de  los  huevos  del  stegomyia  con- 
taminado, y  en  la  trasmisión  de  la  fiebre  amarilla  en  forma  de  casos 
benignos,  á  los  naturales  de  los  países  en  que  prevalece  este  mal. 
Debo  hacer  constar  que  llamé  la  atención  sobre  las  indicaciones 
Marchoux  y  Simon  en  las  reuniones  de  la  Sociedad  Médica  Parisiense 
de  Nueva  Orleans  durante  mi  reciente  visita  á  esa  ciudad.  La 
teoría  de  la  trasmisión  por  medio  de  los  huevos  del  stegomyia  infec- 
tado tiene  ciertamente  mucha  importancia;  pero  á  mi  me  parece  que 
todo  indica  la  probabilidad  de  un  error  de  opinión,  ó  de  hechos,  en 
esa  declaración  hecha  por  esos  señores.  He  leído  su  publicación 
original  y  ellos  mismos  admiten  que  solo  han  tenido  un  caso — un 
experimento — que  fué  en  esta  forma :  Hicieron  que  stegomyias  infec- 
tados echaron  huevos  en  el  duodécimo  día  de  su  infección — y  este  es 
un  punto  interesante,  en  el  cual  insisten,  que  la  madre  debe  poner 
los  huevos  cuando  está  infectada  activamente,  es  decir,  cuando  está 
dispuesta  á  producir  la  enfermedad  mediante  la  picadura,  que  es  en  el 
duodécimo  día  después  de  haber  picado  á  un  paciente  de  fiebre 
amarilla.  Así  pues,  los  huevos  fueron  puestos  en  el  duodécimo  día  y 
después  de  criarse  mosquitos  de  estos  huevos  y  de  que  se  lucieron 
varias  inoculaciones  con  los  mismos  consiguieron  producir  un  solo 
caso  de  fiebre  amarilla.  Como  es  obvio,  los  experimentos  de  esta 
clase  no  tienen  mucho  peso,  sobre  todo  si  se  han  llevado  á  cabo  en  una 
localidad  contaminada — en  Rio  de  Janeiro — porque  la  infección  de 
ese  único  caso  pudo  haber  sido  producida  por  un  mosquito  contami- 
nado. Ellos  mismos  admiten,  ó  por  lo  menos  reconocen  que  quita 
mucha  fuerza  á  su  argumento,  que  solamente  pueden  presentar  un 
caso. 

Además,  por  los  experimentos  hechos  en  la  Habana,  objeto  contra 
este  supuesto  nuevo  medio  de  transmisión  de  la  fiebre  amarilla. 
Siento  que  esos  experimentos  de  la  Habana  no  estén  registrados 
cuidadosamente  de  modo  que  hayan  podido  servir  de  muestra  para 
cualquier  investigación  científica,  pero  de  todos  modos  tienen  algún 
peso,  y  espero  que  el  Doctor  Carroll,  á  quien  se  le  han  concedido  las 
prerrogativas  de  la  Convención,  nos  dará  á  conocer  su  parte  de  los 
experimentos  que  voy  á  mencionar.  He  dicho  que  hemos  hecho  en 
la  Habana  experimentos  que  contradicen  la  opinión  de  Marchoux. 
Los  que  yo  llevé  á  cabo  en  Las  Animas  contradicen  esa  nueva  teoría 
en  esta  forma.  En  realidad  de  verdad,  todos  los  mosquitos  que  usába- 
mos en  nuestra  estación  experimental  de  la  Habana,  desde  un  principio, 


294:  SEíiUNDA    CONFEBENCIA    SANITARIA    INTERNACIONAL. 

qrocedían  de  mosquitos  infectados.  Es  decir,  empezamos  con  mos- 
quitos que  habían  sido  alimentados  en  pacientes  de  fiebre  amarilla, 
puedando  infectados  de  ese  modo,  j  esos  mosquitos  ponían  huevos 
y  en  esta  forma  se  fueron  multi])licando.  Los  mosquitos  nuevos 
obtenidos  así  se  alimentaban  en  personas  no  inmunes.  Dos  indi- 
viduos de  estos  metían  constantemente  sus  manos  en  el  jarro  que 
contenía"  estos  mosquitos,  con  el  fin  de  alimentarlos  j  para  que 
pusieran  hueVos.  Así  pues  estuvimos  haciendo  el  experimento 
constantemente  sin  notarlo.  Pero  recuerdo  haber  llamado  la  aten- 
ción de  varios  caballeros,  en  dos  ocasiones,  sobre  este  particular, 
diciéndoles  ''He  aquí  un  mosquito,  producto  de  mosquitos  infectados, 
alimentado  en  individuos  no  inmunes  y  criado  de  los  huevos  puestos 
por  una  hembra  contaminada,  y  sin  embargo,  no  puede  trasmitir  la 
enfermedad."  Por  lo  que  la  infección  no  es  hereditaria  en  el  stegomyia 
como  sucede  en  el  caso  de  la  fiebre  tejana  con  la  garrapata.  Varias 
veces  llamé  la  atención  de  algunas  personas  sobre  este  particular, 
por  más  que  no  tomamos  nota  de  ello.  Creo  que  el  Doctor  Carroll 
les  dirá  lo  mismo.  Tengo  entendido  que  él  liizo  experimentos  seme- 
jantes, y  que  vio  en  varias  ocasiones  á  personas  no  inmunes  al  ser 
Íñcadas  por  mosquitos  criados  de  huevos  de  mosquitos  infectados, 
os  mosquitos  á  que  hacen  referencia  Marchoux  y  vSimón. 

Por  último,  me  parece  que  si  fuera  cierto  que  la  infección  de  la 
fiebre  amarilla  puede  ser  trasmitida  por  la  hembra  infectada  á  los 
huevos,  hubiera  sido  absolutamente  imposible  causar  la  desaparición 
del  mal  de  la  Habana,  como  lo  hemos  hecho.  Si  esa  teoría  fuera 
cierta,  abandonaría  todas  las  esperanzas  que  tengo  de  hacer  desapa- 
recer del  mundo  la  fiebre  amarilla.  Me  parece  que  sería  imposible 
combatir  el  mal  si  existiera  tan  activo  medio  de  propagación,  que 
estaría  fuera  de  nuestro  dominio,  porque  son  innumerables  los  huevos 
que  los  mosquitos  ponen  durante  su  existencia,  todos  los  cuales, 
según  esta  teoría,  podrían  producir  mosquitos  infectados. 

Hay  otra  cuestión  envuelta  en  esta  teoría  de  Marchoux — al  menos 
yo  creo  que  lo  está — y  es  la  de  que  la  fiebre  amarilla  ocasionada  por 
un  mosquito  criado  de  supuestos  huevos  infectados  es  de  un  carácter 
benigno.  Creo  que  éste  es  un  error  fundamental;  si  la  fiebre  amarilla 
trasmitida  en  esta  forma  fuera  de  un  carácter  benigno,  el  mal  hubiera 
desaparecido  de  la  tierra,  desde  hace  mucho  tiempo,  por  sí  mismo. 
Hubiera  habido  un  proceso  de  inoculación  natural  de  la  enfermedad, 
porque  creo,  y  todos  Vds.  lo  admitirán,  que  los  casos  producidos  por 
dichos  huevos  deben  ser  mucho  más  numerosos  que  los  produci- 
dos directamente  por  las  hembras  infectadas,  porque  una  madre 
puede  producir  solamente,  durante  su  vida  de  150  días,  picando  cada 
tres  días,  50  casos  de  fiebre  amarilla,  en  tanto  que  puede  poner  de  400 
á  500  huevos — quizás  varios  cientos — de  los  cuales  se  producen  varios 
cientos  de  mosquitos,  que  ocasionarían  casos  benignos  de  la  enferme- 
dad; de  modo  que  en  tanto  que  la  hembra  produce  sólo  50  casos, 
tendríamos  que  este  constante  proceso  de  inoculación  se  verifica  en  la 
raza  humana,  en  forma  de  casos  benignos,  y  la  enfermedad  hubiera 
desaparecido  por  la  inoculación  natural. 

Estas  son  las  objeciones  que  presento  contra  la  teoría  de  Marchoux 
j  Simon. 

El  Doctor  Guiteras  repitió  sus  declaraciones  en  castellano. 

El  Presidente.  Tendríamos  mucho  gusto  en  oir  la  opinión  del 
Doctor  Carroll. 


SEGUNDA    CONFEEENCIA    RANT'I'APJA    TNTETíNAí'IONAL.  295 

Doctor  Carroll.  Estoy  conforme  sinceramente  con  todo  lo  cjue  ha 
.  dicho  el  Doctor  Guitci-as  sobi'c  el  particular.  No  creo  que  es  j)ruílente 
aceptar  la  teoría  de  esos  cal)aJleros  basada  en  un  solo  experimento 
que  no  está  coníii'mado,  porque  |)odemos  presentar  otro  experimento 
que  se  hizo  con  el  fin  de  comprobar  esa  misma  teoría.  Después  que 
habíamos  terminado  casi  todo  nuestro  trabajo  en  uno  de  estos  sitios, 
colocamos  un  número  de  mosquitos  incu])ados  de  huevos  puestos  por 
hembras  infectadas,  en  un  jarro,  é  hicimos  que  un  individuo  no 
inmune  metiera  la  mano  en  él,  la  cual  fué  picada  por  los  insectos  unas 
treinta  ó  cuarenta  veces.  No  esperamos  ningún  resultado,  y  efecti- 
vamente nada  ocurrió. 

Nuestros  insectos  no  se  obtuvieron  en  exactamente  la  misma  forma 
que  ha  indicado  el  Doctor  Guiteras.  Los  primeros  los  obtuvimos  de 
los  que  nos  facilitó  el  Doctor  Finlay.  Casi  toda  la  segunda  cría  la 
obtuvimos  de  insectos  cogidos  en  los  cuarteles  de  Santa  Bárbara. 

Doctor  Guiteras.  ¿Y  no  es  posible  que  entre  esos  mosquitos 
hubiera  algunos  infectados? 

Doctor  Carroll.  Sí,  señor,  lo  admito. 

Doctor  Guiteras.  Es  probable. 

Doctor  Carroll.  Fueron  incubados  y  criados  en  el  laboratorio  de 
la  guarnición,  y  sólo  después  fueron  llevados  al  laboratorio  especial 
en  donde  se  conservaban  nuestros  mosquitos  infectados,  y  una  vez 
contaminadas,  sus  crías  se  encerraban  en  la  jaula  de  mosquitos 
contaminados. 

Creo  que  no  debemos  aceptar  la  teoría  en  cuestión,  que  es  como 
otras  muchas  del  mundo  científico,  hasta  que  reciba  confirmación. 
Es  evidente  que  no  se  tomaron  las  precauciones  necesarias,  y  no  es 
prudente  aceptarla. 

Y  además,  como  dice  el  Doctor  Guiteras,  si  aceptáramos  la  posi- 
bilidad de  la  infección  de  la  descendencia  de  mosquitos  contaminados, 
la  desinfección  de  habitaciones  contaminadas  no  haría  desaparecer 
la  enfermedad  tan  completamente  como  se  ha  hecho  en  La  Habana. 
Creo  que  el  Doctor  Licéaga  puede  hacer  algunas  observaciones  intere- 
santes sobre  el  particular,  por  la  experiencia  que  tiene  de  Méjico. 

Doctor  Guiteras.  Trataré  de  vertir  al  castellano,  brevemente,  la 
esencia  de  lo  que  ha  dicho  el  Doctor  Carroll,  porque  ésta  es  una 
cuestión  en  la  que  algunos  de  nuestros  colegas  latino-americanos 
podrán  ayudarnos  con  su  opinión. 

El  Doctor  Guiteras  tradujo  al  castellano  las  declaraciones  del 
Doctor  Carroll. 

El  Doctor  Licéaga  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  El  Doctor  Licéaga  dice  que  felicita  al  Doctor 
Guiteras  por  la  excelente  explicación  que  ha  dado  sobre  el  particular, 
la  cual,  no  solamente  la  considera  como  una  contradicción  de  la 
teoría  de  Marchoux  y  Simon,  sino  que  también  dice  que  ha  dado  un 
mentís  á  estos  caballeros  por  haber  afií'inado  algo  basado  en  un  solo 
caso.  Dice  que  según  su  conocimiento  no  hay  ninguna  enfermedad 
aguda  cuya  infección  sea  trasmitida  por  la  descendencia  ó  por  los 
huevos  de  los  insectos.  Confirma  la  opinión  del  Doctor  Guiteras  de 
que  si  la  teoría  de  Marchoux  y  Simon  fuere  cierta,  la  desaparición  de 
la  fiebre  amarilla  que  se  ha  efectuado  en  la  Habana  de  una  manera 
tan  eficaz  hubiera  sido  completamente  imposible.  Dice  que  los 
experimentos  y  las  opiniones  de  los  Doctores  Carroll  y  Guiteras  son 
suficientes,  á  su  jucio,  para  convencernos  de  la  falsedad  de  la  teoría 


296  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

expuesta  por  los  doctores  de  la  comisión  del  Brasil.  Dice  que  un 
argumento  que  pudiera  usarse  contra  esta  opinión  es  el  que  los  Doc- 
tores Marchoux  y  Simon  admiten  que  su  teoría  es  algo  débil  porque 
solamente  tuvieron  un  caso  en  sus  experimentos,  y  además,  que  no 
han  podido  decir  de  una  manera  cierta  si  este  caso  fué  producido  por 
un  mosquito  infectado;  y  que,  como  el  Doctor  Guiteras  ha  dicho,  los 
experimentos  se  llevaron  á  cabo  en  un  sitio  contaminado  de  fiebre 
amarilla,  en  la  donde  la  picadura  de  un  mosquito  era  cosa  bien 
factible. 

El  Doctor  Licéaga  terminó  diciendo  que  este  punto  débil  de  la 
teoría  de  Marchoux  y  Simon  está  en  contradicción  maniñesta  con 
los  puntos  demostrados  por  el  trabajo  de  los  Doctores  Carroll,  Gui- 
teras, Reed  y  otros  que  hicieron  experimentos  en  la  Habana,  quienes, 
si  bien  al  principio  no  pudieron  afirmar  los  hechos  con  seguridad, 
gracias  á  experimentos  minuciosos  y  prolongados,  que  han  dado  como 
resultado  la  prevención  contra  la  fiebre  amarilla,  han  establecido 
sus  opiniones  como  una  verdad. 

El  Presidente.  Tenemos  entre  nosotros  el  jefe  del  Departamento 
Médico  del  Servicio  de  Hospitales  Marítimos,  y  quisiera  rogarle  que 
nos  exponga  su  opinión  sobre  el  particular. 

Doctor  Stiles.  Estoy  en  todo  conforme  con  lo  dicho  por  los  Doc- 
tores Guiteras  y  Carroll  de  que  no  hay  razón  para  que  nos  atemorizemos 
por  esta  declaración  de  París.  Pero  en  justicia  á  nuestros  colegas 
franceses  debemos  recordar  una  manifestación  que  hacen  en  su  artículo, 
á  saber,  que  tal  método  de  transmisión  es  excepcional.  Esto  es  lo  que 
pretenden.  No  dicen  que  este  sea  un  modo  ordinario  de  transmisión, 
sino  solamente  que  es  excepcional,  y  en  esta  manifestación  no  veo  nada 
que  contradiga  las  declaraciones  hechas  por  nuestros  buenos  amigos  los 
Doctores  Guiteras  y  Carroll.  Es  muy  posible  que  hayan  hecho  cin- 
cuenta ó  cien  experimentos  de  esta  clase  en  Cuba  y  que  todos  hayan 
resultado  nulos,  pero  no  es  una  prueba  concluyente.  Además, 
debemos  tener  presente  de  que  existen  por  lo  menos  unas  seis  enfer- 
medades que  se  transmiten  de  una  generación  á  otra  en  los  insectos. 
De  ninguna  manera  soy  de  la  opinión  que  debemos  aceptar  inmediata- 
mente esa  teoría  que  ha  venido  de  París,  pero  sí  debemos  estar  dis- 
puestos para  recibir  nuevas  pruebas.  No  es  prudente  rechazar  de 
repente  una  teoría  como  ésta.  Pongamos,  por  ejemplo,  la  fiebre 
palúdica;  según  Schaudinn  se  ha  demostrado  que  esta  fiebre  puede 
ser  transmitida  de  una  generación  á  otra  de  mosquitos.  La  enferme- 
dad de  Pehrin  es  hereditaria  en  el  gusano  de  seda.  Existen  enferme- 
dades flagelantes  que  son  transmitidas  del  mismo  modo  en  las  moscas. 
Existen  dos  enfermedades  en  una  especie  de  buho  de  Alemania,  las 
cuales,  según  se  dice,  son  hereditarias  en  el  parásito  llamado  Culex. 
Ahora  bien,  hasta  que  sepamos  de  un  modo  determinado  cuál  és  el 
parásito  de  la  fiebre  amarilla,  creo  que  será  difícil  que  podamos  decir 
terminantemente  que  no  es  hereditario  en  el  mosquito.  Me  parece 
probable  que  el  parásito  de  la  fiebre  amarilla  resulte  ser  con  el  tiempo 
un  organismo  más  ó  menos  relacionado  íntimamente  con  los  parásitos 
de  la  misma  clase  general  de  enfermedades  como  las  que  he  men- 
cionado ;  es  decir,  un  organismo  que  venga  á  estar  entre  los  infusorios 
y  los  esporozoarios.  También  podría  citarse  la  fiebre  tejana  del 
ganado  y  la  hemoglobinuria  en  los  perros — la  plasmosis  canina — á 
guisa  de  comparación. 

En  vista  del  hecho  de  que  sabem,os  hay  un  número  de  enfermedades 
que  son  hereditarias  en  el  parásito  intermediario,  creo  que  es  muy 


SEGUNDA    CONFEEENCIA    SANlTAltlA    IN'l'KKNACTONAí..  297 

prematuro  el  rechazar  tan  de  súbito  esta  teoría  franeesa.  Debernos, 
simplemente,  estar  preparados,  y  si  nuestnjs  colegas  franceses  pueden 
demostrar  que  esta  enfermedad  es  hereditaria,  en  el  mosquito,  como 
se  ha  demostrado  en  otras  enfermedades,  hagánu^sk^s  justicia,  recor- 
dando que  ellos  no  dicen  que  este  no  es  un  medio  ordinario  de 
transmisión;  dicen  claramente  que  es  un  medio  excepcional. 

Las  observaciones  del  Doctor  Stilcs  fueron  traducidas  al  castellano  • 
por  el  Secretario. 

El  Secretario.  Doctor  Stiles,  varios  delegados  preguntan  si  Vd. 
dijo  que  la  fiebre  palúdica  es  transmisible  por  herencia  en  el  agente 
intermedio. 

Doctor  Stiles.  Sí,  según  Schaudinn  el  parásito  de  la  fiebre  palú- 
dica es  transmisible  de  la  hembra  del  mosquito  á  la  siguiente  genera- 
ción. Esta  teoría  fué  publicada  en  1894  por  la  Oficina  Imperial  de 
Sanidad  de  Alemania.  Se  descubrió  que  este  parásito  pasa  de  una 
generación  á  otra.  No  ha  habido  casos  clínicos  basados  en  tal  teoría, 
pero  se  ha  visto  al  parásito  trasladarse  á  los  huevos. 

El  Presidente.  El  Doctor  Guiteras  desea  presentar  á  la  Conferen- 
cia un  asunto  importante. 

Doctor  Guiteras.  Señor  Presidente,  deseo  presentar  una  serie  de 
artículos  para  que  sean  añadidos  á  la  Convención  que  ya  hemos  apro- 
bado en  nuestra  última  sesión,  los  cuales  deben  numerarse  28a,  28b, 
28c  y  28d,  con  el  fin  de  no  alterar  la  numeración  del  original  francés, 
y  para  evitar  que  sean  colocados  al  final,  como  al  principio  pensé 
nacer,  en  dondje  no  estarán  adecuadamente.  Estos  artículos  son 
cuatro. 

El  Secretario.  Mejor  sería  llamarlos  artículos  adicionales.  Es 
el  único  modo  de  hacerlo. 

Se  sostuvo  una  discusión  en  castellano. 

Doctor  Guiteras.  Propongo  que  estos  artículos  adicionales  sean 
insertados  después  del  último  artículo  aprobado  en  nuestra  última 
sesión.  El  último  artículo  lleva  el  número  45,  por  lo  que  estos 
artículos  adicionales  serán  numerados  46,  47,  48  y  49. 

El  Presidente.  ¿Están  bajo  el  epígrafe  de  ''Artículos  referentes  á 
la  fiebre  amarilla  "  ? 

Doctor  Guiteras.  Sí,  señor,  ese  es  el  epígrafe. 

El  Presidente.  Ruego  al  Doctor  Moore  que  tome  la  copia 
española  de  estos  artículos  y  los  vaya  leyendo  después  de  los  que 
están  en  inglés,  como  se  hizo  en  la  primera  parte  de  la  Convención. 

El  Doctor  Guiteras  leyó  el  siguiente  artículo : 

Artículo  46.  Con  respecto  á  los  buques  infectados  de  fiebre  amarilla  se  observará  el 
régimen  siguiente: 

1.  Visita  médica  (inspección). 

2.  Los  enfermos  serán  desembarcados  iimiediatamente  en  una  lancha  protegida  contra 
los  mosquitos  por  tela  de  alambre,  y  conducidos  al  lugar  de  aislamiento  en  una  ambulancia 
ó  camilla  igualmente  protegida  contra  los  mosquitos. 

El  Doctor  Moore  leyó  esta  parte  del  artículo  46  en  castellano. 

El  Presidente.  ¿Debemos  aprobar  estos  párrafos  antes,  ó  todo  el 
artículo  en  conjunto? 

Se  sostuvo  una  breve  discusión. 

El  Presidente.  Leeremos  este  artículo  párrafo  por  párrafo,  y  si 
alguien  tiene  alguna  pregunta  que  hacer  ú  objeción  que  presentar, 
la  hará  después  de  la  lectura  del  respectivo  párrafo.  Continuaremos 
con  la  lectura  hasta  haber  leído  todo  el  artículo,  j  después  discutire- 
mos su  aprobación. 


298  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Lo  dicho  por  el  Presidente  ñié  interpretado  por  el  Doctor  Ulloa. 
El  Doctor  Giiiteras  continuó  con  la  lectura  del  artículo  46 : 

3.  Las  demás  personas  deben  ser  también  desembarcadas,  si  es  posible,  y  sometidas  á 
una  observación  de  seis  días,  é.  contar  desde  el  de  la  llegada. 

Este  párrafo  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  Presidente.  Debe  tenerse  presente  que  toda  alteración  en  la 
fraseología  debe  ser  propuesta  ahora,  tanto  en  español  como  en  inglés. 
De  otro  modo  las  copias,  conforme  se  vayan  leyendo,  se  entregarán 
á  los  copistas. 

El  secretario  interpretó  estas  palabras  del  Presidente. 

El  Doctor  Guiteras  continuo  con  la  lectura  del  artículo  46 : 

4.  En  los  campamentos  de  observación  habrá  casetas  ó  jaulas  alambradas  donde  se 
recluirá  inmediatamente  á  toda  persona  que  presente  una  temperatura  superior  á  37.6°  C, 
hasta  que  se  le  pueda  conducir  en  ambulancia  ó  camilla  ad  hoc  al  lugar  de  aislamiento. 

5.  El  buque  deberá  anclar  á  una  distancia  de  600  pies,  por  lo  menos,  de  tierra  habitada, 
habitada. 

El  Doctor  Barnet  hizo  uso  de  la  palabra  en  castellano. 

Doctor  Guiteras.  El  Doctor  Barnet  propone  cjue  pongamos  en  la 
copia  española  ''200  metros,"  porque  en  los  países  latinos  está  en  uso 
el  sistema  métrico,  siendo  200  metros  equivalentes  á  600  pies.  • 

Doctor  Geddings.  Yo  propondría  que  se  ponga  "200  metros"  en 
ambos  idiomas,  porc^ue  600  pies  no  es  el  equivalente  exacto  de  200 
metros,  aunque  lo  sea  aproximadamente. 

Doctor  Guiteras.  No  son  menos. 

Doctor  Geddings.  Nó,  señor,  en  todo  caso  más. 

El  Presidente.  Entonces,  pondremos  "200  metros"  en  vez  de 
600  pies." 

Doctor  Guiteras.  En  este  caso  el  párrafo  5  dirá: 

5.  El  buque  deberá  anclar  á  una  distancia  de  200  metros,  por  lo  menos,  de  la  tierra 
habitada. 

El  Doctor  Guiteras  continuó  la  lectura  del  artículo  46,  como  sigue: 

6.  Siempre  que  sea  posible  se  fumigará  el  buque  contra  los  mosquitos,  antes  de  la  descarga, 
pero  si  la  fumigación  no  fuese  practicable,  la  autoridad  sanitaria  podi-á  disponer  uno  de 
estos  dos  medios,  á  saber: 

(a)  El  empleo  para  la  descarga  de  un  personal  inmune,  ó  (b)  si  esto  fuese  imposible,  se 
sujetará  á  observación  al  personal  de  descarga  durante  el  tiempo  de  esta  y  por  seis  días  más 
á  contar  desde  el  último  de  exposición  á  bordo. 

El  Presidente.  Ahora  votaremos  la  aprobación  de  este  artículo 
en  conjunto.  Será  denominado  con  el  número  46,  y  el  último 
artículo  tendrá  que  ser  cambiado  á  otro  número. 

El  artículo  46  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  47,  como  sigue: 

Artículo  47.  Los  buques  sospechosos  de  fiebre  amarilla  serán  sometidos  á  las  medida- 
indicadas  en  los  incisos  1,  3  y  5  del  artículo  anterior,  y  cuando  no  sean  fumigados  se  descars 
garán  mediante  los  requisitos  señalados  en  el  párrafo  (a)  ó  (b)  de  dicho  artículo. 

El  Doctor  Moore  leyó  este  artículo  en  español. 

El  Doctor  Barnet  hizo  uso  de  la  palabra  en  castellano,  mas  sus 
observaciones  no  fueron  interpretadas  al  inglés. 
El  artículo  47  fué  aprobado. 
El  Doctor  Guiteras  leyó  el  artículo  48,  como  sigue: 

Artículo  48.  Los  buques  inmunes  de  fiebre  amarilla,  procedentes  de  puertos  infectados, 
serán  puestos  en  libre  plática  después  de  la  visita  médica  de  inspección,  si  el  viaje  ha  durado 
más  de  seis  días.  Si  este  ha  sido  más  corto  se  tratará  al  barco  como  sospechoso  hasta  cjue  se 
•complete  el  período  de  seis  días,  á  contar  desde  el  de  la  partida. 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  299 

Si  se  presentare  un  caso  (](;  íltibre  ainarilla  entre  los  pasajei'os  d  tiipulantes  durante  el 
período  de  observación  so  tratará  al  bucjue  coino  inl'eetado. 

•  El  Presidente.  Va\  la  j)r¡incríi,  línea  de  este  artículo,  sej^ún  la 
copia  que  tenjüio  aíjuí,  se  usa  la})alabra"  indemne"  en  vez  de  "  inmune," 

Doctor  GuiTJouAS.  En  mi  copia  está  también  "indemne." 

El  Presidente.  Vd.  leyó  "inmune." 

Doctor  GuiTintAS.  Ciertamente  (|uc  llamaríamos  "indemne"  á  un 
buque  procedente  de  un  puerto  infectado  y  que  no  ha  tenido  ningún 
caso  de  fiebre  amarilla,  ¿no  es  así?  No  llamaríamos  "sospechoso"  á 
un  buque  que  viene  del  río  San  Lorenzo,  en  el  norte,  por  ejemplo. 
Sería  un  buque  indemne,  procedente  de  un  puerto  limpio. 

Doctor  Geddings.  Lo  que  se  quiere  decir  en  este  caso  es  un  buque 
procedente  de  un  puerto  infectado  y  en  el  que  no  ha  ocurrido  caso 
alg;uno  de  fiebre  amarilla. 

Doctor  GuiTERAS.  ¿Cómo  se  llamaría  á  un  buque  que  está  completa- 
mente libre  de  la  enfermedad?  Esto  no  aparece  en  la  convención 
forma  alguna. 

El  Presidente.  Sería  un  buque  solamente.     [Risas.] 

El  Doctor  Guiteras  volvió  á  leer  el  artículo  48,  cambiando  la 
palabra  "inmune"  por  "indemne." 

El  Doctor  Moore  leyó  el  artículo  48  en  castellano. 

El  artículo  48  fué  aprobado. 

El  Doctor  Guiteras  leyó  el  artículo  49,  como  sigue: 

Artículo  49.  Se  permitirá  inmediatamente  el  desembarco  de  todo  individuo  que  demues- 
tre ser  inmune  á  la  fiebre  amarilla,  á  la  satisfacción  de  la  autoridad  sanitaria  del  puerto  de 
arribo. 

Este  artículo  fué  leído  en  castellano  por  el  Doctor  Moore. 

El  artículo  49  fué  aprobado. 

El  Presidente.  Las  copias  mecanografidas  del  convenio  que 
acabamos  de  aprobar,  artículo  por  artículo,  están  listas.  Ruego  al 
Doctor  Gatewood  que  lea  la  copia  en  inglés  y  al  Doctor  Lavorería  que 
lea  la  copia  en  español,  con  el  fin  de  que  si  hay  algún  defecto  técnico  en 
cualquiera  de  ambas  copias,  ó  si  hay  alguna  parte  dudosa  en  la 
fraseología  ó  error  gramatical  en  el  lenguaje,  se  llame  la  atención  á 
ello  inmediatamente  para  que  se  corrija  aquí  mismo,  puesto  que  esta 
es  la  copia  final  que  ha  de  ser  firmada  por  nosotros.  De  este  modo  se 
habrá  observado  el  mayor  cuidado  para  que  las  copias  inalteradas  en 
español  y  en  inglés  sean  firmadas  de  hecho  por  los  delegados  de  esta 
Conferencia.  El  trabajo  de  mecanografiar  estas  copias  está  casi  termi- 
nado, y  podemos  comenzar  con  las  páginas  terminadas  dando  así 
tiempo  para  que  se  terminen  las  que  están  sin  hacerse,  con  lo  cual  no 
habrá  demora  alguna. 

Las  observaciones  que  preceden  fueron  interpretadas  al  castellano 
por  el  secretario. 

El  preámbulo  fué  leído  en  inglés  por  el  Doctor  Gatewood. 

Habiéndose  designado  al  Dr.  H.  L.  E.  Johnson  en  el  preámbulo 
como  "miembro  de  la  Asociación  Médica  Americana,"  dicho  señor 
rogó  que  se  cambiará  ese  título  por  el  de  "miembro  de  la  Junta 
Directiva  de  la  Asociación  Médica  Americana." 

Esta  alteración  fué  aprobada. 

La  lectura  de  las  copias  finales  de  la  Convención  fué  continuada  por 
el  Doctor  Gatewood  en  inglés,  y  el  Doctor  Lavorería  en  castellano, 
hasta  la  una  y  veinte  minutos  de  la  tarde,  en  cuya  hora  se  suspendió 
la  sesión  hasta  las  de  la  misma  tarde. 


300  SEGUNDA    CONFERENCIA    SANITAEIA    INTEENACIONAL. 

Sesión  de  la  Tarde. 

El  presidente  declaró  abierta  la  sesión  á  las  dos  y  media  de  la  tarde. 

El  Presidente.  Continuaremos  con  la  lectura  de  los  artículos. 
Quedamos  en  al  artículo  8. 

La  lectura  de  la  Convenicón  fué  continuada  en  inglés  y  en  castellano. 

El  Presidente.  Se  desea  hacer  una  averiguación-  con  respecto  á 
los  "Consejos  sanitarios  internacionales"  que  se  mencionan  en  el 
artículo  10.  Esta  Convención  tiene  una  Oficina  Sanitaria  Inter- 
nacional, pero  no  sé  si  la  palabra  "consejos"  se  ha  puesto  con  la 
intención  de  que  tenga  un  sentido  más  lato,  ó  de  que  se  refiera  á 
cualquier  clase  de  consejos  ó  los  nacionales. 

Doctor  Geddings.  Los  consejos  sanitarios  internacionales  mencio- 
nados en  el  Convenio  son  el  Consejo  Sanitario  Internacional  de 
Constantinopla  y  el  Consejo  Sanitario  y  de  Cuarentenas  de  Egipto, 

El  Presidente.  Está  incluida  también  nuestra  Oficma  Sanitaria 
Internacional  ? 

Doctor  Guiteras.  Sí,  señor. 

Doctor  Geddings.  Lo  hemos  dejado  deliberadamente,  creyendo 
que  esas  notificaciones  debían  hacerse  á  las  Repúblicas  de  Centro  y 
Sur  América,  á  los  Estados  Unidos  y  la  Oficina  Sanitaria  Internacional. 

El  Presidente.  No  tenemos  nada  que  ver  con  las  naciones 
extranjeras.     ¿No  lo  entiende  Vd.  así,  Doctor  Geddings? 

Doctor  Geddings.  Mi  manera  de  entender  es  que  se  dejó  simple- 
mente con  el  fin  de  no  variar  el  texto,  pero  la  Oficma  Sanitaria  Inter- 
nacional quedó  incluida  dentro  del  significado  de  ese  párrafo. 

El  Presidente.  En  ninguna  otra  parte  de  esta  Convención,  hasta 
donde  se  ha  leído,  se  hace  referencia  á  otros  consejos  sanitarios 
internacionales  que  los  de  las  Repúblices  Americanas. 

Doctor  Geddings.  Eso  es  cierto. 

El  Presidente.  ¿Entonces  por  qué  habremos  de  usar  esa  frace 
aquí?  Es  algo  confusa.  No  sé  que  es  lo  que  opinaran  los  demás 
miembros  de  la  Convención,  pero  creo  que  este  es  un  punto  que  debe 
ser  discutido,  si  se  debe  cambiar  esa  frase  á  "Oficina  Sanitaria 
Internacional,"  ó  nó. 

Doctor  Geddings.  Propongo  que  se  haga  eso  cambio. 

Esta  propuesta  fué  secundada. 

El  Presidente.  Se  ha  propuesto  que  las  palabras  "consejos  sani- 
tarios internacionales"  sean  cambiadas  por  "Oficina  Sanitaria  Inter- 
nacional," que  es  la  oficina  establecida  por  esta  Convención. 

La  cuestión  fué  discutida  y  quedó  aprobada  la  propuesta. 

La  lectura  de  la  Convención  fué  continuada  en  inglés  y  en  español 
hasta- el  artículo  21,  en  cuyo  punto  el  Doctor  Licéaga  hizo  uso  de  la 
palabra  en  castellano,  siendo  traducidas  sus  observaciones  al  inglés 
por  el  Doctor  Ulloa.  El  Doctor  Licéaga  dijo  que,  habiéndose  fijado 
en  la  última  sesión  la  distancia  de  200  metros,  debia  cambiarse  la 
última  parte  del  artículo  20,  que  deja  á  la  discreción  de  las  autoridades 
sanitarias  el  fijar  la  distancia  en  que  deben  anclar  los  buques,  de  la 
orilla. 

Doctor  Medina.  Se  fijó  el  mínimum  de  modo  que  las  autoridades 
pudieran  prescribir  distancias  más  largas. 

Los  Doctores  Licéaga,  Medina  y  Moore  sostuvieron  una  discusión. 

El  Secretario.  Dice  "una  distancia  de  200  metros  por  lo  menos." 
El  Doctor  Licéasa  está  conforme  con  ello. 


SEGUNDA    CONFERJÍNCIA    SANITAKÍA    INTEKNACIONAL.  301 

Doctor  Gatewood.  En  esta  nota  al  pie  relativa  á  la  palabra 
''tripulación/'  existe  en  el  texto  español  la  disposición  de  que  esa 
palabra  debe  ser  interpretada  en  Ja  forma  definida  siempre  que 
aparezca  en  la  Convención. 

El  Secretario.  vSí,  eso  esta  en  el  texto  español.     Está  bien. 

La  lectura  díú  Convenio,  en  español  y  en  infieles,  fué  continuada 
hasta  el  final  del  artícido  83. 

El  Presidente.  Hay  un  y)unto  que  debe  aclararse,  y^es  la  parte 
que  dice  que  un  buque  no  será  desinfectado  por  segunda  vez.  Qui- 
siera saber  si  esto  es  incompatible  con  nuestra  desinfección  de  lo  que 
llamamos  buques  de  línea.  ¿Se  refiere  ese  artículo  á  todas  las  enf^er- 
medades  ó  solamente  á  alsi;unas? 

El  Doctor  Gatewood  volvió  á  leer  el  artículo  33. 

El  Presidente.  ¿No  impediría  esa  disposición  la  nueva  desinfec- 
ción de  un  buque  en  un  puerto  del  sur? 

Se  sostuvieron  discusiones  en  inglés»  y  en  español. 

El  Presidente    Muy  bien;  continuemos. 

El  Doctor  Gatewood  leyó  el  artículo  34  en  inglés. 

Un  delegado  Quisiera  preguntar  ¿  cuál  es  la  definición  de  las  pala- 
bras ''vapores  correos?" 

El  Presidente.  Son  palabras  tomadas  de  la  convención  de  París. 
¿Fueron  discutidas  esas  palabras  allá,  Dr.  Geddings? 

Doctor  Geddings.  Por  ejemplo,  son  buques  correos  los  que  hacen 
viajes  entre  puertos  de  la  América  Británica  y  los  del  norte  de  los 
Estados  Unidos,  los  cuales  están  exentos  de  las  medidas  relativas  á 
certificados  de  sanidad.     Hay  buques  correos  que  viajan  en  los  lagos. 

Doctor  Gatewood.  Y  los  buques  correos  que  cruzan  el  Canal  de 
la  Mancha  de  CpJais  á  Dover.  Consultando  un  diccionario  se  encon- 
trara la  definición  de  las  palabras  "buques  correos"  (packet),  como 
esta: 

Originalmente  buques  empleados  por  gobiernos  para  llevar  despachos  y  correspondencia 
y  que  por  lo  tanto  tenían  un  carácter  naval  ó  militar.  Por  extensión  se  aplica  á  los  buques 
que  trasportan  materiales  y  tienan  un  día  fijo  de  salida. 

Los  vapores  trasatlánticos  caerían  dentro  de  este  significado. 
Doctor  Ulloa.  He  aquí  una  definición  del  Diccionario  de  Webster : 

Buque  correo  (packet) :  Origialmente  era  un  barco  empleado  por  un  gobierno  para  llevar 
despachos  y  correspondencia.  Por  extesión,  se  apUca  á  los  barcos  que  trasportan  corres- 
pondencia, pasajeros  y  mercancías. 

.  Doctor  Gatewood.  Eso  es. 

El  Presidente.  ¿Hay  inconveniente  en  dejar  esas  palabras  contal 
significado  ? 

Doctor  Gatewood.  Los  "packets"  son  buques  correos. 

El  Presidente.  Evidentemente  se  ha  intendado  aplicar  esas  pala- 
bras á  puertos  que  no  están  muy  distantes  uno  de  otro. 

Dr.  Gatewood.  Según  mi  entender  "packet"  es  un  buque  que 
hace  uno  ó  dos  viajes  al  día,  y  por  lo  tanto  hace  la  travesía  dentro  de 
un  pequeño  radio  desde  el  punto  de  partida.  Pero  una  barca  de  pasaje 
(ferry  boat),  que  no  lleva  correspondencia  ni  despachos,  no  caería 
dentro  de  ese  significado. 

El  Secretario.  Los  llamaremos  "barcos  de  cabotaje"  en  español. 
Son  los  que  viajan  entre  distintos  puertos  del  mismo  país. 

Doctor  Gatewood.  Si  es  entre  distintos  puertos  del  mismo  país, 
¿porqué  dice  el  artículo  en  cuestión:  "Los  vapores  correos  serán 


802  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

objeto  de  un  régimen  especial  que  se  establecerá  de  común  acuerdo 
entre  los  países  interesados"? 

El  Secretario.  Es  verdad. 

El  Presidente.  Creo  que  se  puede  dejar  tal  como  está. 

El  Doctor  Gatewood  leyó  el  artículo  35  en  inglés,  y  el  Doctor  Lavo- 
rería  lo  leyó  en  castellano. 

Se  sostuvo,  una  discusión  en  castellano  entre  los  Doctores  Moore  y 
Guiteras,  la  cual  no  se  interpretó  al  inglés. 

La  lectura  de  la  convención  fué  continuada  hasta  el  artículo  41. 

El  Doctor  Gatewood  leyó  el  artículo  42,  como  sigue: 

Artículo  42.  Los  coches  que  hacen  el  trasporte  de  pasajeros,  del  correo  y  de  equipajes 
no  pueden  ser  retenidos  en  las  fronteras. 

El  Presidente.  La  palabra  "retenidos"  fué  cambiada  por  "dete- 
nidos," ¿no  es  así? 

Doctor  Geddings.  No,  no;  se  dejo  "retenidos"  después  de  una 
discusión.     Decidimos  dejarla  así. 

La  lectura  de  la  convención  fué  continuada  hasta  el  artículo  48. 

Doctor  Geddings.  Con  respecto  al  segundo  párrafo  del  artículo  48, 
el  artículo  que  tenemos  ante  nosotros  dice: 

Los  buques  indemnes  de  fiebre  amarilla,  procedentes  de  puertos  infectados,  serán  puestos 
en  libre  plática  después  de  la  visita  médica  de  inspección,  si  el  viaje  ha  durado  más  de  seis 
días. 

Ahora  bien,  los  reglamentos  de  cuarentena  de  los  Estados  Unidos 
preveen  el  mismo  caso,  pero  van  más  adelante,  disponiendo  que  si  la 
duración  del  viaje  excede  de  cinco  días  y  es  menor  de  diez,  se  observará 
el  mismo  procedimiento;  pero  si  el  viaje  excede  de  diez  días  el  buque 
tiene  que  ser  desinfectado  y  puesto  en  observación.  Esta  regla  está 
basada  en  el  hecho  de  que  si  ocurre  á  bordo  un  caso  benigno  de  fiebre 
amarilla,  el  paciente  puede  haberse  repuesto  lo  suficiente  para  pasar 
una  inspección  médica  satisfactoria,  pero  puede  haber  infectado  los 
mosquitos  que  hay  á  bordo,  y  dado  origen  á  otros  casos.  Cuando 
esta  mañana  se  estaba  discutiendo  este  artículo,  se  indicó  que  se 
insertara  una  disposición  similar,  pero  parece  que  hubo  razones  por 
las  cuales  no  se  hizo  así,  y  sin  deseo  de  reservar  ningún  derecho  para 
los  Estados  Unidos,  creo  que  en  casos  análogos  esta  nación  tendrá 
que  recurrir  á  alguna  disposición  general  de  la  Convención  que  per- 
mita que  se  dicíen  reglamentos  especiales  á  la  discreción  de  las 
autoridades  sanitarias  para  prevenir  circunstancias  especiales. 

Doctor  Gatewood.  ¿Se  podría  hacer  eso  si  así  se  declarara  espe- 
cíficamente ? 

Doctor  Guiteras.  Con  respecto  al  hecho  de  la  necesidad  de  desin- 
fección en  estos  casos,  debe  recordarse  que  los  reglamentos  de  los 
Estados  Unidos  evidentemente  no  hacen  referencia  á  lo  que  hemos 
definido  aquí  como  "buques  indemnes"  con  respecto  á  la  fiebre 
amarilla.  Hemos  hecho  una  definición  especial  de  los  buques 
indemnes  con  respecto  á  la  fiebre  amarilla,  en  la  cual  se  dice  que  el 
buque  no  ha  estado  á  tal  distancia  de  la  orilla  que  haga  posible  el 
acceso  de  los  mosquitos  al  mismo.  Por  lo  tanto  no  puede  haber 
mosquitos  en  un  buque  tal  como  se  ha  definido.  Los  buques  que  se 
sujetan  á  fumigación  en  los  Estados  Unidos  no  son  los  indemnes  á  que 
se  refiere  esta  definición.  Hay  buques  que  pueden  contener  mos- 
quitos infectados,  pero  los  que  se  mencionan  en  la  definición  de  que  se 
trata  no  pueden  contenerlos,  porque  se  dice  claramente  que  deben 


•  SEGUNDA    CONFEKENCIA.   SAiNITAKIA    INTERNACIONAL.  lMj<Í 

haber  anclado  á  tal  distancia  de  la  orilla  que  no  permita  el  acceso  de 
mosquitos.  Por  todo  lo  cual  no  creo  que  los  Estados  Unidos  tengan 
necesidad  de  cambiar  su  procedimiento  actual  con  respecto  á  estos 
buques. 

El  Presidente.  ¿  Es  esta  explicación  satisfactoria  para  Vd.,  Doctor 
Geddings  ? 

Doctor  Geddings.  Sí,  señor;  con  esa  explicación  el  j)árrafo  está 
bien. 

Doctor  GuiTERAS.  Supongo  que  esta  explicación  se  hará  constar 
en  el  acta. 

El  Presidente.  Sí,  señor.  El  taquígrafo  toma  nota  de  t(jdo  lo 
que  se  dice;  todo  ello  se  hace  constar  en  las  actas. 

La  lectura  de  la  convención  fué  continuada  en  ambos  idiomas  por 
los  Doctores  Gatewood  y  Lavorería,  respectivamente,  hasta  el  final 
de  la  disposición  transitoria. 

Los  Doctores  Barnett  y  Lavorería  sostuvieron  una  discusión  en 
castellano. 

El  Secretario.  El  Doctor  Lavorería  propone  que  en  vez  de 
decirse  que  se  enviarán  copias  de  la  convención  á  cada  país  repre- 
sentade,  se  diga  que  se  enviarán  copias  en  inglés  y  en  español  á  cada 
uno  de  los  países  signatarios  de  ésta  Convención. 

Doctor  Barnett.  Porque  el  texto  inglés  es  el  que  ha  de  servir  de 
guía. 

El  Presidente.  Sí,  es  verdad. 

Se  sostuvo  una  discusión  en  castellano. 

Doctor  GuiTERAS.  El  Doctor  Licéaga  ha  presentado  una  propo- 
sición que  voy  á  interpretar. 

El  Doctor  Licéaga  propone  que  en  vez  de  decirse  que  el  texto 
inglés  servirá  de  base  ó  guía,  se  diga  que  en  caso  de  duda  servirá 
la  interpretación  del  texto  inglés. 

El  Secretario.  No,  no,  que  prevalecerá  el  texto  inglés — que  la 
interpretación  del  texto  inglés  prevalecerá. 

Doctor  GuiTERAS.  Sí,  que  la  interpretación  del  texto  inglés 
prevalecerá. 

Doctor  Gatewood.  Entonces  dirá: 

Aetículo  50.  Se  estipula  que  en  caso  de  dudas  para  interpretar  esta  Convención  preva- 
lecerá la  interpretación  del  texto  inglés. 

Doctor  Guiteras.  Eso  es. 

El  Presidente.  ¿  No  hay  inconveniente  para  que  se  haga  el  cambio  ? 
Entonces  creo  que  deben  añadirse  las  palabras  'en  ambos  idiomas" 
en  la  última  cláusula  de  la  disposición  transitoria,  de  modo  que  se  lea 
como  sigue— 

con  el  propósito  de  que  se  remitan  por  la  vía  diplomática  copias  en  ambos  idiomas  á  cada 
imo  de  los  países  signatarios. 

¿Queda  aprobado  este  cambio? 

No  habiendo  objeción  alguna  se  considera  aprobado. 

Creo  que  la  convención  tal  como  se  ha  redactado  en  ambos  idio- 
mas ha  sido  leída  y  aprobada  artículo  por  artículo.  Ahora  es 
necesario  aprobarla  en  conjuncto.  Espero  que  se  haga  una  propo- 
sición al  efecto. 

Doctor  Johnson.  Señor  Presidente,  propongo  que  sea  aprobada 
en  su  totalidad  la  convención  tal  como  se  ha  leído  y  aprobado  artículo 
por  artículo. 


SO-Í  SEGUNDA    CONFEKENCIA   SANITARIA    INTERNACIONAL. 

Doctor  GuiTERAS.  Apoyo  esta  propuesta. 

El  Secretario  tradujo  al  castellano  esta  proposición. 

La  convención  fué  aprobada  en  su  totalidad. 

El  Presidente.  La  convención  ha  quedado  aprobada.  (Muchos 
aplausos.) 

El  Doctor  Medina  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  El  Doctor  Medina  propone  que  se  publique  esta 
convención  y  c[ue  se  envien  copias  de  ella  á  cada  uno  de  los  delegados. 
Tengo  el  placer  de  comunicar  al  Doctor  Medina  que  ya  se  ha  deci- 
dido la  publicación  del  convenio  y  que  se  enviarán  copias  del  mismo 
á  los  delegados  tan  pronto  como  se  termine;  como  casi  todos  ellos 
irán  á  Nueva  York,  pueden  ir  á  recoger  los  ejemplares  á  mi  oficina, 
ó  mandar  por  ellos,  y  yo  les  daré  tantos  como  deseen — diez  ejemplares 
para  cada  uno,  si  los  necesitan. 

El  Presidente.  ¿Desea  Mr.  Fox  hacer  uso  de  la  palabra? 

Mr.  Fox.  Señor  Presidente,  como  la  Oficina  de  las  Repúblicas 
Americanas  existe  para  llevar  á  cabo  los  deseos  de  las  mismas,  creo 
que  es  mejor  que  ésta  sea  quien  se  encargue  de  enviar  los  ejemplares 
y  de  ver  que  se  imprimen  y  arreglan. 

El  Secretario.  Claro  está  que  esa  Oficina  se  encargará  de  la 
impresión  de  los  ejemplares.  Hice  mi  indicación  para  la  conveniencia 
de  los  delegados. 

El  Doctor  Licéaga  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  El  Doctor  Licéaga  dice  que  el  objeto  no  es 
obtener"  copias  oficiales.  Estas  serán  enviadas  por  la  Oficina  de  las 
Repúblicas  Americanas. 

Ño  deseo  entremeterme  en  las  funciones  de  la  Oficina  de  las  Repúbli- 
cas American  is,  sino  que  mi  intención  es  simplemente  facilitar  el 
trabajo  de  los  delegados  para  que  puedan  redactar  sus  memorias 
para  los  respectivos  gobiernos. 

Mr.  Fox.  Le  aseguro  á  Vd.  que  nuestra  Oficina  se  hará  cargo  de 
ello  inmediatemente. 

El  Secretario.  Lo  hago  para  la  conveniencia  de  los  delegados, 
porque  se  marchan  muy  pronto,  y  desean  redactar  sus  recpectivas 
memorias. 

Mr.  Fox.  Ya  comprendo. 

El  Presidente.  Hay  algunas  resoluciones  que  la  junta  consultora 
ha  preparado,  y  el  Doctor  Moore  las  leerá. 

El  Doctor  Moore  leyó  estas  resoluciones  en  castellano. 

El  Doctor  Guiteras  las  leyó  en  inglés. 

Son  como  sigue: 

Por  cuanto  la  República  de  México  y  la  Zona  del  Canal  de  Panamá,  mediante  de  la  apli- 
cación de  la  doctrina  de  la  trasmisión  de  la  fiebre  amarilla  por  el  mosquito,  al  saneamiento 
público,  están  aproximándose  rápidamente  á  la  consecución  del  exterminio  final  de  dicho 
mal,  y 

Por  cuanto  la  República  de  Cuba,  mediante  la  aplicación  de  la  misma  doctrina  ha  mante- 
nido y  sigue  manteniendo  su  territorio  libre  de  la  fiebre  amarilla,  y 

Por  cuanto  á  causa  de  la  falta  de  preparación  para  aplicar  estas  medias,  se  ha  propagado 
la  fiebre  amarilla  en  ciertos  países,  y 

Por  cuanto,  en  la  ciudad  de  Nueva  Orleans  una  epidemia,  que  desgraciadamente  permi- 
tieron las  autoridades  del  estado  que  se  arraigara  fií'mente,  ha  sido  atajada  y  gradualmente 
extinguida  mediante  la  aplicación  de  dichos  métodos  en  medio  de  la  población  de  personas 
no  inmunes  más  gi-ande  que  ha  sido  expuesta  á  la  fiebre  amarilla. 

Por  o  tanto  se  resuelve: 

1.  Que  esta  conferencia  considera  estos  resultados  como  una  prueba  más  de  la  exactitud 
de  la  doctrina  de  que  la  fiebre  amarilla  es  trasmitida  únicamente  mediante  la  picadura  de 
un  mosquito  infectado. 


SEGUNDA    CONFEEENCIA    SANITARIA    INTERNACIONAL.  305 

2.  Que  la  convención  es  de  la  opinión  de  que  al  principio  de  una  epidemia  so  puede 

establecer  fácilmente  un  plan  eficaz  do  defensa  basado  en  esta  doctrina. 

3.  Que  la  próspera  ejecución  do  esto  plan  dependo  do  la  poifocta  conipronsi»'.!  de  esta 
doctrina  por  ol  pueblo,  y  del  apoyo  que  ósio  presto  dando  noticia  pronta  y  francamente  de 
los  primeros  casos  y  do  los  sospechosos  y  cuidándolos  adocuadaínonte. 

4.  Que  son  merecedoras  de  la  censura  de  la  Conferencia  las  autoridades  sanitarias  que 
no  notifiquen  á  tiempo  la  presencia  de  la  íicibro  amarilla  en  sus  respectivos  territorios. 

5.  Que  la  conferencia  dó  la  enhorabuena  á  las  iiopi'iblicas  de  México  y  Cuba  y  la  Zona 
del  Canal  de  Panamá  por  ol  éxito  que  han  ol)tonido,  así  corno  también  al  Servicio  de  Sanidad 
Pública  y  Hospitales  Marítimos  poi'  ol  brillante  trabajo  que  ha  hecho  en  Nueva  Orleans. 

(5.  Y  se  resuelve,  además,  que  esta  Convención  es  de  la  opinión  que  se  encomienden  á 
las  autoridades  nacionales  de  sanidad  todas  las  cuarentenas  y  la  misión  de  combatir  las 
epidemias  que  amenacen  extenderse  á  los  estados  y  países  vecinos. 

El  Presidente.  Estas  resoluciones  han  recibido  el  informe  favo- 
rable de  la  junta  consultora. 

Dr.  lí.  L.  E.  Johnson.  Propongo  que  se  adopten  estas  resoluciones 
tal  como  han  sido  leídas. 

Sostúvose  una  discusión  en  castellano  en  la  que  tomaron  parte  los 
Doctores  Lavorería,  Moore,  Guiteras,  Medina  y  Ulloa. 

Doctor  Guiteras.  Señor  Presidente,  el  caballero  que  ha  estado 
haciendo  uso  de  la  palabra  en  castellano  es  de  la  opinión  de  que  no  se 
deben  usar  palabras  tan  duras  con  respecto  á  las  autoridades  de 
Nueva  Orleans.     La  resolución  dice: 

Por  cuanto  en  la  ciudad  de  Nueva  Orleans  una  epidemia,  que  desgraciadamente  permi- 
tieron las  autoridades  del  estado  que  se  arraigara  firmemente,  etc. 

Cree  este  señor  que  eso  es  demasiado  duro.  Yo  opino  que  ello  no  es 
una  acusación  directa  y  que  no  tiene  efecto  como  una  censura  dada 
específicamente  contra  la  ciudad  de  Nueva  Orleans,  sino  que  es  simple- 
mente la  declaración  de  un  hecho,  que  las  autoridades  de  Nueva  Orleans 
han  permitido  que  esta  enfermedad  se  propogara  como  sucedió.  Y  cier- 
tamente no  se  inclinará  á  hacer  menos  dura  esta  declaración  el  que 
haya  viajado  por  esa  parte  del  sur  y  haya  visto  esas  ciudades  de  los 
Estados  de  Luisiuna  y  Florida  infectadas  de  fiebre  amarilla,  porque 
las  personas  que  hicieron  excursiones  á  Nueva  Orleans  por  placer 
volvieron  atacadas  de  fiebre  amarilla. 

El  Secretario.  La  cuestión  que  se  ha  suscitado  es  muy  delicada, 
en  verdad.  Varios  de  nosotros  tenemos  cargos  de  un  carácter  diplo- 
mático en  este  país,  por  lo  que  debemos  tener  mucho  cuidado  en 
exponer  cualquier  opinión  que  pudiera  interpretarse  como  una  cen- 
sura contra  las  autoridades  de  cualquier  parte  de  la  nación  en 
donde  representamos  las  nuestras.  Por  más  que  bajo  el  punto  de 
vista  científico  estoy  de  acuerdo  con  el  Doctor  Guiteras,  como  dele 
gado  que  soy  de  Costa  Rica  quisiera  que  se  haga  esa  declaración  todo 
lo  menos  dura  que  sea  posible,  porque  Nueva  Orleans  es  una  parte  de 
los  Estados  Unidos;  aún  cuando  se  llena  la  idea  con  la  enhorabuena 
que  se  da  al  Servicio  de  Sanidad  Pública  y  Hospitales  Marítimos,  que 
es  quien  realmente  representa  á  los  Estados  Unidos  en  este  asunto, 
sin  embargo,  las  autoridades  de  Nueva  Orleans  podrían  tomar  nota 
de  estas  resoluciones  y  considerarlas  como  una  censura.  Quisiera 
que  estudiemos  esa  parte  un  poco  más  y  que  la  sustituyamos  por  algo 
que  nos  ponga  en  buen  lugar.  Yo  propondría  esta  alteración.  Tal 
como  está  ahora,  esa  parte  dice: 

Por  cuanto  en  la  ciudad  de  Nueva  Orleans  una  epidemia,  que  desgraciadamente  per- 
mitieron las  autoridades  del  Estado  que  se  arraigara  firmemente,  etc. 

1112a— 06 20 


306  SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL. 

Yo  la  pondría  de  este  modo : 

Por  cuanto  en  la  ciudad  de  Nueva  Orleans  una  epidemia  que  desgraciadamente  se  arraigó 
de  una  manera  firme,  etc. 

De  esta  manera  se  expresa  la  idea  sin  herir  el  amor  propio  de  nadie. 

Doctor  GuiTERAS.  ¿Lo  pondría  Vd.  de  este  modo  que  desgracia- 
damente se  arraigo" ? 

El  Secretario.  Sí. 

El  Presidente.  Creo  que  la  alteración  propuesta  ha  sido  expli- 
cada claramente  en  castellano  y  en  inglés. 

El  Secretario.  Sí,  señor. 

El  Presidente.  El  que  desee  puede  hacer  observaciones  con  res- 
pecto á  esta  resolución. 

Los  Doctores  Barnet  y  Lavorería  hicieron  uso  de  la  pa^abja  en 
castellano. 

El  Secretario.  El  Doctor  Barnet  añade  un  argumento  para 
reforzar  la  proposición  de  la  junta,  mencionando  el  hecho  de  que  las 
autoridades  locales  de  San  Francisco  fueron  duramente  censuradas  en  la 
reunión  celebrada  en  New  Haven,  Connecticut,  y  dice  que  la  censura  fué 
aún  más  dura  que  la  propuesta  aquí  hoy.  El  Doctor  Lavorería  ha 
contestado  al  Doctor  Barnet  en  una  forma  que  yo  hago  mía  también. 
Trataré  expresarla  de  lleno,  porque  yo  soy  de  la  misma  opinión: 

Es  verdad  que  la  censura  que  hizo  la  conferancia  de  Connecticut 
fué  muy  dura,  pero  también  debemos  recordar  que  esta  conferencia 
se  celebró  en  los  Estados  Unidos  y  estaba  compuesta  de  médicos  de 
esta  nación  solamente.     Así  fué,  ¿no  es  verdad? 

El  Presidente.  Sí,  es  cierto. 

El  Secretario.  Y  además,  no  era  una  conferencia  oficial.  En 
este  caso  la  cuestión  es  diferente.  Hemos  venido  aquí  representando 
naciones  extranjeras — países  distintos — y  no  queremos  herir  el  amor 
propio  de  los  Estados  Unidos  en  manera  alguna.  ^  En  este  caso  la 
cuestión  afecta  á  los  Estados  Unidos  y  debemos'  tratarlos  lo  más 
cortesmente  posible. 

Doctor  Gatewood.  Propongo  que  se  haga  un  cambio  en  la  altera- 
ción propuesta  por  el  delegado  de  Costa  Rica,  en  esta  forma : 

Por  cuanto  en  la  ciudad  de  Nueva  Orleans  una  epidemia  que  se  arraigó  de  un  modo  firme 
á  paciencia  de  las  autoridades,  locales,  etc. 

El  Secretario.  Siento  decir  que  no  acepto  este  cambio.  Deseo 
que  mi  reforma  quede  tal  como  la  he  presentado  ante  la  Convención. 
La  mayoría  decidirá  la  cuestión,  y,  como  es  claro,  puede  que  no 
apruebe  la  alteración  propuesta  por  mí;  pero  quiero  hacer  constar  que 
no  votaré  en  otra  forma. 

Doctor  Gatewood.  En  la  manera  que  yo  propongo  se  dirá  sim- 

Í)lemente  que  existió  una  epidemia  á  paciencia  de  las  autoridades 
ocales. 

El  Presidente.  ¿Cómo  es  la  alteración  que  propone  el  Doctor 
Ulloa? 

Doctor  Gatewood.  Solo  suprime  la  palabra  "desgraciadamente." 
Doctor  Ulloa.  Esta  es  la  alteración  que  he  propuesto : 

Por  cuanto  en  la  ciudad  de  Nueva  Orleans  una  epidemia,  que  desgraciadamente  se 
arraigó  de  una  manera  firme,  etc. 

Este  es  el  cambio  que  propongo. 

El  Presidente.  Creo  que  la  proposición  del  Doctor  Ulloa  no  ha 
sido  apoyada. 


SEGUNDA    CONFERENCIA    RANTTAKTA   INTEIINAOTONAL.  807 

Dr.  II.  L.  E.  Johnson.  Yo  la  apoyaré.  Comprendo  la  con- 
veniencia de  ella. 

El  Presidente.  La  propuesta  del  Doctor  Ulloa  ha  sido  apoyada. 
El  Doctor  Gatewood  hti  pi-opucsto  que  se  haga  un  cambio  en  esa 
propuesta,  y  la  reforma  (¡ue  propone  el  Doctor  Gatewood  no  ha  sido 
aceptada  por  el  Doctor  Ulloa. 

Doctor  Gatewood.  La  alteración  que  propongo  es  solamente  para 
suprimir  la  palabra  "desgraciadamente/'  y  decir  "se  arraigó  en 
Nueva  Orleans."     Pero  la  retiro. 

El  Presidente.  Entonces  la  cuestión  que  se  ha  de  discutir  es  la 
aprobación  de  la  alteración  propuesta  por  el  Doctor  Ulloa. 

La  alteración  propuesta  por  el  Doctor  Ulloa  fué  aprobada. 

El  Presidente.  Ahora  la  cuestión  que  so  ha  cíe  discutir  es  la 
aprobación  de  las  resoluciones,  á  propuesta  del  Doctor  Johnson,  apo- 
yada por  el  Doctor  Medina,  según  creo. 

Las  resoluciones  fueron  adoptadas. 

El  Doctor  Moore  hizo  uso  de  la  palabra  en  castellano. 

Doctor  GuiTERAS.'  El  Doctor  Moore,  presidente  de  la  junta  con- 
sultora, me  ruega  que  traduzca  una  resolución  que  presenta  dicha 
junta,  la  cual  tiene  por  objeto  dar  las  gracias  de  la  Convención  al 
Doctor  Ulloa  por  su  cortesía  y  la  ayuda  que  ha  prestado  á  los  delega- 
dos, tanto  durante  las  sesiones  de  la  Conferencia  como  en  la  visita 
que  hicimos  al  Presidente  de  los  Estados  Unidos. 

El  Presidente.  Biabéis  oido  la  propuesta.  Como  Presidente  de 
la  Convención  añado  mi  testimonio  sobre  la  cortesía  y  los  valiosos 
servicios  del  Doctor  Ulloa,  y  ruego  á  los  que  están  á  favor  de  esta 
resolución  que  demuestren  su  conformidad  levantándose. 

Los  miembros  de  la  Convención  se  levantaron  unánimamente. 
[Aplausos.] 

El  Secretario.  Señores,  les  agradezco  desde  el  fondo  de  mi  cora- 
zón por  este  gran  honor  que  me  confieren.  He  tratado  de  hacer  todo 
lo  posible  para  cumplir  con  los  deberes  que  Vds.  me  han  impuesto 
al  nombrarme  secretario.  No  me  importa  lo  mucho  que  tenga  que  tra- 
bajar, 5^  realmente  no  me  importa  tener  que  trabajar  cinco  veces  más 
de  lo  que  he  trabajado,  si  después  siento  la  grande  satisfacción  que 
Vds.  me  han  proporcionado  hoy.  Esta  es  la  mejor  recompensa  que 
podéis  darme  por  mi  trabajo,  y  nada  me  remuneraría  tanto  como  el 
verles  satisfechos  con  lo  poco  que  he  hecho. 

Tengo  el  honor  de  someter  á  la  consideración  de  mis  estimados 
colegas  las  siguientes  resoluciones: 

Se  resuelve  que  la  Convención  Sanitaria  Internacional  dé  un  voto  de  gracias  á  Su  Exce- 
lencia Teodoro  Roosevelt,  Presidente  de  los  Estados  Unidos,  por  su  valiosa  cooperación  en 
el  éxito  de  esta  Conferencia  y  por  el  elevado  significado  del  cordial  discurso  con  que  saludó 
á  los  delegados  en  la  recepción  con  que  les  honró  en  la  Casa  Blanca,  en  el  12  del  presente. 

Se  resuelve  que  se  dé  un  voto  de  gracias  al  honorable  Secretario  de  Estado  y  al  hono- 
rable Secretario  Interino  del  Tesoro  por  sus  discursos  de  bienvenida  en  la  apertura  de  esta 
Conferencia. 

Se  resuelve  que  se  dé  un  voto  de  gracias  al  Honorable  Gonzalo  de  Quesada,  Mnistro 
Plenipotenciario  de  Cuba. 

Se  resuelve  que  se  dé  un  voto  de  gracias  al  Director  Fox,  como  representante  de  la  Oficina 
de  las  Repúblicas  Americanas,  por  las  atenciones  que  ha  dispensado  á  los  delegados  y  por  los 
preparativos  que  hizo  para  hacerles  agradable  su  estancia  en  esta. 

Se  resuelve  que  se  exprese  nuestro  sincero  aprecio  á  nuestro  altamente  estimado  Presi- 
dente, el  Cirujano  General  Wyman,  por  su  trato  cortés  y  por  la  manera  tan  eficaz  con  que 
ha  cumplido  con  sus  deberes  oficiales. 


308  SEGUNDA    CONFERENCIA   SANITAKIA   INTERNACIONAL. 

Se  resuelve  que  se  extienda  un  voto  de  gracias  al  Cosmos  Club  y  á  la  prensa  de  la  ciudad 
de  Washington  por  la  manera  cortés  con  que  nos  han  tratado  durante  nuestra  estancia  en 
la  capital. 

Se  resuelve  que  se  dé  un  voto  de  gracias  en  nombre  de  los  delegados  de  las  Repúblicas 
Hispano-Americanas  á  los  delegados  de  los  Estados  Unidos  por  su  hospitalidad  y  com- 
pañerismo. 

El  Presidente.  ¿Quién  presenta  estas  resoluciones? 

El  Secretario.  Yo  mismo.  Y,  si  Vds.  me  permiten,  tendré  que 
actuar  como  Presidente  en  este  momento,  porque  el  Cirujano  General 
Wyman  no  quiere  presentarlas  ante  la  Convención  por  la  razón  de  que 
una  de  ellas  se  refiere  á  el  mismo. 

El  Doctor  Lavoreria  lüzo  uso  de  la  palabra  en  castellano. 

El  Secretario.  El  Doctor  Lavoreria  propone  que  no  se  discutan 
estas  resoluciones,  sino  que  se  adopten  por  aclamación. 

Doctor  Guiteras.  Votaremos  levantándonos. 

El  Secretario.  Sí,  levantándonos. 

El  Doctor  Barnet  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  El  Doctor  Barnet  hace  una  indicación,  que  yo 
acepto  sinceramente,  con  el  fin  de  que  se  subsane  lo  que  realmente  fué 
una  omisión  involuntaria  por  mi  parte,  á  saber,  que  se  dé  también 
un  voto  de  gracias  á  la  Asociación  de  Banqueros  del  Distrito  de 
Columbia. 

Las  resolucions  fueron  aprobadas. 

El  Presidente.  Ahora  comenzaremos  á  firmar  la  Convención.  Se 
han  preparado  dos  copias,  una  en  inglés  y  otra  en  castellano,  las  cuales 
firmarán  cada  uno  de  los  delegados.  La  lista  de  las  Repúblicas  se 
leerá  por  orden  alfabético,  y  se  entiende  que  cada  delegado  firmará 
su  nombre  poniendo  ''De  tal  y  tal  República." 

Doctor  Guiteras.  ¿Se  leerá  la  lista  por  orden  alfabético  de  acuerdo 
con  los  nombres  de  las  Repúblicas  en  castellano  ó  en  inglés  ?  Habrá 
diferencia  en  el  orden  en  que  se  vayan  á  leer  según  el  idioma. 

El  Secretario.  La  indicación  del  Doctor  Guiteras  es  muy  im- 
portante. En  inglés  los  Estados  Unidos  serán  uno  de  los  últimos  en 
la  lista,  en  tanto  que  en  español  el  nombre  de  esta  nación  será  uno 
de  los  primeros. 

El  Doctor  Johnson  propuso  que  los  países  fueran  llamados  en  el 
orden  alfabético  de  cada  lengua,  es  decir,  que  para  firmar  el  texto 
inglés  sean  llamadas  las  Repúblicas  por  su  nombre  inglés,  y  del  mismo 
modo  en  el  caso  del  texto  español. 

El  Presidente.  El  Doctor  Geddings,  que  tiene  algún  conocimiento 
en  estos  procedimientos,  dice  que  no  es  necesario  poner  los  nombres 
de  las  Repúblicas.  Creo  que  esto  es  lo  que  el  Doctor  Johnson  iba  á 
proponer.  Tanto  los  nombres  de  los  delegados  como  los  de  las 
Repúblicas  están  ya  puestos,  y  todo  lo  que  tenemos  que  hacer  es  firmar 
nuestros  nombres  respectivos. 

Dr.  H.  L.  E.  Johnson.  Pido  que  los  delegados  firmen  en  el  orden 
en  que  aparecen  sus  nombres  en  el  preámbulo.  Allí  se  hallan  men- 
cionados uno  después  de  otro,  y  seria  mejor  que  fií'men  en  el  mismo 
orden.  La  copia  española  está  lo  mismo  que  la  inglesa,  y  esta  es  la 
ha  de  servir  de  guía. 

Examináronse  ambas  copias  resultando  que  efectivamente  el  orden 
de  las  Repúblicas  era  el  mismo  en  uno  y  otro  texto. 

Entonces  los  delegados  firmaron  la  Convención. 


SEGUNDA    CONFEKENCIA    SANITARIA    INTERNACIONAL.  80^) 

El  Presidente.  Tres  son  los  delegados  que  todavía  no  han  firmado 

este  Convenio.  Son  los  de  Uruguay  y  Venezuela  y  uno  de  los  Estados 
Unidos,  el  Doctor  Kennedy,  quien  se  vio  obligado  k  salir  de  la  capital, 
según  anunció  el  otro  día  (|ue  muy  probablemente  tendría  que  hacerlo. 
Paréceme  necesario  que  tengamos  las  íirmas  de  estos  señores,  á  todo 
evento,  por  lo  que  vuestro  presidente  espera  que  al<^uno  de  Vds. 
indique  la  manera  de  conseguir  esas  firmas.  ¿Desea  alguno  de  Vds. 
hacer  una  proposición  con  este  objeto 'í 

El  Secretario.  Propongo  que  se  entregue  este  documento  al  Señor 
Fox,  Director  de  la  Oficina  de  las  Repúblicas  Arhericanas,  para  que 
se  encargue  de  obtener  las  firmas  de  esos  tres  delegados,  y  tan  pronto 
como  las  consiga  que  envíe  el  documento  al  Secretario  de  Estado, 
según  se  ha  convenido. 

Esta  proposición  fué  apoyada  y  aprobada. 

El  Presidente.  Deseo  manifestar  que  los  ejemplares  para  el  uso 
de  los  delegados  serán  impresos  tan  rápidamente  como  sea  posible. 
La  impresión  comenzará  á  hacerse  el  lunes  por  la  mañana,  j  creo  que 
se  podrán  facilitar  á  cada  delegado  ejemplares  en  ambos  idiomas; 
pero  estos  ejemplares  no  deben  ser  considerados  como  oficiales;  son 
únicamente  para  uso  personal.  Las  copias  oficiales  se  imprimirán 
más  adelante  j  serán  distribuidas. 

Estas  observaciones  fueron  traducidas  al  castellano  por  el  Secre- 
tario. 

El  Presidente.  Señores:  Está  para  terminarse  el  trabajo  por  el 
cual  se  reunió  esta  Conferencia.  Antes  de  marcharnos,  si  es  que  os 
place,  lo  cual  no  dudo,  cada  delegado  hará  uso  de  la  palabra  en  un 
breve  discurso  de  enhorabuena  ó  expresando  la  satisfacción  que  se 
ha  experimentado,  ó  en  el  que  haga  los  comentarios  que  crea  conve- 
niente. Se  irán  llamando  á  los  delegados  por  el  orden  en  que  aparecen 
sus  nombres  en  la  convención. 

Estas  observaciones  fueron  traducidas  al  castellano  por  el  secre- 
tario. 

El  Presidente.  Llamaré  primeramente  al  Dr.  Eduardo  Moore, 
delegado  de  Chile. 

El  Doctor  Moore  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  Se  me  ha  rogado  que  interprete  las  oportunas 
observaciones  del  Doctor  Moore,  de  Chile.  Trataré  de  hacer  un 
extracto  de  ellas,  y  le  ruego  que  me  llame  la  atención  si  es  que  se  me 
olvida  decir  alguna  parte. 

El  Doctor  Moore  manifestó  su  admiración  ante  los  resultados  obte- 
nidos en  esta  Conferencia.  Dice  que  nunca  esperó  que  se  ejecutera 
tanto  trabajo  y  de  un  carácter  tan  eficaz  como  el  que  se  ha  hecho; 
que  cuando  vino  de  su  país  pensaba  que  iba  á  asistir  á  una  Convención 
ó  Congreso  por  el  estilo  del  último  que  se  celebró  en  Wásliington,  pero 
que  en  la  presente  Convención  hemos  conseguido  resultados  muy 
elevados  y  de  una  naturaleza  importantísima,  y  que  la  adopción  de 
este  Convenio  es  un  gran  adelanto  hacia  la  consecución  del  objeto  de 
estas  reuniones.  Dice  que  ninguno  de  los  documentos  que  ha  firmado 
de  esta  naturaleza  le  ha  proporcionado  tanto  placer  como  el  presente, 
y  que  espera  nos  volveremos  ó  reunir  dentro  de  breve  tiempo,  que 
todos  nosotros  estaremos  presentes  en  la  próxima  conferencia  que  se 
celebrará  en  México,  con  la  seguridad  de  que  lo  pasaremos  agradable- 
mente y  de  que  se  nos  recibirá  cordialmente,  como  acostumbran 
á  hacer  los  mejicanos.     [Aplausos.] 


310  SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL. 

El  Presidente.  Aliora  oiremos  á  nuestro  distinguido  secretario, 
el  Dr.  Juan  J.  Ulloa,  representante  de  la  República  de  Costa  Rica, 
ex  vicepresidente,  ex  ministro  de  lo  interior  y  ex  presidente  de  la 
Facultad  Médica  de  Costa  Rica. 

Doctor  Ulloa.  Señor  Presidente,  Señores  Delegados:  Es  para  mí 
un  placer  muy  grande  el  expresarles,  en  pocas  palabras,  el  alto  apre- 
cio que  tengo  de  vuestros  méritos  como  hombres  de  ciencia  y  de  vuestros 
dotes  como  colegas.  Nunca  me  sentí  orgulloso  antes,  pero  ahora  sí 
porque  me  hallo  entre  Vds.  Me  siento  orgulloso  ahora  porque  cuando 
salga  de  Washington  esta  noche — ó  mañana  ó  cuando  sea^ — podré 
decir  que  fui  uno  de  los  miembros  de  la  Segunda  Convención  Sanitaria 
Internacional  de  las  Repúblicas  Americanas,  y  que  fui  uno  de  los  que 
firmaron  el  Convenio  que  tanto  significado  tendrá  para  todas  nuestras 
Repúblicas,  el  Convenio  que  para  todo  aquél  que  piensa  sensatamente 
significa  el  mayor  resultado  que  podiamos  haber  conseguido;  significa 
garantía  para  la  hioiene,  facilidad  para  el  comercio  y  destrucción  de 
las  infundadas  é  ignorantes  medidas  de  cuarentena;  significa  un 
gran  adelanto  del  vigésimo  siglo  j  la  muerte  de  la  ignorancia  en  asun- 
tos relativos  á  la  higiene  pública.  Señores,  en  nombre  de  Costa  Rica, 
les  do}^  las  gracias  por  vuestra  cooperación.  Doy  mis  más  sinceras 
gracias  á  mi  distinguido  amigo  el  Doctor  Wyman,  á  todos  los  dele- 
gados de  los  Estados  Unidos  y  á  los  de  las  Repúblicas  hispano- 
americanas. 

Al  partir  no  les  diré  "Adiós,"  sino  que  les  abrazaré  diciendo 
''líasta  la  vista."  Me  uno  al  Doctor  Moore  en  la  esperanza  de  que 
nada  obstruirá  nuestro  camino  para  que  nos  volvamos  á  reunir  en  la 
patria  de  nuestro  querido  compañero  el  Doctor  Licéaga.  Tengo  la 
seguridad  de  que  después  de  la  estancia  tan  agradable  que  aqui  hemos 
pasado,  á  pesar  de  que  hemos  trabajado  algo  rudamente,  el  tiempo 
que  pasemos  en  Méjico  también  será  agradable,  y  espero  que  estos  dos 
años  se  pasarán  volando  para  que  podamos  ir  á  México  cuanto  antes. 
[Aplausos.] 

El  Presidente.  Sigue  la  República  de  Cuba.  Apenas  encuentro 
palabras  para  presentarles  á  nuestro  grande  y  buen  amigo  el  Doctor 
Guiteras,  cuyo  nombre  goza  de  fama  internacional  en  todos  los  asuntos 
que  se  han  discutido  en  la  Convención.  Su  amable  personalidad,  sus 
grandes  facultades  científicas,  y  el  gran  interés  que  se  toma  en  estos 
asuntos,  han  ejercido  poderosa  influencia  en  esta  Convención,  Ruego 
al  Doctor  Guiteras  que  haga  algunas  observaciones. 

Doctor  Guiteras.  Señor  Presidente,  agradézcole  infinitamente  por 
sus  palabras.  Sólo  me  queda  por  decir  que  también  me  siento  orgu- 
lloso, como  el  Doctor  Moore,  de  haber  podido  firmar  este  documento,  y 
creo  que  á  medida  que  pasen  los  años,  todos  nos  sentiremos  más  y  más 
orgullosos  por  el  trabajo  que  hemos  hecho.  Doy  la  más  cordial 
enhorabuena  á  la  Convención  por  el  esfuerzo  que  ha  hecho  para 
coronar  esta  labor  con  el  éxito.      (Aplausos.) 

El  Doctor  Guiteras  repitió  sus  palabras  en  castellano. 

El  Presidente.  ¿Tendrá  el  Doctor  Guiteras  la  bondad  de  explicar 
á  los  que  hablan  el  castellano  solamente,  lo  que  ha  dicho  el  Doctor  Ulloa 
en  inglés?  Creo  que  tendrían  mucho  gusto  en  saberlo.  Un  resumen 
solamente. 

Dr.  Guiteras:  Quisiera  haberme  acordado  de  ello  cuando  el 
Doctor  Ulloa  hablaba.  Sus  palabras  me  impresionaron  muy  pro- 
fundamente, y  por  lo  general  acostumbro  á  hablar  mejor  por  otras 
personas  que  por  mí  mismo. 


SEGUNDA    CONFERENCIA   BANlTAJíIA    ]NTEJINA(;J(j:n Al..  1^1  1 

El  discurso  del  Doctor  Ulloa  fué  traducido  al  castellano  por  el  Doc- 
tor Guiteras. 

El  secretario  hizo  uso  de  la  palabra  en  castellano. 

El  Secretario.  Con  respecto  á  las  resoluciones  que  se  han  pro- 
sentado,  dando  las  gracias  á  los  que  nos  han  dispensado  atenciones,  he 
tenido  el  honor  de  hacer  la  proposición  en  castellano  dando  las  gracias 
también  al  Señor  Fox,  Director  de  la  Oficina  de  las  Repúblicas 
Americanas. 

El  Presidente.  Quisiéramos  oir  también  al  distinguido  represen- 
tante del  jefe  ejecutivo  del  Departamento  de  Sanidad  de  la  Habana, 
el  Dr.  Enrique  B.  Barnet. 

El  Doctor  Barnet  hizo  uso  de  la  palabra  en  castellano.  (Aplau- 
sos.) 

El  Presidente.  La  República  del  Ecuador,  el  Dr.  Miguel  Alcivar. 
Este  señor  me  dispensará  que  no  pronuncie  bien  su  nombre,  pero 
todos  sabemos  quien  es,  de  cualquier  modo  que  pronuncie  su  nombre. 

El  Doctor  Alcivar  hizo  uso  de  la  palabra  en  castellano.  Su  discurso 
no  fué  interpretado. 

El  Presidente.  Nos  consideramos  afortunados  por  tener  entre 
nosotros  al  Ministro  de  la  República  Dominicana,  c[uien  también  es 
uno  de  los  delegados  de  esta  Convención,  y  quisiéramos  oirle,  el 
Señor  Don  Emilio  C.  Joubert. 

El  Señor  Joubert  hizo  uso  de  la  palabra  en  castellano.  (Véase  el 
apéndice,  page  415.) 

El  Presidente.  Tengo  la  seguridad  de  que  todos  hemos  tenido  ia 
satisfacción  de  oir  al  Señor  Joubert,  y  aprovecho  esta  ocasión  para 
decirles  que  cuando  se  leyó  la  lista  de  las  Repúblicas  no  estaba  pre- 
sente, pero  después  me  dijo  que  presentaría  un  informe  como  los  de  las 
demás  Repúblicas,  y  más  tarde  me  prometió  que  me  lo  enviaría  por 
escrito,  y  le  aseguro  que  tendríamos  mucho  gustos  en  recibirlo,  así 
como  las  observaciones  que  ha  hecho,  si  tiene  la  bondad  de  escribirlas. 
Espero  que  todos  los  que  hablan  el  español  comprenderán  perfecta- 
mente que  tendríamos  muchos  placer  si  enviaran  sus  observaciones 
escritas,  al  Director  de  la  Oficina  de  las  Repúblicas  Americanas,  para 
que  así  puedan  imprimirse  con  el  acta  de  la  sesión  de  hoy,  en  español 
y  en  inglés.     Estoy  seguro  que  Mr.  Fox  las  hará  traducir. 

Ahora  llamaré  á  los  Estados  Unidos.  Yo  haré  algunas  observa- 
ciones cuando  todos  terminen,  al  mismo  tiempo  que  les  dé  la  despedida. 
El  Cirujano  General  Auxiliar,  Dr.  H.  D.  Geddings,  tendrá  la  bondad  de 
dirigirnos  la  palabra. 

Doctor  Geddings.  Señor  Presidente^  señores,  tengo  la  seguridad  de 
que  me  haré  eco  de  los  sentimientos  de  los  delegados  de  los  Estados 
Unidos  al  decir  que  el  recuerdo  de  esta  Conferencia  debe  ser  causa  de 
orgullo  y  placer;  cuando  recordemos  que  el  trabajo  en  que  nos  hemos 
ocupado  toda  esta  semana  y  que  hemos  terminado  esta  tarde,  traza 
un  nuevo  rumbo  en  el  Hemisferio  Occidental.  Y  no  quiero  mar- 
charme sin  decir  antes  cuanto  placer  he  experimentado  por  el  buen 
ánimo,  el  sentimiento  fraternal  y  el  espíritu  de  reciprocidad  que  han 
caracterizado  los  trabajos  de  esta  Conferencia.  El  haber  conocido 
tantos  hombres  distinguidos  de  distintos  países  ha  sido  motivo  de  un 
placer  indecible,  y  me  hago  eco  de  los  sentimientos  del  Doctor  Ulloa,  á 
quien  todos  hemos  llegado  á  estimar  tan  altamente,  al  decir  que  los 
años  que  deben  transcurrir  antes  de  la  Conferencia,  que  se  ha  de 
celebrar  en  Méjico  bajo  los  auspicios  del  Doctor  Licéaga,  no  podrán 
pasar  todo  lo  rápidamente  que  deseamos. 


312  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Siempre  cuesta  trabajo  de  decir  "adiós,"  pero  los  buenos  deseos  de 
los  delegados  de  los  Estados  Unidos  acompañan  á.los  caballeros  que 
vuelven  á  sus  patrias.      (Aplausos.) 

El  Presidente.  Aliora  llamaré  á  un  representante  de  nuestro  gran 
ejército,  de  su  departamento  médico,  el  Dr.  Walter  D.  McCaw,  coman- 
dante, cirujano  del  Ejército  de  los  Estados  Unidos. 

Doctor  McCaw.  Señor  Presidente,  señores,  como  individuo  del 
Ejército  de  los  Estados  Unidos,  siento  un  orgullo  especial  por  habér- 
seme permitido  que  tome  parte  en  un  Congreso  tan  importante  como 
este.  Nuestra  pequeña  fuerza  militar  es  tanto  del  pueolo  como  para 
el  pueblo,  Cjue  está  interesada,  como  es  claro,  del  mismo  modo  que 
los  demás  ciudadanos,  en  las  cuestiones  que  afectan  la  higiene  pública 
de  este  país  y  de  los  vecinos.  Sé  que  los  individuos  de  ellos  tendrán 
mucho  placer  al  saber  que  un  representante,  aunque  humilde,  de  la 
misma  ha  tenido  el  honor  de  firmar  el  importantísimo  convenio  que  se 
ha  adoptado  hoy. 

Quiero  decir,  como  los  que  me  han  precedido  en  la  palabra,  que 
espero  con  impaciencia  la  reunión  que  tendrá  lugar  en  Méjico,  pero 
temo  que  serán  tantos  los  individuos  del  ejército  que  querrán  gozar  de 
los  placeres  de  la  estancia  en  dicha  ciudad,  que  tendré  muchos  pode- 
rosos competidores  para  conseguir  la  representación  de  mi  departa- 
mento.    Sólo  espero  que  saldré  victorioso  en  la  lucha. 

Algunos  de  nosotros  han  tomado  en  el  pasado  parte  importante  en 
el  saneamiento  del  continente  americano.  Espero  que  podamos  hacer 
algo  en  lo  porvenir  cuando  se  nos  llame  para  ello.  En  el  entretanto 
esperamos  y  contemplamos  con  admiración  la  magnífica  obra  que 
están  ejecutando  este  Gobierno  y  los  de  otros  países,  y  cada  uno  de 
nosotros  sentirá  la  viva  emoción  que  produce  la  victoria  cuando  se  diga 
que  ya  no  existe  la  fiebre  amarilla  y  que  la  peste  bubónica  y  el  cólera 
no  pueden  ser  introducidos  en  el  continente  americano.      (Aplausos.) 

El  Presidente.  Es  casi  innecesario  que  les  presente  al  siguiente 
delegado  de  los  Estados  Unidos,  cuyos  servicios  han  sido  tan  notorios 
en  este  congreso.  Tengo  el  placer  de  llamar  al  Dr.  J.  D.  Gatewood,  de 
la  Marina  de  los  Estados  Unidos. 

Doctor  Gatewood.  Señor  Presidente,  señores,  siendo  como  soy  un 
individuo  simplemente  y  no  un  orador,  temo  que  me  quedaré  muy 
atrás  de  los  notables  oradores  que  me  han  precedido  en  el  uso  de  la 
palabra  esta  tarde.  Me  siento  muy  honrado  al  estar  entre  Vds.  como 
representante  del  departamento  médico  de  la  Marina  de  los  Estados 
Unidos.  La  Marina  está  interesada  particularmente  en  los  asuntos 
que  tienen  relación  con  cuarentenas,  en  todos  aquellos  que  afectan 
cuarentenas  internacionales,  por  cuanto  que  sus  buques  visitan  todos 
los  puertos  del  mundo.  He  contribuido  con  mi  humilde  grano  de 
arena  en  el  trabajo  que  Vds.  han  realizado;  como  represento  á  Un 
número  de  individuos  que  constantemente  visitan,  así  como  yo,  á  los 
países  que  Vds.  representan  aquí,  creo  que  muy  adecuadamente  puedo 
darles  mi  enhorabuena  por  el  importantísimo  trabajo  que  han  ejecu- 
tado durante  esta  Conferencia.  Como  estamos  próximos  á  partir,  por 
haber  completado  ya  esa  obra,  con  rumbo  á  distintas  direcciones  de  la 
tierra,  sólo  puedo  decir  que  espero  que  cuando  abandonen  este  país 
lleven  consigo  los  más  gratos  recuerdos  y  la  satisfacción  de  haber 
cumplido  con  vuestros  deberes  en  esta  Convención. 

Espjero  que  nos  volveremos  á  ver  en  otras  partes  del  mundo; 
abrigo  esa  esperanza  con  el  mayor  placer  imaginable.     Les  felicito 


SEGUNDA   CONFEKENCIA   SANITARIA   INTERNACIONAL.  ^13 

por  el  trabajo  que  habéis  realizado  y  me  despido  de  Vds.  con  la 
sincera  esperanza  de  volverles  á  ver.     (Aplausos.) 

El  Presidente:  Ahora  llamaré  al  delegado  de  los  Pastados  Unidos 
que  no  solamente  está  aqui  con  ese  carácter,  sino  que  también  repre- 
senta á  la  gran  Asociación  Médico  Americana,  que  es  la  sociedad  de  los 
médicos  de  los  Estados — recalco  la  palabra  "la"  porque  quiero  decir 
que  es  la  corporación  mas  numerosa  y  poderosa  en  su  género — siendo 
al  mismo  tiempo  individuo  de  la  Junta  Directiva  de  dicha  asociación, 
la  importante  junta  que  rige  los  destinos  de  la  misma.  Kuego  al 
Dr.  Ii..L.  E.  Johnson  que  haga  uso  de  la  palabra. 

Dr.  H.  L.  E.  Johnson:  Señor  Presidente,  señores  delegados  de  la 
convención,  considero  como  un  alto  honor  el  haber  sido  uno  de  los 
individuos  de  esta  organización.  Aprecio  perfectísimamente  el  exce- 
lente trabajo  que  los  otros  caballeros  han  realizado,  y  es  para  mí  un 
placer  muy  grande  el  estar  aquí  presente  y  el  haber  visto  á  mis 
antiguos  amigos  de  los  países  extranjeros,  á  quienes  he  conocido 
desde  hace  años,  y  en  cuyas  casas  he  gozado  de  su  hospitalidad  en 
varias  ocasiones  y  en  sus  propios  países,  y  ahora  considero  que  nos 
hemos  vuelto  á  reunir  como  hermanos. 

Espero  que  nos  volveremos  á  reunir,  como  ahora,  en  Méjico,  y  que 
disfrutaremos  de  I00  placeres  y  atenciones  que  tuvimos  la  dicha  de 
ser  objeto  cuando  estuvimos  en  aquella  ciudad  en  1897. 

iJreo  que  los  frutos  de  este  Congreso  no  pueden  ser  calculados  coii 
exiageración.  Prácticamente,  hemos  sembrado  la  semilla  de  buena 
salud  pn  los  Estados  Unidos,  y,  en  unión  con  los  demás  miembros  de 
la  Convención  que  han  hecho  el  mismo  trabajo  en  sus  respectivos 
países,  representamos  ahora  un  cuerpo  unificado  para  la  protección 
mutua  contra  las  enfermedades,  que  es  actualmente  el  más  alto  fin 
de  los  trabajos  médicos. 

Tengo  la  seguridad  que  después  de  algunos  meses  ó  años,  se  habrán 
exterminado  las  enfermedades  que  han  obstruido  el  camino  de  la  termi- 
nación del  Canal  de  Panamá,  la  cual  podemos  considerar  como  el 
ideal  del  Presidente  de  los  Estados  Unidos,  y  que  de  esa  terminación 
se  originará  el  gran  bien  que  se  espera  en  este  país,  en  salud,  riqueza 
y  prosperidad,  y  que  gozaremos  de  esos  beneficios  en  unión  con 
nuestros  hermanos  de  los  países  latino-americanos.  Estoy  seguro 
que  con  el  exterminio  de  estas  enfermedades,  en  lo  futuro,  en  vez 
de  hacer  viajes  frecuentes  á  los  países  extranjeros  del  otro  lado,  los 
haremos  á  los  de  éste  para  conocer  mejor  á  nuestros  hermanos  del 
continente. 

Considero  como  uno  de  los  mayores  placeres  y  honores  de  mi  vida 
el  haber  sido  individuo  de  esta  corporación;  en  fin,  el  haber  podido 
ver  una  vez  más  á  los  amables  amigos  y  hermanos  á  quienes  soy  tan 
adicto,  y  que  no  pueden  ser  más  apreciados  de  lo  que  son.     (Aplausos.) 

El  Presidente  :  La  República  de  Guatemala,  el  Señor  Don  Joaquín 
Yela. 

El  Secretario:  No  está  presente. 

El  Presidente  :  La  República  de  México ;  y  cuando  se  menciona 
en  esta  Convención  el  nombre  de  México,  ya  se  sabe  que  le  sigue  el  de 
Licéaga.  El  Doctor  Licéaga  es  uno  de  los  fundadores  originales  de 
esta  Conferencia.  Tomó  parte  muy  activa  al  principio,  y  en  la 
Conferencia  de  los  Estados  americanos,  celebrada  en  1  a  ciudad  de 
México  en  1890-91,  trabajó  con  el  mayor  interés  para  que  se  adoptaran 
las  resoluciones  que  crearon  estas  conferencias.     Como  dije  en  el 


31-1  SEGUNDA    CONFEEENCIA   SANITARIA   INTERNACIONAL. 

dircurso  que  pronuncié  en  la  apertura  de  este  Congreso,  gracias  á  su 
personalidad  é  interés  activo,  á  sus  conocimientos  científicos  y  á  su 
fuerza  administrativa,  se  tomaron  en  México  todas  las  medidas 
necesarias  para  impedir  la  reaparición  de  la  fiebre  amarilla  después 
de  la  epidemia  de  1902.  Y  en  el  hallé  un  medianero  j  auxiliar  muy 
apto  para  poner  en  práctica  las  medidas  que  yo  y  otros  deseaban 
que  se  llevaran  á  cabo  en  los  Estados  Unidos.  Así  es  que  entonces 
México  y  los  Estados  Unidos  trabajaron  juntamente,  de  hecho,  en 
el  exterminio  de  la  fiebre  amarilla,  habiendo  obtenido  éxito  en  los 
resultados. 

lluego  al  Doctor  Licéaga  que  dirija  la  palabra  á  la  Convención. 
(Aplausos.) 

El  Doctor  Licéaga  hizo  uso  de  la  palabra  en  castellano,  pero  no  se 
interpretó  lo  que  dijo. 

El  Presidente:  Ahora  tendré  el  honor  de  llamar  al  delegado  de 
Nicaragua,  el  cual  ha  sido  uno  de  los  miembros  más  activos  de  esta 
Convención  en  todo  lo  que  se  refiere  á  la  higiene  y  cuarentenas  en 
los  puertos  de  nuestras  respectivas  repúblicas.  Ruego  al  Dr.  J.  L. 
Medina  que  haga  uso  de  la  palabra.     (Aplausos.) 

Doctor  Medina  :  Señor  Presidente,  en  primer  lugar  deseo  darles  las 
gracias  por  sus  corteses  palabras;  en  segundo  lugar  diré,  en  nombre 
de  la  República  de  Nicaragua,  á  la  cual  tengo  el  honor  de  representar, 
que  estoy  seguro  que  mis  colegas  recibirán  con  placer  las  disposiciones 
del  convenio,  y  que  no  solamente  se  aceptará  la  determinación  de  la 
convención,  sino  que  también  haremos  todo  lo  que  podamos  para 
que  este  trabajo  práctico  sea  realizado  fielmente. 

Después  deseo  dar  mis  gracias  á  todos  mis  compañeros  de  esta 
Convención.  Ha  sido  un  placer  para  mí  el  que  todos  estemos  reunidos 
aquí,  todos  trabajando  con  tal  sentimiento  de  fraternidad  que  nos 
hace  olvidar  realmente  las  asperezas  por  que  un  americano  tiene  que 
atravesar  en  esta  "vdda.  No  con  frecuencia  tenemos  la  ocasión  de 
una  reunión  de  compañeros  con  un  sentimiento  de  amistad  como  el 
que  se  ha  demostrado  aquí,  y  con  el  cual  esta  convención  ha  desempe- 
ñado sus  funciones.  Espero  que  nos  volveremos  á  reunir  pronto, 
como  todos  mis  colegas  han  expresado  la  esperanza  de  vernos  otra 
vez  en  México. 

Puede  que  hayan  personas  que  crean  que  hemos  exagerado  el  tra- 
bajo de  esta  Convención,  y  que  lo  critiquen.  Creo  que  nuestra  obra 
será  perfectamente  apreciada,  pero  nó  actualmente.  Tengo  la  seguri- 
dad de  que  la  labor  de  esta  Convención  llegará  á  ser  un  monumento 
en  lo  futiu-o,  porque  otros  la  continuarán,  la  mejorarán,  y  conseguirán 
lo  que  no  haya  podido  estar  á  nuestro  alcance  en  estos  días. 

Espero  que  nos  volveremos  á  reunir  en  México,  y  para  terminar, 
deseo  solamente  expresar  mi  más  sincero  respeto  por  al  Doctor 
Licéaga,  que  realmente  ha  sido  la  figura  saliente  de  esta  conferencia. 
(Aplausos.) 

El  Presidente  :  Tengo  la  seguridad  que  todos  han  experimentado 
mucho  placer  al  saber  que  teníamos  en  la  presente  conferencia  un 
delegado  del  Perú;  como  Vds.  recordarán,  esta  república  no  estuvo 
representada  en  la  última  conferencia.  Cuando  recibí  la  visita  del 
Doctor  Lavorería  me  alegré  muchísimo,  porque  había  oído  hablar 
de  él  por  algunos  de  mis  empleados  de  Panamá,  así  como  también 
me  alegré  mucho  al  saber  que  el  Perú  iba  á  estar  representado, 
especialmente  porque  las  relaciones  entre  esta  república  y  las  demás, 


SEGUNDA   CONFERENCIA    SANITARIA    INTERNACIONAL.  315 

sobre  todo  los  Estados  Unidos,  van  siendo  más  íntimas  cada  día. 
Nuestras  relaciones  van  siendo  más  íntimas;  nos  estamos  uniendo 
más  y  más  en  estos  asuntos,  y  dopondenios  más  unos  de  otros  que 
antes;  y  deseo  decir  que  las  autoridades  del  Perú  han  demostrado 
su  disposición  para  hacer  todo  lo  posible  en  la  destrucción  de  la  peste 
bubónica  y  otras  enfermedades  epidémicas.  En  otras  palabras,  esa 
república  está  en  primera  línea.  Ruego  á  su  distin^^uido  repre- 
sentante, el  Doctor  Lavorería,  que  tenga  la  bondad  de  hacer  uso  de 
la  palabra.     (Aplausos.) 

El  Doctor  Lavorería  hizo  uso  de  la  palabra  en  castellano.  (Aplau- 
sos.)    Sus  observaciones  no  se  tradujeron  al  inglés. 

El  Presidente  :  Hemos  tenido  entre  nosotros,  durante  las  sesiones 
de  la  Convención  la  genial  presencia  del  Encargado  de  Negocios  del 
Uruguay,  y  hubiéramos  tenido  mucho  gusto  en  oirle,  pero  según  me 
han  informado  está  ausente. 

El  representante  de  la  República  de  Venezuela  tampoco  está  aquí 
ahora,  por  más  que  ha  estado  en  la  sala  varias  veces. 

Tenemos  entre  nosotros  á  distinguidos  caballeros  á  quienes  se 
concedieron  las  prerrogativas  de  la  Convención,  y  quisiera  rogar  al 
Doctor  Carroll,  del  Ejército  de  los  Estados  Unidos,  que  haga  uso  de 
la  palabra. 

Doctor  Carroll:  Señor  Presidente,  caballeros  de  la  Convención, 
ruégeles  acepten  mis  más  sinceras  gracias  por  el  gran  honor  y  el 
privilegio  que  me  habéis  concedido  para  estar  presente  en  las  sesiones 
de  esta  conferencia.  Aseguróles  que  me  han  sido  tan  interesantes 
como  instructivas,  y  sus  resultados  tienen  tanto  alcance  que  sólo 
podemos  conjeturar  la  consecuencia  final.  Me  regocijo  al  par  que 
Vds.  por  el  éxito  que  se  ha  obtenido  hasta  ahora,  y  más  particular- 
mente porque  creo  que  podemos  predecir,  con  casi  absoluta  seguridad, 
la  consecución  en  lo  porvenir  del  completo  exterminio  de  la  fiebre 
amarilla  en  el  continente  de  Norte  America,  y  más  tarde  de  todo  el 
Hemisferio  Occidental,  que  prácticamente  viene  á  ser  el  mundo  entero. 

Ha  pasado  el  tiempo  tan  rápidamente,  y  es  ya  tan  tarde,  que  no 
estaría  bien  que  yo  les  detenga  por  un  minuto  más.  Deseo  expresar- 
les una  vez  más  el  alto  aprecio  que  tengo  por  el  honor  que  me  habéis 
conferido.     (Aplausos.) 

El  Presidente:  Ruego  al  Doctor  Stiles,  zoólogo  del  Servicio  de 
Sanidad  Pública  y  Hospitales  Marítimos,  que  nos  dirija  la  palabra. 

Doctor  Stiles.  Señor  Presidente,  señores:  Estoy  seguro  que  me 
hago  eco  de  los  sentimientos  de  mis  colegas  del  laboratorio  higiénico, 
á  quienes  habéis  concedido  las  prerrogativas  de  la  Convención,  al 
agradecerles  por  los  ratos  tan  instructivos  que  hemos  pasado  durante 
las  sesiones  de  esta  semana.  Para  nosotros  han  sido  instructivas 
bajo  varios  puntos  de  vista.  Como  es  claro,  en  un  laboratorio 
trabajamos  sobre  bases  teóricas,  y  para  nosotros  es  de  mucho  valor 
el  estar  en  contacto  con  la  clase  de  hombres  cuya  experiencia  les 
coloca  en  los  ramos  más  amplios  de  los  trabajos  administrativos. 
Es  para  nosotros,  además,  una  grande  satisfacción  el  ver  que  los 
resultados  prácticos  de  nuestros  trabajos  de  laboratorio  son  puestos 
en  letras  de  molde  por  una  clase  de  hombres  capaces  de  entender 
la  influencia  de  los  mismos  en  la  liigiene  pública.  Esos  resultados 
pueden  ser  utilizados  únicamente  por  personas  que  tienen  amplia 
noción  de  los  trabajos  administrativos,  al  par  que  un  profundo  cono- 
cimiento de  los  trabajos  teóricos  del  laboratorio. 


olH  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Hablando  personalmente,  lie  tenido  otra  grande  satisfacción  por 
estar  aquí,  no  como  médico,  sino  como  zoólogo.  Tengo  la  convicción 
desde  hace  años,  que  hay  un  número  de  problemas  en  la  medicina 
que  deben  ser  solucionados  bajo  el  punto  de  vista  zoológico.  Ya  se 
han  aclarado,  parcial  ó  totalmente,  algunas  enfermedades,  mediante 
trabajos  zoológicos.  Curioso  es,  pero  no  han  sido  los  zoólogos  los 
que  han  sacaáo  á  la  luz  estos  hechos,  sino  los  médicos  que  han 
invadido  el  campo  zoológico  y  descubierto  los  principios  y  hechos 
zoológicos  que  los  mismo  zoólogos  han  pasado  por  alto.  Así  es  que 
siempre  es  un  placer  para  el  zoólogo  de  profesión  el  reconocer  la  deuda 
que  la  zoología  debe  á  la  medicina  por  demostrar  al  zoólogo  cuan 
importante  es  aquélla  para  ésta. 

También  he  tenido  mucho  placer  en  asistir  á  estas  sesiones  bajo 
otro  punto  de  vista  completamente  distinto — la  inspiración  que  un 
joven  recibe  con  el  roce  personal  con  hombres  que  son  sus  mayores 
en  experiencia,  edad,  y  trabajos  realizados. 

y  finalmente,  aquí  se  me  ha  dado  otro  ejemplo:  Algunos  de  nos- 
otros, en  el  laboratorio,  no  queremos  trabajar  demasiado  en  una 
semana  por  tem.or  de  enflaquecer;  conforme  paso  la  vista  por  la  sala 
y  pienso  cuanto  han  trabajado  los  miembros  de  esta  Conferencia,  me 
admiro  al  notar  que  no  ha  habido  reducción  alguna  en  la  circun- 
ferencia de  mi  buen  amigo  el  Dr.  H.  L.  E.  Johnson,  ó  en  la  de  mi 
estimado  colega  del  Ejército,  ó  en  la  de  nuestro  digno  Presidente. 

Agradézcoles  infinito  por  haberme  concedido  las  prerrogativas  de 
la  Convención,  y  en  la  ausencia  de  mis  colegas,  los  Doctores  Anderson 
y  Hunt,  les  doy  las  gracias  en  su  nombre  por  el  mismo  motivo. 
[Aplausos.] 

El  Presidente.  Señores,  aquí  hay  un  caballero  que  deseo  haga 
uso  de  la  palabra  por  cuanto  tiempo  quiera,  y  al  cual  debemos  tanto 
por  la  preparación  de  esta  Convención  y  la  ayuda  prestada  en  la 
dirección  de  la  misma.  Allí  le  tenéis,  parado  y  custodiando  el 
sagrado  documento  que  acabamos  de  firmar  [risas],  por  más  que 
literalmente  hablando  está  sentado,  pero  alerta.  Tengo  la  seguridad 
que  todos  nos  alegraremos  de  oir  al  Hon.  W.  C.  Fox,  Director  de  la 
Oficina  de  las  Repúblicas  Americanas. 

Mr.  Fox.  Señor  Presidente,  señores.  Es  tan  tarde  que  creo  que  no 
debo  detenerles,  pero  deseo  darles  mis  sinceras  gracias  y  las  de  la 
Oficina  por  las  corteses  palabras  que  habéis  dicho  sobre  nosotros,  y 
quiero  asegurarles,  además,  que  lo  que  hemos  hecho  por  vosotros  ha 
sido  únicamente  en  cumplimiento  de  nuestro  deber — deber  que  hemos 
ejecutado  con  el  mayor  placer.  La  Oficina  tiene  ciertas  funciones, 
y  en  esta  ocasión  ha  demostrado  que  estas  funciones  son  dignas. 
Recuerdo  que,  cuando  en  la  apertura  de  este  Congreso  tuve  el  honor 
de  acompañar  al  Honorable  Secretario  de  Estado  hasta  esta  sala,  al 
bajar  del  coche  hablamos  de  algunos  asuntos,  y  entonces  le  dije  que 
no  sabía  qué  resultados  prácticos  daría  esta  Convención  ó  el  trabajo 
de  la  Oficina.  Me  contestó  diciendo,  "No  se  preocupe  Vd.  por  eso. 
Vds.  se  asemejan  en  mucho  á  un  abogado  que  está  arguyendo  ante 
un  tribunal.  El  argumento  puedo  ser  bueno  ó  indiferente,  pero 
mientras  lo  estáis  haciendo  tenéis  embargada  la  atención  del  tribu- 
nal." Y  yo  creo  que  esto  es  lo  que  estáis  haciendo.  Me  alegro 
mucho  de  haber  tenido  la  oportunidad  de  serles  de  alguna  utilidad, 
aunque  poca,  al  ayudaros,  distinguidos  señores,  en  la  terminación  de 
esta  magnífica  obra  maestra.     [Aplausos.] 


SEGUNDA   CONFERENCIA    SANITARIA   INTERNACIONAL.  817 

El  Presidente.  El  acta  de  la  sesión  de  hoy  tendrá  que  ser  apro- 
bada por  alguien  después  del  cierre  final  cíe  la  Convención,  por 
lo  que  sería  conveniente  que  uno  de  Vds.  proponga  qiie  se  autorice 
al  Presidente  y  al  secretario  para  ({ue  aprueben  esa  acta,  ó  que  se 
haga  alguna  disp(jsición  en  la  forma  (|ue  crea  conveniente  la  Conven- 
ción, con  ese  fin. 

Dr.  11.  L.  E.  Johnson.  Pido  que  el  acta  de  esta  sesión  sea  remitida 
al  Presidente  y  al  secretario  para  que  la  apnielxín,  y  <|ue  se  con- 
sidere su  aprobación  como  si  fuera  la  de  la  Conferencia. 

Esta  proposición  fué  apoyada,  y,  después  de  discutida,  quedó 
aprobada. 

El  Presidente.  Señores  delegados  [aplausos]:  Ha  llegado  el 
momento  para  levantar  esta  Convención,  hasta  que  nos  volvamos  á 
reunir  de  aquí  á  dos  años  en  la  Tercera  Conferencia  Sanitaria  Inter- 
nacional de  las  Repúblicas  Americanas,  en  la  Ciudad  de  México.  Se 
presume  que  un  discurso  de  despedida  debe  haber  sido  redactado 
cuidadosamente.  Como  Vds.  han  visto,  el  trabajo  de  esta  Conven- 
ción ha  sido  tan  grande,  tan  absorvente,  que  me  ha  sido  virtualmente 
imposible  preparar  un  discurso  que  sea  digno  de  esta  ocasión.  Así 
es  que  solamente  les  dare  la  despedida  con  los  pensamientos  que  se 
me  vayan  ocurriendo  á  medida  que  hablo.  Repasando  el  trabajo 
de  esta  semana,  veo  que  todos  y  cada  uno  de  los  delegados  de  esta 
Convención  merecen  ser  felicitados.  Nos  hemos  conocido  unos  á 
otros  como  nunca.  Cuando  leamos  los  periódicos  ó  revistas  de  los 
países  representados  en  esta  Conferencia,  nuestros  recuerdos  se  con- 
centrarán en  las  caras  que  aquí  vemos  ahora.  .  Cada  uno  de  nosotros 
relacionará  á  los  demás  con  los  países  que  representan,  y  por  lo  tanto 
tendremos  un  sentimiento  más  profundo  y  más  personal  hacia  las 
naciones  aquí  representadas. 

Creo  que  hemos  pasado  el  tiempo  aprovechadamente,  bajo  el 
punto  de  vista  de  roce  social.  Hemos  aprendido  á  conocernos  unos 
á  otros,  á  apreciar  las  altas  aptitudes  de  los  individuos  de  esta  Con- 
vención, j  á  apreciar  las  provechosas  ideas  que  constantemente  se 
han  expresado  durante  las  sesiones. 

También  debemos  ser  felicitados  por  las  pruebas  de  los  resultados 
científicos  que  han  sido  tan  manifiestos  en  las  sesiones  de  este  Con- 
gresp.  No  sé  si  les  ha  ocurrido,  como  á  mí,  que  una  de  las  razones 
por  que  hemos  tenido  éxito  en  nuestras  discusiones  y  conclusiones, 
es  el  hecho  de  que  las  repúblicas  que  han  tomado  parte  en  esta  Con- 
ferencia están  representadas  por  hombres  da  elevada  educación; 
caballeros  cultos  y  perfectos.  Este  hecho  ha  facilitado,  relativa- 
mente, el  que  hayamos  convenido  en  estos  grandes  principios  que 
hemos  puestos  en  forma  y  que  esperamos  poner  en  práctica. 

Además,  debemos  ser  felicitados  por  el  gran  efecto  internacional 
de  la  Conferencia  que  hemos  celebrado.  Dejando  aparte  las  cues- 
tiones de  medicina  é  higiene,  las  convenciones  de  este  género  hacen 
que  las  naciones  se  unan,  que  es  uno  de  los  propósitos  y  el  ideal  del 
pensamiento  moderno.  Perú  y  Chile  ya  no  nos  parecen  tan  distantes 
como  nos  parecían  hace  diez  años,  3^  espero,  señores,  que  los  Estados 
Unidos  no  les  parecerá  tan  distante  como  antes.  Somos  pues  un 
elemento  en  el  progreso  de  la  civilización,  en  el  establecimiento  de  la 
fraternidad  universal,  que  es  el  ideal  más  elevado  que  puede  perse- 
guir cualquier  corporación,  ó  varios  individuos  que  trabajan  en  con- 
junto ó  separadamente. 


318  SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL. 

Personalmente  deseo  darles  las  gracias  á  todos  y  cada  uno  de  Vds. 
por  el  trato  tan  cortés  que  me  habéis  dado  como  vuestro  Presidente. 
No  ha  habido  durante  toda  la  semena  la  más  minima.  Creo  que 
en  los  esfuerzos  que  he  hecho  para  duigir  la  Convención  he  tenido 
la  simpatía  y  la  ayuda  de  todos  Vds.,  sin  las  cuales  la  convención 
no  hubiera  tenido  éxito  en  lo  que  se  refiere  á  mi  presidencia.  Deseo 
darles  de  nuevo  las  gracias  y  expresarles  el  gran  aprecio  que  siento 
por  el  hecho  de  me  hayáis  reelegido  para  presidir  esta  Segunda 
Conferencia  Sanitaria  Internacional  de  las  Repúblicas  Americanas, 
conferencia  que  se  registrará  en  los  anales  de  la  historia  como  el 
origen  de  los  grandes  sucesos  y  adelantos  que  tendrán  lugar  en  el 
Hemisferio  Occidental,  adelantos  en  la  higiene,  el  saneamiento  y  el 
comercio,  los  cuales  serán  una  grande  adquisición  para  la  sanidad 
pública  y  la  prosperidad  de  las  naciones. 

Ahora  les  deseo  un  afectuoso  adiós.  Al  decir  "afectuoso  adiós," 
quiero  significar  que  cuando  os  marchéis  llevéis  consigo  recuerdos 
gratos  de  los  delegados  de  los  Estados  Unidos  y  míos;  que  espera- 
mos la  Tercera  Convención  de  la  Ciudad  de  México  con  el  mayor 
placer.  Todos  estamos  acordes  con  la  opinión  de  uno  de  los  dele- 
gados, cuando  dijo  que  deseaba  que  el  tiempo  se  pasara  volando 
entre  esta  Conferencia  y  la  próxima. 

Con  estas  breves  palabras  les  doy  la  despedida,  y  declaro  terminada 
la  Segunda  Conferencia  Sanitaria  Internacional  de  las  Repúblicas 
Americanas.     [Aplausos[. 


APÉNDICE. 


319 


SEGUNDA  CONVENCIÓN  GENERAL  SANITARIA  INTERNACIONAL. 


CONVENCIÓN  AD  REFERENDUM  FIRMADA  EN  LA  SEGUNDA 
CONVENCIÓN  GENERAL  SANITARIA  INTERNACIONAL  DE  LAS 
REPÚBLICAS  AMERICANAS  EN  WASHINGTON  EL  14  DE  OCTUBRE 
DE  1905. 

Los  Presidentes  de  las  Repúblicas  de  Chile,  Costa  Rica,  Cuba,  República  Dominicana, 
Ecuador,  Estados  Unidos  de  América,  Guatemala,  Méjico,  Nicaragua,  Perú  y  Venezuela, 
habiendo  encontrado  que  es  útil  y  conveniente  codificar  todas  las  medidas  destinadas  á 
resguardar  la  salud  pública  contra  la  invasión  y  propagación  de  la  fiebre  amarilla,  de  la 
peste  bubónica  y  del  cólera,  han  nombrado  por  sus  delegados  á  las  siguientes  personas: 

La  República  de  Chile,  al  Señor  Dr.  D.  Eduardo  Moore,  profesor  de  la  facultad  de 
medicina,  médico  de  hospital. 

La  República  de  Costa  Rica,  al  Señor  Dr.  D.  Juan  J.  Ulloa,  ex-vicepresidente,  ex- 
tninistro  del  interior  de  Costa  Rica  y  ex-presidente  de  la  facultad  médica  de  Costa  Rica. 

La  República  de  Cuba,  al  Señor  Dr.  D.  Juan  Guiteras,  miembro  de  la  junta  superior  de 
salubridad  de  Cuba,  director  del  hospital  "Las  Animas,"  profesor  de  patología  general  y 
de  medicina  tropical  de  la  Universidad  de  la  Plabana,  y  al  Señor  Dr.  D.  Eru-ique  B.  Barnet, 
jefe  ejecutivo  del  departamento  de  sanidad  de  la  Habana,  vocal  y  secretario  de  la  junta 
superior  de  sanidad  de  Cuba. 

La  República  del  Ecuador,  al  Señor  Dr.  D.  Serafín  S.  Wither,  encargado  de  negocios  y 
cónsul  general  del  Ecuador  en  Nueva  York,  j  al  Señor  Dr.  D.  Miguel  H.  Alcivar,  miembro 
de  la  junta  superior  de  sanidad  de  Guayaquil,  profesor  de  la  facultad  de  medicina  y  cirujano 
del  Hospital  General  de  Guaj'aquil. 

La  República  de  los  Estados  Unidos  de  América,  al  Señor  Dr.  D.  Walter  Wyman,  cirujano 
general  del  Servicio  de  Salud  Pública  y  Hospitales  de  Marina  de  los  Estados  Unidos;  al 
Señor  Dr.  D.  H.  D.  Geddings,  cirujano  general,  ayudante  del  Servicio  de  Salud  Pública 
y  Hospitales  de  Marina  de  los  Estados  Unidos  y  representante  de  los  Estados  Unidos  en 
la  Convenf'ión  Sanitaria  de  París;  al  Señor  Dr.  D.  J.  F.  Kennedy,  secretario  de  la  oficina 
de  salud  pública  del  Estado  de  íowa:  al  Señor  Dr.  D.  John  S.  ÍFulton.  secretario  de  la 
oficina  de  sahid  pública  del  Estado  de  Mar^'land;  al  Señor  Dr.  D.  Walter  D.  McCaw. 
mayor  cirujaat)  del  ciér<ito  de  los  Est:idos  Unidos;  al  Señor  D.  J.  D.  Gatewood,  cirujano 
de  la  marina  de  los  Estados  Unidos,  y  ai  Señor  D- .  D.  H.  L.  E.  Johnson,  miembro  de  la 
Asociación  Médica  Americana  (miembro  de  la  junta  directiva). 

La  República  de  Guatemala,  al  Señor  Dr.  D.  Joaquín  Yela,  cónsul  general  de  Guatemala 
en  Nueva  York; 

La  Repúbhca  de  Méjico,  al  Señor  Dr.  D.  Eduardo  Licéaga,  presidente  del  consejo 
superior  de  salubridad  de  Méjico,  director  y  profesor  de  la  Escuela  Nacional  de  Medicina, 
miembro  de  la  Academia  de  Medicina. 

La  República  de  Nicaragua,  al  Señor  Dr.  D.  J.  L.  Medina,  miembro  del  Segundo  Congreso 
Médico  Pan,-Americano  de  la  Habana  en  190L 

La  República  del  Perú,  al  Señor  Dr.  D.  Daniel  Eduardo  Lavorería,  profesor  de  la  facultad 
de  medicina,  miembro  de  la  Academia  Nacional  de  Medicina,  médico  del  hospital  "Dos  de 
Mayo,"  jefe  de  la  sección  de  higiene  del  ministerio  de  fomento. 

La  República  Dominicana,  al  Señor  Licenciado  D.  Emilio  C.  Joubert,  ministro  resident* 
en  Washington. 

La  República  de  Venezuela,  Al  Señor  D.  Nicolás  Veloz-Goiticoa,  encargado  de  negocio» 
de  Venezuela. 

Quienes,  habiendo  cambiado  sus  poderes  y  encontrándolos  en  buena  y  debida  forma 
convinieron  en  aceptar  ad  referendum,  las  siguientes  proposiciones: 

1112a— 06 21  321 


822  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIÓN  AL, 

CAPÍTULO  I. 

PRESCRIPCIONES    QUE    DEBERÁN    OBSERVAR    LOS    PAÍSES    SIGNATARIOS    DE    LA    CONVENCIÓN 
CUANDO   EL  CÓLERA,  LA  PESTE  Ó    LA   FIEBRE   AMARILLA  APAREZCA   EN   SU  TERRITORIO. 

Sección  primera. — Notificación  y  comunicaciones  ulteriores  ú  los  otros  países. 

Artículo  I.  Cada  Gobierno  debe  notificar  inmediatamente  á  los  otros  la  primera  apari- 
ción, en  su  territorio,  de  los  casos  confirmados  de  peste,  cólera  ó  de  fiebre  amarilla. 

Art.  II.  Esta  notificación' irá  acompañada  ó  muy  prontamente  seguida  de  informes 
circunstanciados  sobre: 

(1)  Lugar  en  donde  la  enfermedad  apareció. 

(2)  Fecha  de  su  aparición,  origen  y  lorma. 

(3)  Número  de  casos  comprobados  y  de  defunciones. 

(4)  Para  la  peste:  la  existencia,  entre  las  ratas  y  ratones,  de  la  peste  ó  de  una  mortalidad 
insólita;  y  para  la  fiebre  amarilla:  la  existencia  del  Stegoinyia  fasciata  en  la  localidad. 

Las  medidas  tomadas  ininedjatam.ente  después  de  esta  primera  aparición. 

Art.  III.  La  notificación  y  las  informaciones  indicadas  en  los  Artículos  I  y  II  serán  diri- 
\  gidas  á  los  agentes  diplomáticos  ó  consulares  en  la  capital  del  país  contaminado,  sin  que 
esto  sea  obstáculo  para  que  los  jefes  de  las  oficinas  sanitarias  superiores  se  comuniquen  estas 
noticias  entre  sí  directamente. 

Á  los  países  que  no  tengan  representación  diplomática  ó  consular  en  el  país  contami- 
nado, les  serán  transmitidas  directamente,  por  telégiafo. 

Art.  IV.  La  notificación  y  las  informaciones  indicadas  en  los  Artículos  I  y  II  serán 
seguidas  de  comunicaciones  ulteriores  hechas  de  un  modo  regular,  de  manera  de  tener  á  los 
Gobiernos  al  comente  del  curso  de  la  epidemia. 

Estas  comunicaciones  que  se  harán  á  lo  menos  una  vez  por  semana,  y  que  serán  tan 
completas  como  sea  posible,  indicarán  muj"  particularmente  las  precauciones  tomadas,  con 
el  objeto  de  impedir  la  extensión  de  la  enfermedad. 

Ellas  deben  precisar:  (1)  las  medidas  profilácticas  adoptadas  con  respecto  á  la  inspección 
sanitaria  ó  á  la  visita  médica,  al  aislamiento  y  á  la  desinfección;  (2)  las  medidas  tomadas 
á  la  partida  de  los  buques  para  impedir  la  exportación  del  mal  y,  especialmente,  en  el  caso 
previsto  por  el  inciso  ('J)  del  Artículo  II,  arriba  mencionado,  las  medidas  tomadas  contra 
las  ratas,  ratones  y  mosquitos. 

Art.  V.  El  pronto  y  fiel  cumplimiento  de  las  prescripciones  que  preceden  es  de  una 
importancia  primordial. 

Las  notificaciones  no  tienen  valor  real  sino  cuando  cada  Gobierno  está  prevenido,  á 
tiempo,  de  los  casos  de  peste,  de  cólera  y  de  fiebre  amarilla,  y  de  los  casos  dudosos  sobre- 
venidos en  su  territorio.  Se  recomienda  pues,  encarecidamente  á  los  diversos  Gobiernos, 
que  hagan  obligatoria  la  declaración  de  los  casos  de  peste,  de  cólera  y  de  fiebre  amarilla, 
y  C|ue  obtengan  informaciones  sobre  cualquiera  mortalidad  insólita  en  las  ratas  ó  ratones, 
particularmente  en  los  puertos. 

Art.  Y1.  Se  entiende  que  los  países  vecinos  se  reservan  el  derecho  de  hacer  arreglos 
especiales  con  el  objeto  de  organizar  un  servicio  de  informaciones  directas  entre  los  jefes 
de  las  administraciones  de  las  fronteras. 

Sección  segunda. — Condiciones  que  permiten  considerar  una  drcunscri'pción  territorial  confio 
contaminada,  ó  como  libre  ya  de  la  enfermedad. 

Art.  vil  La  notificación  de  un  primer  caso  de  peste,  ó  cólera  ó  de  fiebre  amarilla,  no 
impone,  contra  la  circunscripción  territorial  en  donde  se  ha  producido,  la  aplicación  de  las 
medidas  previstas  en  el  Capítulo  II,  que  más  adelante  se  declararán. 

Pero  cuando  varios  casos  de  peste  ó  uno  de  fiebre  amarilla  no  importados,  se  han  mani- 
festado, ó  cuando  los  casos  de  cólera  forman  foco,  la  cucunscripción  se  declara  contaminada. 

Art.  VIII.  Para  restringir  las  medidas  únicamente  á  las  regiones  atacadas,  los  Gobiernos 
no  deben  apHcarlas  sino  á  las  procedencias  de  las  circunscripciones  contaminadas. 

Se  entiende  por  la  palabra  "circumscripción,"  una  parte  del  territorio  bien  determinada 
en  las  infoi-maciones  que  acompañen  ó  sigan  á  la  notificación,  así:  una  provincia,  un  estado, 
un  "gobierno,"  un  distrito,  un  departamento,  un  cantón,  una  isla,  una  comuna,  una  ciudad, 
un  barrio  de  ima  ciudad,  una  aldea,  un  puerto,  un  polder,  una  aglomeración,  etc.,  cua- 
lesquiera que  sean  la  extensión  y  la  población  de  esas  porcior.es  de  territorio. 

Pero  esta  restricción  limitada  á  la  circunscripción  contaminada,  no  debe  ser  aceptada, 
sino  con  la  condición  formal  de  que  el  Gobierno  del  país  contaminado,  tome  las  medidas 
necesarias:  (1)  Para  prevenir,  á  menos  de  desinfección  previa,  la  exportación  de  los  objetos 
á  que  se  refieren  los  incisos  (1  y  2)  del  Artículo  II,  procedentes  de  la  circunscripción 
contaminada;  y  (2)  para  combatir  la  extensión  de  la  epidemia  y  con  la  condición  de  que 


SEGUNDA    CONFERENCIA    KAN  I  TARTA    INTERNACIONAL.  'i2í\ 

no  haya  duda  de  que  las  autoridades  sanitarias  del  f)aí,s  infectado  luin  ciiinpüdo  íiolinonte 
con  el  Artículo  I  de  esta  Convencif'tn. 

Cuando  una  circunscripción  (s.sté  containinada,  no  se  tomará  ninj^una  medida  restrictiva 
contra  las  procedencias  de  esa  circunscripción,  si  esas  procedencias  las  han  abandonado 
cinco  días  al  menos  ani.es  del  principio  de  la  epidemia. 

Aur.  IX.  Para  (\u.o  una  circunscripción  no  so  consider;;  ya  como  contaminada,  se  necesita 
la  coiii¡)ro))a(!Íón  olicial:  (1)  l^e  que  no  ha  habido  ni  defunciones  ni  caso  nuevo  de  peste 
6  de  cólera  desde  hace  cinco  días,  sea  des|>uós  del  aislamiento,"  sea  después  de  la  muerte 
ó  do  la  curación  del  último  pestoso  ó  colérico;  en  el  caso  de  fiebre  ainaiilla  el  período  será 
do  dieciocho  días;  pero  los  Gobiernos  se  ies(!rvan  el  derecho  de  prolon<rar  este  peilodo. 
(2)  Que  todas  las  medidas  de  desinfección  han  sido  aplicadas,  y  si  se  ti'ata  de  los  casos 
de  peste,, que  se  han  ejecutado  las  medidas  contra  las  ratas,  y  en  el  caso  de  fiebre  amarilla 
que  se  han  ejecutado  las  medidas  contra  el  mosquito. 

CAPÍTULO  II. 

MEDIDAS   DE   DEFENSA   TOMADAS   POR   LOS    OTROS    PAÍSES    CONTRA    LOS   TERRITORIOS 
DECLARADOS   CONTAMINADOS. 

Sección  primera. — -Publicación  de  las  medidas  prescritas. 

Art.  X.  El  Gobierno  de  cada  país  está  obligado  á  publicar  inmediatamente  las  medidas 
que  crea  necesario  prescribir  contra  las  procedencias  de  un  país  ó  de  una  circunscripción 
contaminada. 

Comunicará  en  el  acto  esta  publicación  al  agente  diplomático  ó  consular  del  país  con- 
taminado, residente  en  su  capital,  así  como  á  la  Oficina  Sanitaria  Internacional. 

Está  igualmente  obligado  á  hacer  conocer,  por  las  mismas  vías,  la  revocación  de  estas 
medidas  ó  las  modificaciones  de  que  hayan  sido  objeto. 

A  falta  de  agente  diplomático  ó  consular,  en  la  capital,  las  comunicaciones  se  harán  direc- 
tamente al  Gobierno  del  país  interesado. 

Sección  Segunda. — Mercancías — Desinfección — Importación  y  tránsito — Equipajes. 

Akt.  XI.  No  existen  mercancías  que  sean  por  sí  mismas  capaces  de  transmitir  la  peste, 
el  cólera,  ó  la  fiebre  amarilla.  No  son  peligrosas  sino  en  el  caso  en  que  hayan  sido  con- 
taminadas por  productos  pestosos  ó  coléricos,  y  en  el  caso  de  fiebre  amarilla,  cuando  sean 
susceptibles  de  conducir  mosquitos. 

Art.  XII.  Ninguna  marcencía  ú  objeto  será  sometido  á  desinfección  en  caso  de  fiebre 
amarilla,  pero  en  el  caso  previsto  al  fin  del  artículo  anterior,  la  desinfección  puede  hacerse 
á  fin  de  destruir  los  mosquitos.  En  caso  de  cólera,  ó  de  peste,  la  desinfección  no  deberá 
aplicarse  más  que  á  las  mercancías  y  objetos  que  la  autoridad  sanitaria  local  considere 
como  contaminados. 

Sin  embargo,  las  mercancías  y  objetos  enumerados  más  adelante,  pueden  s*  sometidos 
á  la  desinfección  y  aun  prohibida  su  entrada,  independientemente  de  toda  comprobación, 
de  que  están  ó  no  contaminados: 

(1)  La  ropa  interior  y  vestidos  que  se  Uevan  (efectos  de  uso)  y  la  ropa  de  cama  ya  usada. 

Cuando  estos  objetos  son  transportados  como  equipaje  ó  á  consecuencia  de  un  cambio 
de  domicilio  (artículos  de  instalación),  no  podrá  prohibii'se  su  entrada,  y  se  sometarán  al 
régimen  del  Artículo  XIX. 

Los  efectos  dejados  por  los  soldados  ó  lo?  marinos  muertos,  y  remitidos  á  su  patria,  se 
asimilarán  á  los  objetos  comprendidos  en  el  primer  párrafo  del  inciso  (1)  de  este  artículo. 

(2) -Los  trapos  viejos,  con  excepción  en  cuanto  al  cólera,  de  los  trapos  viejos  compri- 
midos que  se  transportan  como  mercancías,  al  por  mayor,  en  pacas  cinchadas. 

No  deberán  ser  detenidos  los  desperdicios  nuevos  que  provienen  directamente  de  los 
talleres  de  hilado,  de  tejido,  de  confección  ó  de  blanqueamiento,  las  lanas  artificiales  y  los 
recortes  de  papel  nuevo. 

Art.  XIII.  En  caso  de  cólera  ó  de  peste,  no  hay  razón  para  prohibir  el  tránsito  á  través 
de  un  distrito  infectado,  de  las  mercancías  y  objetos  especificados  en  los  incisos  (1)  y  (2) 

«La  palabra  "aislamiento"  significa:  Aislamiento  del  enfermo,  de  las  personas  que  lo 
cuidaban  de  un  modo  permanente  é  interdicción  de  visitas  de  cualquiera  otra  persona, 
exceptuándose  al  médico. 

Por  la  palabra  "aislamiento,"  tratándose  de  fiebre  amarOla,  se  entenderá:  Aislamiento 
del  enfermo  en  una  sala  que  tenga  sus  puertas  y  ventanas  provistas  de  maUas  de  alambre 
que  impidan  que  los  mosquitos  puedan  picar  á  los  enfermos. 


321  SEGUNDA    CONFEEENCIA    SANITARIA   INTERNACIONAL. 

del  artículo  anterior,  si  están  embalados  de  tal  modo,  que  no  puedan  ser  infectados  en  el 
tránsito. 

De  la  misma  manera,  cuando  las  mercancías  ú  objetos  son  transportados  de  modo  que 
en  el  camino  no  hayan  podido  estar  en  contacto  con  los  objetos  contaminados,  su  tránsito 
á  través  de  una  circunscripción  territorial  contaminada,  no  debe  ser  un  obstáculo  para  bu 
entrada  al  país  de  destino. 

Art.  'S.TV.  Las  mercancías  y  objetos  especificados  en  los  incisos  (1)  y  (2)  del  artículo 
XII,  no  caen  bajo  la  aplicación  de  las  medidas  de  prohibición  á  la  entrada,  si  se  demuestra, 
á  la  autoridad  dí^l  país  de  destino,  que  han  sido  expedidos  cinco  días  al  menos  antes  del 
principio  do  la  epidemia. 

AiíT.  XV.  El  modo  y  el  sitio  de  la  desinfección,  á  la  llegada  de  las  mercancías,  así  como 
los  proci'dimientos  que  deberán  emplearse  para  as.'gnJrar  la  destmcción  de  las  ratas  y  mos- 
quitos, se  fijarán  por  la  autoridad  del  país  de  destino.  Estas  operaciones  deberán  hacerse 
de  manera  de  deteriorar  los  objetos  lo  menos  posible. 

Corresponde  á  cada  país  arreglar  la  cuestión  relativa  al  pago  eventual  de  indemnización 
que  resultare  de  la  desinfección  ó  de  la  desti-ucción  de  las  ratas  ó  mosquitos. 

Si,  con  ocasión  de  las  medidas  tomadas  para  asegurar  la  destrucción  de  las  ratas  ó  los 
mosquitos  á  bordo  de  los  buques,  la  autoridad  sanitaria  percibiere  algún  impuesto,  sea 
directamente,  sea  por  intermedio  de  una  sociedad  ó  de  un  particular,  el  monto  de  este 
impuesto  deberá  fijarse  por  una  tarifa  publicada  de  antemano  y  establecida  de  manera  que 
no  pueda  resultar  de  su  aplicación  una  fuente  de  beneficios  para  el  Estado  ó  para  la  Admi- 
nistración sanitaria. 

Aet.  XVI.  Las  cartas  y  correspondencia,  impresos,  libros,  periódicos,  papeles  de  negocios, 
etc.  (no  comprendiendo  las  encomiendas  postales,  "colis  postaux"),  no  se  someterán  á 
ninguna  restricción  ni  desinfección.  En  caso  de  fiebre  amarilla,  los  paquetes  postales 
(colis  postaux)  no  se  someterán  á  restricción  alguna. 

Aet.  X\'II.  Las  mercancías  que  lleguen  por  tierra  ó  por  mar,  no  podrán  ser  retenidas 
en  las  fronteras  ni  en  los  puertos. 

Las  únicas  medidas  que  se  permitirá  prescribir  respecto  á  aquéllas,  quedan  especificadas 
en  el  Ai-tículo  XII. 

Sin  embargo,  si  las  mercancías  que  llegan  por  mar  á  granel  ("vrac")  ó  en  embalajes 
defectuosos  han  sido,  durante  la  travesía,  contaminadas  por  ratas  que  se  reconozcan  como 
apestadas,  y  si  no  pueden  aquéllas  ser  desinfectadas,  la  destrucción  de  los  gérmenes  puede 
asegurarse  depositando  las  mercancías  por  el  tiempo  que  determine  la  autoridad  sanitaria 
en  el  puerto  de  Uegada. 

Se  entiende  que  la  aplicación  de  esta  última  medida  no  deberá  traer  consigo  ni  detención 
para  la  nave,  ni  gastos  extraordinarios  que  resulten  de  la  falta  de  ahnac  -nes  en  los  puertos. 

Art.  XVIII.  Cuando  las  mercancías  han  sido  desinfectadas,  por  aplicación  de  las  pres- 
cripciones del  Artículo  XII  ó  puestas  en  depósito  temporal,  en  virtud  del  párrafo  tercero 
del  Articulo  XVII,  el  propietario  ó  su  representante  tiene  el  derecho  de  reclamar  de  la 
autoridad  sanitaria  que  ha  ordenado  la  desinfección  ó  el  depósito,  un  certificado  que  indique 
las  medidas  tomadas. 

Art.  XIX.  Equipajes.  La  desinfección  de  la  ropa  sucia,  vestidos  y  objetos  que  hacen 
parte  de  equipaje  ó  de  mobiliario  (artículos  de  instalación)  que  provengan  de  una  circun- 
scripción territorial  declarada  contaminada,  no  se  hará  efectiva  sino  en  los  casos  en  que  la 
autoridad  sanitaria  los  considere  como  contaminados. 

No  habrá  desinfección  de  equipajes  cuando  se  trata  de  fiebre  amarilla. 

Sección  tercera. — Medidas  en  los  puertos  y  en  las  fronteras  de  mar. 

Art.  XX.  Clasificación  de  los  buques.  Se  considera  como  infectado  el  buque  que  tenga 
la  peste,  el  cólera  ó  la  fiebre  amarilla  á  bordo  ó  que  haj^a  presentado  uno  ó  más  casos  de 
cólera,  ó  de  peste  á  bordo,  durante  los  últimos  siete  días,  y  en  caso  de  fiebre  amarilla,  uno 
ó  más  casos  durante  la  travesía. 

Se  considera  como  sospechosa  la  nave  á  bordo  de  la  cual  ha  habido  casos  de  peste  ó  de 
cólera  en  ti  momento  de  la  partida  ó  durante  la  travesía,  pero  en  la  cual  no  se  ha  declarado 
ningún  caso  nuevo  desde  hace  siete  días.  Serán  también  sospechosos,  tratándose  de  fiebre 
amarilla,  los  buques  que  hayan  permanecido  en  tal  proximidad  á  las  costas  infectadas,  que 
haya  hecho  posible  la  entrada  de  mosquitos  en  ellos. 

Se  considera  como  indemne,  aun  cuando  llegue  de  puerto  contaminado,  una  nave  que  no 
ha  tenido  ni  defunciones  ni  casos  de  peste,  de  cólera  ó  de  fiebre  amarilla  á  bordo,  sea  antes 
de  la  partida,  sea  durante  la  travesía  ó  en  el  momento  de  la  llegada,  y  que,  en  el  caso  de 
fiebre  amarilla,  no  se  haya  aproximado  á  la  costa  infectada  á  una  distancia  suficiente,  á 
juicio  de  las  autoridades  sanitarias,  para  recibir  mosquitos. 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  825 

Art.  XXI.  Los  buques  infectados  de  pente  so  somotfirán  al  régitruin  siguiente: 

(1)  Visita  médica  (inspoccii'm). 

(2)  Los  onl'cnnos  serán  (icseiribarcados  intncdiatainonto  y  aislados. 

(3)  Las  otras  personas  deben  s -r  igualnu^nte  d<!scin barcadas,  si  va  posible,  y  sometidas, 
á  contar  desde  la  llegada,  á  una  observación  a  fjuc  no  oxoxiderá  de  cinco  días. 

(4)  La  ropa  sucia,  los  (afectos  de  uso  y  los  objetos  de  la  tripulación  b  y  de  los  pasajeros 
que,  según  (^1  pan^cer  de  la  autoridad  sanitaria,  sean  considerados  como  contaminados, 
deben  ser  desinfectados. 

(5)  Las  partes  di-1  buque  que  han  sido  habitadas  por  apestados  ó  que,  según  el  parecer 
de  la  autoridad  sanitaria  se  consideran  como  contaminados,  deben  ser  desinfectados. 

(6)  La  destrucción  de  las  ratas  del  buque  debe  efectuarse,  antes  ó  después  de  la  di-scarga, 
lo  más  rápidamente  posible,  y,  (^n  todo  caso,  en  un  plazo  máximo  de  48  horas,  evitando 
deteriorar  las  mercancías,  el  buque  ó  las  máquinas. 

Para  los  buques  en  lastre,  esta  operación  debe  hacerse  lo  más  pronto  posible  antes  de  la 

carga.  •    v      i 

Art.  XXII.  Los  buques  sospechosos  de  peste  sa  someterán  á  las  medidas  indicadas  en  los 
números  1,  4  y  5  del  Art.  XXL 

Además,  la  tripulación  y  los  pasajeros  pueden  ser  sometidos  á  una  observación  que  no 
excederá  de  cinco  días,  á  partir  di;  la  llegada  del  buque.  Se  puede,  durante  el  mismo 
tiempo,  impedir  el  desembarque  de  la  tripulación,  siempre  que  no  lo  exija  el  servicio.  Se 
recomienda  dcstmir  las  ratas  del  buque.  Esta  operación  se  efectuará  antes  ó  después  de 
la  descarga,  lo  más  rápidamente  posible,  y  en  todo  caso,  en  una  dilación  máxima  de 
cuarenta  y  ocho  horas,  evitando  deteriorar  las  mercancías,  el  buque  ó  las  máquinas. 

Para  los  buques  en  lastre  esta  operación  se  hará,  si  hay  lugar,  lo  más  pronto  posible,  y  en 
todo  caso  antes  de  la  carga. 

Art.  XXIII.  Las  naves  indemnes  de  peste  serán  admitidas  á  libre  plática  inmediatamente, 
cualquiera  que  sea  la  naturaleza  de  su  patente. 

El  único  régimen  que  puede  establecer  la  autoridad  sanitaria  del  puerto  de  llegada, 
consiste  en: 

(1)  Visita  médica  (inspección). 

(2)  Desinfección  de  la  ropa  sucia,  efectos  de  uso  y  otros  objetos  de  la  tripulación  y  de  los 
pasajeros,  pero  solamente  en  los  casos  excepcionales,  cuando  la  autoridad  sanitaria  tenga 
razones  especiales  para  creer  en  su  contaminación. 

(3)  Sin  que  la  medida  pueda  ser  exigida  como  regla  general,  la  autoridad  sanitaria  puede 
someter  á  los  buques  que  lleguen  de  un  puerto  contaminado,  á  una  operación  destinada  á 
destruir  las  ratas  de  á  bordo  antes  ó  después  de  la  descarga.  Esta  operación  deberá  hacerse 
tan  pronto  como  sea  posible,  y  en  todo  caso  no  deberá  durar  más  de  veinticuatro  horas, 
evitando  deteriorar  las  mercancías,  el  buque  ó  las  máquinas,  y  estorbar  la  circulación  de  los 
pasajeros,  ó  la  tripulación  entre  el  buque  y  la  costa.  Para  los  buques  en  lastre  se  pro- 
cederá, si  hay  lugar,  á  esta  operación  lo  más  pronto  posible  y,  en  todo  caso,  antes  de  la  carga. 

Cuando  un  buque  procedente  de  un  puerto  contaminado  haya  sido  sometido  á  la  destruc- 
ción de  las  ratas,  esta  operación  no  podrá  ser  renovada  sino  cuando  el  buque  ha  hecho  escala 
en  un  puerto  contaminado,  amarrándose  á  un  muelle,  ó  si  la  presencia  de  las  ratas  muertas  ó 
enfermas  se  ha  comprobado  á  bordo. 

La  tripulación  y  los  pasajeros  pueden  ser  sometidos  á  una  vigilancia  que  no  excederá  de 
cinco  días,  á  contar  de  la  fecha  en  que  el  buque  salió  del  puerto  contaminado. 

Se  puede  igualmente  durante  el  mismo  tiempo  impedir  el  desembarque  de  la  tripulación, 
excepto  por  causa  del  servicio.     . 

La  autoridad  competente  del  puerto  de  llegada  puede  siempre  reclamar,  bajo  juramento, 
un  certificado  del  médico  de  á  bordo  ó,  en  su  defecto,  del  capitán,  que  atestigüe  que  no  ha 
habido  caso  de  peste  en  la  nave  desde  su  partida,  y  que  no  se  ha  observado  mortalidad 
insólita  de  ratas. 

Art.  XXrV.  Cuando  en  una  nave  indemne,  después  de  examen  bacteriológico,  se  ha 
averiguado  que  hay  á  bordo  ratas  apestadas,  ó  bien  cuando  se  comprueba  una  mortalidad 
insólita  en  estos  roedores,  habrá  que  aplicar  las  siguientes  medidas: 

1.  Naves  con  ratas  apestadas: 

(a)  Visita  médica  (inspección). 

(h)  Las  ratas  deberán  ser  destruidas  antes  ó  después  de  la  descarga,  lo  más  rápidamente 
posible  y,  en  todo  caso,  en  un  plazo  máximo  de  48  horas,  evitando  deteriorar  las  mercancías, 
los  buques  ó  las  máquinas.  Los  buques  en  lastre  sufrirán  esta  operación  lo  más  pronto 
posible  y,  en  todo  caso,  antes  de  hacer  la  carga. 

a  La  palabra  "observación"  significa  aislamiento  de  los  viajeros  á  bordo  de  un  buque  ó 
en  una  estación  sanitaria,  antes  de  ponerlos  á  libre  plática. 

bLa  palabra  "tripulación"  se  aphca  á  las  personas  que  hacen  parte  de  la  dotación  del 
buque  ó  del  personal  del  servicio,  comprendiendo  los  mayordomos,  criados,  "cafedji."  etc. 


826  SEGUNDA    COXFEEENCTA    SANITARIA    INTERNACIONAL. 

(c)  Las  partes  del  buque  y  los  objetos  que  la  autoridad  sanitaria  loca]  coiísidere  conta- 
minados serán  desinfectados. 

(f/)  Los  pasajeros  3'  tripulación  pueden  ser  sometidos  á  una  observación  que  jio  exceda 
de  cinco  días,  contados  desde  la  l'eciía  de  llegada,  salvo  en  casos  excepcionales  en  los  que  la 
autoridad  sanitaria  puede  prolonpir  la  observación  hasta  un  máximum  de  diez  días. 

2.  Buques  en  donde  se  ha  comprobado  una  mortalidad  insólita  en  las  ratas: 

(a)  Visita  médica  (inspección). 

(6)  El  examen  de  las  ratas,  desde  el  punto  de  vista  de  la  peste,  que  se  hará  tan  pronto 
como  se  pueda.    - 

(c)  Si  la  destrucción  de  ratas  se  juzga  necesaria,  se  hará  en  las  condiciones  antes  indicadas, 
con  respecto  á  los  buques  con  ratas  apestadas. 

(d)  Hasta  que  toda  sospecha  se  haya  disipado,  los  pasajeros  y  la  tripulación  pueden  ser 
sometidos  á  una  observación  c|ue  no  exceda  de  cinco  días,  contados  á  partir  de  la  fecha  de 
llegada,  salvo  en  casos  excepcionales  en  los  que  la  autoridad  sanitaria  puede  prolongar  la 
observación  hasta  un  máximum  de  10  días. 

Art.  XXV.  La  autoridad  sanitaria  del  puerto  entregará  al  capitán,  al  armador  ó  á  su 
agente,  siempre  cjue  se  le  pida,  un  certificado  en  el  que  conste  que  las  medidas  de  destrucción 
de  las  ratas  han  sido  efectuadas  y  que  indique  las  razones  por  las  cuales  estas  medidas  han 
sido  aplicadas. 

Art.  XXVI.  Los  buques  infectados  de  cólera  se  someterán  al  siguiente  régimen: 

(!)  Visita  médica  (inspección). 

(2)  Los  enfermos  se  desembacarán  y  aislarán  inmediatamente. 

(3)  Las  otras  personas  se  desembarcarán  también  si  es  posible,  y  se  someterán,  desde  la 
llegada  del  buque,  á  una  observación  cuya  duración  no  excederá  de  cinco  días. 

(4)  La  ropa  sucia,  los  efectos  de  uso  y  los  objetos  de  los  tripulantes  y  de  los  pasajeros  que, 
confonne  al  parecer  de  la  autoridad  sanitaria  del  puerto,  se  consideren  como  contaminados, 
serán  desinfectados.  ^ 

(5)  Las  partes  del  buque  que  han  sido  habitadas  por  los  enfermos  de. cólera  ó  que  las 
autoridades  del  puerto  consideren  como  contaminadas,  serán  desinfectadas. 

(6)  El  agua  de  la  cala  será  evacuada  después  de  la  desirJeccion. 

La  autoridad  sanitaria  puede  ordenar  la  substitución  de  una  buena  agua  potable  á  la  que 
está  almacenada  á  bordo. 

Se  prohibirá  derramar  las  deyecciones  humanas  ó  dejarlas  escurrir  en  las  aguas  del 
puerto,  á  menos  de  que  aquéllas  sean  desÍTifecíadas  previamente. 

Art.  XXVII.  Los  buques  sospechosos  de  cólera  serán  sometidos  á  las  medidas  prescritas 
en  los  incisos  (1),  (4),  (5)  y  (6)  del  Art.  XXVI. 

La  tripulación  y  los  pasajeros  pueden  ser  sometidos  á  uia  observación  que  no  excederá 
de  5  días  después  de  la  llegada  del  buque.  Se  recomienda  impedir,  durante  el  mismo 
tiempo,  el  desembarque  de  los  tripulantes,  salvo  por  razo"xes  del  servicio. 

Art.  XXVIII.  Los  buques  indemnes  de  cólera  serán  admitidos  á  libre  plática  imuediata- 
mente,  cualquiera  que  sea  la  naturaleza  de  su  patente. 

El  único  régimen  que  puede  establecer  la  autoridad  sanitaria  del  puerto  de  llegada,  con- 
sistirá en  las  medidas  indicadas  en  los  números  (1),  (4),  y  (6)  del  Art.  XXVI. 

La  tripulación  y  los  pasajeros  pueden  ser  sometidos,  desde  el  punto  de  vista  del  estado 
de  salud,  á  una  observación  que  no  excederá  de  cinco  días  contados  desde  la  fecha  en  que 
el  buque  salió  del  puerto  contaminado. 

Es  de  recomendarse  que  se  impida,  durante  el  mismo  espacio  de  tiempo,  el  desembarque 
de  la  tripulación,  salvo  por  razones  del  servicio. 

La  autoridad  competente  del  puerto  de  llegada  puede  siempre  reclamar,  bajo  juramento, 
un  certificado  del  médico  de  á  bordo  ó,  en  su  defecto,  del  capitán,  en  el  que  se  haga  constar 
que  no  ha  habido  caso  de  cólera  en  el  buque  después  de  su  partida. 

Art.  XXIX.  La  autoridad  competente  tendrá  en  cuenta,  para  la  aplicación  de  las 
medidas  indicadas  en  los  artículos  del  XXI  al  XXVIII,  la  presencia  de  un  médico  y  de 
aparatos  de  desinfección  (estufas)  á  bordo  de  los  buques  de  las  tres  clases  arriba  mencio- 
nadas. 

En  lo  que  se  refiere  á  la  peste,  tendrá  también  en  cuenta  la  instalación  á  bordo  de  aparatos 
destinados  á  la  destrucción  de  las  ratas. 

Las  autoridades  sanitarias  de  los  países  á  los  cuales  convenga  entenderse  sobre  este 
punto,  podrán  dispensar  de  la  visita  médica  y  de  otras  medidas  á  las  naves  indemnes  que 
tuvieren  á  bordo  un  médico  especialmente  comisionado  por  su  país. 

Art.  XXX.  Pueden  prescribirse  medidas  especiales  para  los  buques  en  que  haya  aglo- 
meración, particularmente  para  las  naves  de  emigrantes  ó  para  cualquier  otro  buque  que 
ofrezca  malas  condiciones  higiénicas. 

Art.  XXXI.  Toda  nave  que  no  quiera  someterse  á  las  obligaciones  impuestas  por  la 
autoridad  del  puerto  en  virtud  de  las  estipulaciones  de  la  presente  Convención,  queda  en 
libertad  de  volverse  á  la  mar. 


SEGUNDA    CONFEBENCÍA    SANITAKIA    INTERNACIONAL.  327 

Puede  ser  autorizada  á  desembarcar  sus  mercancías  después  de  haber  tomado  las  siguientes 
precauciones : 

(1)  Aislamiento  del  buque,  de  la  tripulación  y  do  los  pasajeros. 

(2)  En  lo  que  concierne  á  la  peste,  pedir  informaciones  relativas  ó,  la  existencia  de  una 
mortalidad  insólita  entre  las  ratas. 

(3)  En  lo  que  concierne  al  cólera,  hacer  la  evacuación  del  agua  de  la  cala,  después  de  su 
desinfección,  y  substitución  de  una  buena  agua  potable  á  la  que  esté  almacenada  á  bordo. 

Puede  iguaimente  ser  autorizada  á  desembarcar  á  ios  pasajeros  nuo  lo  soliciten,  á  con- 
dición de  que  éstos  se  sujeten  á  las  medidas  prescritas  por  la  autoridad  local. 

Akt.  XXXÍI.  Las  naves  de  ima  procedencia  contaminada,  que  han  sido  desinfectada.s  y 
que  han  sido  objeto  de  medidas  sanitarias  aplicadas  de  una  manera  suficiente,  no  sufráren 
una  segunda  vez  estas  medidas  á  su  llegada  íi  un  puerto  nuevo,  á  condición  de  que  no  si 
haya  producido  ningún  caso  después  que  se  practicó  la  desinfección  y  que  no  hayan  hecho 
escala  en  un  puerto  contaminado. 

Cuando  uu  buque  desembarque  solamente  pasajeros  y  sus  equipajes  6  las  valijas  del 
coireo,  sin  haber  estado  en  comunicación  con  la  costa,  no  debe  considerársele  como  habiendo 
tocado  el  puerto ;  y. 

En  el  caso  de  fiebre  amarilla,  cuando  no  se  haya  aproximado  suficientemente  á  la  costa 
para  recibir  mosquitos  á  bordo. 

Akt.  XXXIII.  Los  pasajeros  llegados  en  una  nave  infectada,  tienen  la  facultad  de 
reclamar  de  la  autoridad  sanitaria  del  puerto  un  certificado  que  indique  la  fecha  de  su 
llegada  y  las  medidas  á  las  cuales  han  sido  sometidos  ellos  y  sus  equipajes. 

Art.  XXXIV.  Los  vapores  correos  serán  objeto  de  un  régimen  especial  que  se  establecerá 
de  común  acuerdo  entre  los  países  interesados. 

Art.  XXXV.  Sin  perjuicio  del  derecho  que  tienen  los  Gobiernos  de  ponerse  de  acuerdo 
para  organizar  estaciones  sanitarias  comvmes,  cada  país  debe  proveer  lo  menos  uno  de  los 
puertos  del  litoral  de  cada  uno  de  sus  mares,  de  una  instalación  y  de  materiales  suficientes 
para  recibir  una  nave,  cualquiera  que  sea  su  estado  sanitario. 

Cuando  un  buque  indemne  procedente  de  un  puerto  contaminado  llegue  á  un  gran  puerto 
de  navegación  marítima,  se  recomienda  no  enviarlo  á  otro  puerto  con  el  objeto  de  que  se 
someta  á  las  medidas  sanitarias  prescritas. 

En  cada  país,  los  puertos  abiertos  á  las  procedencias  de  otros  contaminados  de  peste, 
de  cólera  ó  de  fiebre  amarilla,  deben  estar  provistos  de  tal  manera,  que  los  buques  indemnes 
puedan  sufrir  allí,  desde  su  llegada,  las  medidas  prescritas  y  no  sean  remitidos  para  este 
efecto  á  otro  puerto. 

Los  Gobiernos  harán  conocer  los  puertos  que  hayan  abierto  á  las  procedencias  de  otros 
infectados  de  peste,  de  cólera  ó  de  fiebre  amarilla. 

Art.  XXXVI.  Se  recomienda  que  en  los  grandes  puertos  de  navegación  marítima  se 
establezca : 

(a)  Un  servicio  médico  regular  y  una  vigilancia  médica  permanente  del  estado  sanitario 
de  las  tripulaciones  y  de  la  población  del  puerto ; 

(6)  Locales  apropiados  al  aislamiento  de  los  enfermos  y  á  la  observación  de  las  personas 
sospechosas.     En  los  lugares  en  donde  existe  stegomyia  fasciata,  deberá  haber  edificios  6 

Í)arte  de  ellos  que  tengan  las  puertas  y  ventanas  protejidas  por  mallas  de  alambre,  una 
ancha  y  una  ambulancia  protejidas  de  la  misma  manera; 

(c)  Las  instalaciones  necesarias  para  una  desinfección  eficaz  y  laboratorios  bacteriológicos ; 

(d)  Un  servicio  de  agua  potable,  no  sospechoso  para  el  uso  del  puerto,  y  la  aplicación 
de  un  sistema  que  presente  toda  la  seguridad  posible  para  la  extracción  de  los  desechos  y 
basuras. 

Sección  cuarta. — Medidas    en    las  fronteras    terrestres — Viajeros — Ferrocarriles — Zonas 

fronterizas — Vias  fluviales. 

Art.  XXXVII.  jSIo  se  deben  establecer  cuarentenas  terrestres,  pero  los  Gobiernos  se 
reservan  el  derecho  de  establecer  campamentos  de  observación,  si  los  consideran  necesarios, 
para  la  detención  temporal  de  los  sospechosos. 

Este  principio  no  excluye  el  derecho  de  cada  país  de  cerrar,  cuando  lo  necesite,  ima  parte 
de  sus  fronteras. 

Art.  XXXVIII.  Es  importante  que  los  viajeros  sean  sometidos,  desde  el  punto  de  vista 
de  su  estado  de  salud,  á  ima  vigilancia  por  parte  del  personal  de  los  fenocarriles. 

Art.  XXXIX.  La  intervención  médica  se  limitará  á  una  visita  á  los  pasajeros,  tomán- 
doles la  temperatura,  y  á  los  cuidados  que  se  han  de  dar  á  los  enfermos.  Si  esta  visita 
■se  hace,  se  combinará  hasta  donde  fuere  posible  con  la  visita  aduanera,  de  modo  que  los 
viajeros  sean  detenidos  el  menor  tiempo  posible.  Las  personas  visiblemente  enfermas 
serán  las  únicas  que  se  someterán  á  un  examen  médico  completo. 


328  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL, 

Art.  XL.  Cuando  los  viajeros  procedentes  de  un  lugar  contaminado  han  llegado  á  su 
destino,  sería  de  la  mayor  utilidad  someterlos  á  una  vigilancia  que  no  exceda  diez  ó  cinco 
días  á  contar  de  la  fecha  de  partida,  según  que  se  trate  respectivamente  de  peste  ó  de  cólera, 
y  de  seis  días  en  caso  do  fiebre  amarilla. 

Art.  XLI.  Los  Gobiernos  se  reservan  el  derecho  de  tomar  medidas  particulares  en  rela- 
ción con  determinadas  categorías  de  personas,  particularmente  con  los  vagabundos,  los 
emigrantes  ó  los  que  atraviesan  la  frontera  en  grandes  grupos  ó  en  bandas. 

Ámt.  XLIL  Los  coches  que  hacen  el  transporte  de  pasajeros,  del  coitco  y  de  equipajes,  no 
pueden  ser  detenidos  en  las  ñ-onteras.  A  fin  de  que  los  coches  que  transportan  los  viajeros 
y  el  correo  no  puedan  ser  detenidos,  se  hará  que  los  coches  que  llegan  de  la  circunscripción 
infectada  se  detengan  en  la  frontera  y  que  los  pasajeros  se  trasborden  á  los  coches  que  lleguen 
á  la  frontera  del  otro  lado. 

Si  sucediera  que  uno  de  esos  coches  se  hubiere  contaminado  ó  hubiere  sido  ocupado  por 
un  enfermo  atacado  de  peste,  de  cólera  ó  de  fiebre  amarilla,  sei'á  desprendido  del  tren  para 
ser  disinfectado  lo  más  pi'onto  posible. 

Art.  XLIIL  Las  medidas  concernientes  al  paso  por  las  fronteras  del  personal  de  los 
ferrocarriles  y  del  correo,  son  de  la  competencia  de  las  autoridades  sanitarias  interesadas. 
Se  combinarán  de  modo  de  no  estorbar  el  servicio. 

Art.  XLIV.  La  reglamentación  del  tráfico  fronterizo  y  de  las  cuestiones  inherentes  á  este 
tráfico,  así  como  la  adopción  de  medidas  excepcionales  de  vigilancia,  deberán  sujetarse  á 
arreglos  especiales  entre  las  naciones  limítrofes. 

Art.  XLV.  Corresponde  á  los  Gobiernos  do  los  países  ribereños  arreglar  por  medio  de 
acuerdos  especiales  el  régimen  sanitario  de  las  vías  fluviales. 

ARTÍCULOS  REFERENTES  Á  LA  FIEBRE  AMARILLA. 

Art.  XL VI.  Con  respecto  á  los  buques  infectados  de  fiebre  amarilla,  se  adoptará  el  régimen 
siguiente: 

1.  Visita  médica  (inspección). 

2.  Los  enfermos  serán  desembarcados  inmediatamente  en  ima  lancha  protegida  contra 
los  moscjuitos  por  tela  de  alambre,  y  conducidos  al  lugar  de  aislamiento  en  una  ambulancia  ó 
camilla  igualmente  protegida  contra  los  mosquitos. 

3.  Las  demás  personas  deben  ser  también  desembarcadas,  si  es  posible,  y  sometidas  á  una 
observación  do  seis  días,  á  contar  desde  el  de  la  llegada. 

4.  En  los  campamentos  de  observación  habrá  casetas  ó  jaulas  alambradas  donde  se 
recluriá  inmediamente  á  toda  persona  que  presente  una  temperatura  superior  á  37.6°  C, 
hasta  que  se  le  pueda  conducir  en  la  ambulancia  ó  camilla  ad  hocal  lugar  de  aislamiento. 

5.  El  buque  deberá  anclar  á  una  distancia  de  doscientos  metros,  por  lo  menos,  de  tierra 
habitada. 

6.  Siempre  que  sea  posible  se  fumigará  el  buque  contra  los  mosquitos,  antes  de  la  des- 
carga, pero  si  la  fumigación  no  fuese  practicable,  la  autoridad  sanitaria  podi'á  disponer  uno 
de  estos  dos  medios,  á  saber: 

(a)  El  empleo  para  la  descarga  de  un  personal  inmune,  ó  (b),  si  esto  fuese  imposible,  se 
sujetará  á  observación  el  personal  de  descarga  durante  el  tiempo  de  ésta  y  por  seis  días  más  á 
contar  desde  el  último  de  exposición  á  bordo. 

Art.  XL  VIL  Los  buques  sospechosos  de  fiebre  amarilla  serán  sometidos  á  las  medidas 
indicadas  en  los  incisos  1 ,  3  y  5  del  artículo  anterior,  y  cuando  no  sean  fumigados,  se  descar- 
garán mediante  los  requisitos  señalados  en  el  párrafo  (a)  6  (h)  de  dicho  artículo. 

Art.  XL VIII.  Los  buques  indemnes  de  fiebre  amarilla,  procedentes  de  puertos  infectados, 
serán  puestos  en  libre  plática  después  de  la  visita  médica  de  inspección,  si  el  viaje  ha  durado 
más  de  seis  días.  Si  éste  ha  sido  más  corto,  se  tratará  al  barco  como  sospechoso  hasta  que  se 
complete  el  período  de  seis  días,  á  contar  desde  el  de  la  partida. 

Si  se  presentare  un  caso  de  fiebre  amarilla  entre  los  pasajeros  ó  tripulantes  durante  el 
período  de  observación,  se  tratará  al  buque  como  infectado. 

Art.  XLIX.  Se  permitirá  inmediatamente  el  desembarco  de  todo  individuo  que  demues- 
tre ser  inmune  á  la  fiebre  amarilla,  á  satisfacción  de  la  autoridad  sanitaria  del  puerto  de 
arribo. 

Art.  L.  Se  estipula  que  en  caso  de  dudas  para  interpretar  esta  Convención  prevalecerá 
la  interpretación  del  texto  inglés. 

DISPOSICIÓN  TRANSITORIA. 

Los  Gobiernos  que  no  han  firmado  la  presente  Convención  pueden  adheiirse  á  ella,  si  así 
lo  desean,  dirigiéndose  por  la  vía  diplomática  al  Gobierno  de  los  Estados  Unidos  de  América, 
á  fin  de  que  éste  lo  comunique  á  los  demás  Poderes  firmantes. 

Hecha  y  firmada  en  la  Ciudad  de  Washington,  el  día  catorce  de  octubre  de  mil  novecientos 
cinco,  en  dos  ejemplares  en  español  y  en  inglés,  respectivamente,  que  se  depositarán  en  el 


SEGUNDA    GONFEllENCIA    SANITARIA    INTEKNACH^NAL.  íj2\) 

Departamento  do  Estado  del  Gobierno  de  los  Estados  Unidos  de  Anif'Tica,  con  el  prof/tsito  de 
que  se  remitan  por  Ja  vía  diplomática  copias  en  ambos  idiomas  ¿  cada  uno  de  los  países 
signatarios. 

'  Dr.  Eduardo  Moobe. 

Juan  J.  Vlíx)a. 

Juan  (íuitkkah. 

E.  B.  ííaknict. 

Emilio  C.  Jouüekt. 

M.  li.  Al<  ÍVAR. 

Waltku  Wyman. 
H.  D.  Gkudingb. 
John  S.  I'^ulton. 
'  VValtkk  D.  íMcCaw. 

J.  D.  Gatiíwoou. 
H.  L.  E.  JoiiNW>N,  M.  D. 
Joaquín  Yela. 

E.  LiCÉAGA. 

J.  L.  Medina,  M.  D. 
Daniel  Edo.  Lavorekía. 

N.  Veloz-Goiticoa. 


MEMORIA  LEÍDA  POR  EL  DOCTOR  E.  LICiÉAGA,  DE  ACUERDO  CON 
EL  PROGRAMA  CIENTÍFICO. 

Señores:  Permitidme  que  antes  de  que  vuestra  atención  se  ocupe  de  los  asuntos  que 
hacen  el  objeto  del  prograrña  científico  la  dirija  por  unos  momentos  hacia  otro  punto  que 
nos  interesa  como  cuestión  preliminar  ahora,  pero  que  será  después  la  cuestión  capitai. 

Esta  cuestión,  señores,  es  la  que  se  refiere  al  objeto  primordial  de  nuestra  reunión;  y 
para  plantearla  convenientemente,  espero  que  me  concedáis  la  licencia  de  que  os  recuerde 
sus  antecedentes. 

Durante  los  últimos  meses  del  año  de  1901  y  primer  mes  de  1902  se  reunió  en  México  la 
Segunda  Conferencia  Internacional  Americana,  á  la  cual  concurrieron  representantes  de 
diecisiete  de  las  Kepúblicas  del  Hemisferio  Occidental,  competentemente  autorizadas  para 
promover  todo  aquello  que  pudiera  aumentar  el  bienestar  moral  y  material  de  los  pueblos 
respectivos. 

En  virtud  de  sus  plenos  poderes,  esos  delegados  aceptaron  y  firmaron  en  29  de  enero  de 
1902  unas  resoluciones  sobre  "  Policía  sanitaria  internacional,"  cuyo  contenido  os  pido 
permiso  de  extractar. 

La  primera  de  esas  resoluciones  propone:  Que  todas  las  medidas  sobre  policía  sanitaria 
internacional  queden  bajo  la  dependencia  de  los  Gobiernos  nacionales. 

La  segunda  pide:  Que  la  detención  que  se  exija  á  los  barcos,  en  los  puertos,  sea  de  dos 
clases,  una  de  observación  é  inspección  y  otra  de  desinfección. 

La  tercera  cláusula  tiene  por  objeto:  Suprimir  la  cuarentena  sobre  las  mercancías  y 
artículos  manufacturados  que  no  han  tenido  ocasión  de  contaminarse  á  su  paso  por  un  país 
infectado, 

La  cláusula  cuarta  propone:  Que  los  Gobiernos  presten  su  cooperación  á  las  autoridades 
provinciales  ó  municipales,  con  el  objeto  de  que  mejoren  las  condiciones  sanitarias  de  los 
lugares  que  lo  necesiten;  esa  cláusula  pide,  además,  que  se  haga  obligatoria  la  declaración 
de  las  enfermedades  infecciosas  de  un  país  á  otro. 

La  quinta  cláusula  me  permito  transcribirla  íntegra,  porque  es  la  que  se  refiere  directa- 
mente al  objeto  de  nuestra  Convención.     Dice  así: 

"V.  La  Segunda  Conferencia  Internacional  Americana  recomienda  igualmente,  en 
beneficio  de  todas  las  Repúblicas  Americanas,  y  á  fin  de  que  estas  cooperen  pronta  y 
eficazmente  en  todo  lo  relativo  á  las  materias  mencionades  en  las  anteriores  resoluciones: 
Que  se  convoque  por  el  consejo  directivo  de  la  Unión  de  dichas  Repúblicas,  la  reunión  en 
Washington,  D.  C,  de  una  convención  general  de  representantes  de  las  oficinas  de  salu- 
bridad de  dichas  Repúblicas,  dentro  de  un  año  contado  desde  la  fecha  en  que  la  Conferencia 
adopte  estas  resoluciones;  que  cada  uno  de  los  Gobiernos  representados  en  esta  Conferencia 
designe  uno  ó  más  delegados  para  que  asistan  á  dicha  Convención,  confiLriéndole  las  facul- 
tades necesarias,  á  fin  de  que,  en  unión  de  los  delegados  de  las  demás  Repúblicas,  celebren 
los  convenios  sanitarios  y  formulen  los  reglamentos  que  á  juicio  de  la  misma  Convención 
fueren  más  benéficos  á  los  intereses  de  todos  los  países  que  en  ella  estén  representados:  que 
los  votos  de  dicha  Convención  sean  computados  por  Repúblicas,  teniendo  cada  una  de  ellas 
un  voto;  que  la  Convención  adopte  las  medidas  más  convenientes  con  el  objeto  de  que,  en 
lo  sucesivo,  se  reúnan  otras  convenciones  sanitarias,  en  la  fecha  y  en  los  lugares  que  se 


330  SEGUNDA    CONFERENCIA    SANITAEIA    INTERNACIONAL. 

juzgue  más  adecuados ;  y,  por  último,  que  se  nombre  un  consejo  ejecutivo  de  cinco  miembros, 
por  lo  menos,  que  funcione  hasta  que  se  congre^e  la  siguiente  convención,  renovándose, 
entonces,  el  pci-sonal  del  consejo  con  un  presidente,  que  será  electo  en  escrutinio  secreto  por 
la  misma  convención.  Dicho  consejo  se  denominará  "Oficina  Sanitaria  Internacional," 
y  residirá  en  Washington,  D.  C." 

Señores,  permitidme  que  llame  vuestra  atención  sobre  estos  hechos: 

1".  Conforme  á  cláusula  que  acabo  de  leer,  se  reunió  la  Primera  Convención  Sanitaria 
Internacional  del  2  al  5  de  cliciembre  de  1902. 

2°.  De  conformidad  con  ella  se  fijó  una  nueva  reunión  para  Santiago  de  Chile,  en  abril 
de  1904. 

3°.  En  obedecimiento  de  la  misma  se  nombró  un  consejo  ejecutivo,  que  funcione  perma- 
nentemente entre  una  convención  y  la  siguiente. 

4".  Este  consejo  ejecutivo,  que  se  denominó  "Oficina  Sanitaria  Insernacional, "  resolvió 
que  la  Convención  que  no  pudo  reunirse  en  Santiago  de  Chile  en  abril  de  1904  se  reuniera 
en  9  de  octubre  de  1905  en  Washington,  D.  C. 

5".  Por  último:  Esta  misma  Oficina  Sanitaria  International  nos  ha  dado  cita  en  esta 
capital  y  en  virtud  de  esa  cita  estamos  aquí  reundios. 

Señores,  todos  los  hechos  que  acabo  de  citar  y  nuestra  presencia  aquí  prueban  hasta  la 
evidencia  que  están  en  vigor  las  resoluciones  que  fuinaron  en  29  de  enero  de  1902  los  repre- 
sentantes de  las  Repúblicas  aquí  representadas. 

Estos  hechos  demuestran  igualmente,  señores  delegados,  que  se  ha  cumplido  con  la 
mayor  parte  de  las  prevenciones  que  contiene  Tá  cláTisula  quinta,  pero  no  se  ha  complido  con 
la  principal,  lo  que  se  demuestra  por  el  hecho  de  no  haber  firmado  una  convención  en  1902. 
Y  digo  la  principal,  porque  esta  es  el  objeto  final,  el  definitivo;  y  por  lo  mismo  la  más 
importante  de  las  prevenciones,  la  que  literahnente  dice  asi:  .  .  .  "que  cada  uno  de  los 
Gobiernos  representados  en  esta  Conferencia  designe  uno  ó  mas  delegados  para  que  asistan 
á  dicha  Convención,  confiriéndoles  las  facultades  necesarias,  á  fin  de  que,  en  unión  de  los 
delegados  de  las  demás  Repúblicas,  celebren  los  convenios 'sanitarios  y  formulen  los 
reglamentos  que  á  juicio  de  la  misma  Convención  fueren  más  benéficos  á  los  intereses  de 
todos  los  países  que  en  ella  estén  representados;  y  con  esta  prevención  no  hemos  cumplido. 

Señores  delegados,  permitidme  que  os  pregunte  j  hay  en  todos  las  resoluciones  que  os 
he  transcrito  algún  precepto  más  concreto,  más  bien  definido,  más  claramente'  expresado? 
^Cabe  duda  de  que  él  contiene  el  objeto  final  de  la  Convención?  La  contestación  no  es 
dudosa.  Este  precepto  es  el  capital;  la  Convención  tiene  por  objeto  llevar  á  la  práctica 
todas  las  resoluciones  de  la  conferencia  reunida  en  México,  relativas  á  la  policía  sanitaria 
internacional,  pei'o  muy  especialmente  la  de  "celebrar  convenios  sanitarios  y  formular 
reglamentos  que  á  juicio  de  la  misma  convención  fueren  más  benéficos  á  los  intereses  de 
todos  los  países  que  en  ella  estén  representados." 

Señores,  jhemos  cumplido  con  este  precepto  capital  en  la  convención  de  1902?  No, 
evidentemente.  Pero  esto  se  explica.  Esa  convención  siendo  la  primera,  era  la  explora- 
dora de  las  intenciones  de  los  Gobiernos  que  aceptaron  concurrir  á  ella ;  estaba  destinada  á 
fijar  los  términos  de  los  problemas  científicos;  á  formularlos  claramente;  á  aprobarlos,  si 
esto  era  posible.  Todo  esto  se  hizo  en  esa  convención;  se  plantearon  los  problemas;  se 
formularon  netamente:  se  resolvieron  en  definitiva  los  que  eran  más  importantes.  Esto 
quiere  decir  que  la  reunión  preparatoria,  la  preliminar,  la  de  orden  científico  ya  está  termi- 
nada; que  de  esos  asuntos  se  ocupó  la  primera  convención.  Esa  cumplió  con  su  deber. 
Ya  pasó.  Señores,  penetrémonos  del  papel  que  estamos  llamados  á  desempeñar  en  la  Con- 
vención actual.  Ya  no  venimos  solamente  con  el  carácter  que  nos  da  nuestra  posición 
oficial  de  consejeros  técnicos  en  asuntos  de  higiene;  como  representantes  de  los  consejos 
sanitarios  venimos  ahora  en  nombre  de  nuestros  .Gobiernos,  provistos  de  los  datos  que 
la  ciencia  sanitaria  ha  alcanzado  hasta  el  momento  actual,  apoyados  en  la  experiencia  que 
cada  uno  de  nosotros  Jia  podido  adquirir  en  su  respectivo  país,  y  suficientemente  autorizados 
para  firmar  una  convención  sanitaria  entre  las  Repúblicas  queí  están  aqu  representadas. 

Esta  es  nuestra  misión;  á  esto  hemos  venido.  Hagamos,  señores,  desde  este  primer 
momento  el  compromiso  solemne  de  no  separarnos  antes  de  firmar  esos  convenios,  formular 
esos  reglamentos  de  que  habla  la  cláusula  quinta,  y  sólo  entonces  habremos  cumplido  con 
nuestro  deber. 

Pensad,  señores,  ¡en  la  responsabilidad  cjue  contraeremos  con  nuestros  respectivos 
Gobiernos,  si  volvemos  á  nuestros  hogares  sin  haber  desempeñado  la  comisión  que  se  nos 
ha  confiado! 

Vuelvo  á  pediros,  señores  delegados,  que  no  nos  separemos  sin  haber  firmado  una  con- 
vención sanitaria. 

Señores,  me  he  ocupado  exclusivamente  de  la  cuestión  legal  porque  esa  es  la  que  nos 
obliga.  De  intento  no  he  ciuerido  tratar  las  cuestiones  de  conveniencia  y  de  utilidad,  porque 
estas  son  indudables. 

Que  subsistieran  las  cuarentenas  en  los  tiempos  pasados,  se  concibe  y  se  explica  porque 
descansaban  solamente  en  un  conocimiento  práctico.     Este  conocimiento  práctico  es  que 


tíEGUJSlDA    CüWlfEKENíJJA    HANITAKJA    J NTEHNAClüNAI.,  831 

las  enferinedadoM  (spiclómicas  son  transtriitidaH  por  liw  hombres,  por  su.s  medios  de  trans- 
porte, por  suH  vestido;-)  de  uso  y  por  las  niorcanf.ías.  Este  es  el  hecho  bruto,  i)ero  es  el  que 
servía  para  dictar  las  medidas  de  ])recauci6ri.  Los  hoinbres  nos  traen  la  enfermedad;  pues 
detenf^amos  á  los  hombrcis.  Los  barcos  transportan  las  enfermedades;  detengamos  los 
barcos.  Las  mercancías  suelen  conducir  la  enfermedad;  impidamos  la  (jntrada  de  las 
mercancías.  Todos  estos  son  hechos  de  observación,  [¡ero  mal  ol)ScrvadoH.  ¿Durante 
cuánto  tiempo  detendremos  ¡x  los  iiombres  y  ó,  las  embarcaciones?  Al  j-csol  ver  esta  cuestión 
comeii/aba  la  diver;.i;onc,ia.  DivíUf^'cncia  que  tenia  por  base  la  obsei-vación  también,  pero 
incompleta,  de  los  luiciios  oljservados. 

Las  embircacioaes  so  detedan  siete  días,  diez  días,  veinte  días,  <;uarenta  días;  ¡dos  meses! 
como  se  hicin  en  Panaraíí  el  año  de  1892  cuando  amenazaba  el  cólera  que  había  invadido 
entonces  á  Espirla!  Poro  al  miedo  como  consejero  higiénico  comienza  á  substituir.se  la 
razón.  Ya  Inglaterra  observa  que  en  las  ciudades  saneadas  las  enfennodades  transmisi- 
bles no  se  hacen  epidémicas  y  sanea  sus  puertos  de  mar,  invirtiendo  en  ello  sumas  enormes; 
y  desde  entonces  separa  á  los  hombres  enfermos,  limpia  Lis  embarcaciones  y  las  deja  entrar. 
Vienen  luego  los  admirables,  los  trascendentales  descubrimientos  do  Pasteur  y  de  una  sola 
vez,  como  si  se  desgarrara  un  velo,  so  descubre  que  las  enfermedades  que  formaban  el  grupo 
de  las  transmisibles  dependían  de  causas  diferentes,  de  gérmenes  vivos.  Y  después  de  Pas- 
teur vienen  los  Koch,  los  Pfeiffer,  los  Roux,  los  Yersin,  los  Kitasato  y  nos  enseñan  que  uno 
es  el  germen  del  cólera  y  otro  el  de  la  tuberculosis  j  otro  el  de  la  difteria  y  otro  diferente  el 
de  la  peste  bubóiuca! 

Y  en  posesión  de  este  conocimiento,  esto  es,  de  que  los  gérmenes  de  esas  enfermedades 
son  seres  vivos,  se  averigua  el  lugar  que  ocupan  en  la  serie;  se  estudia  su  historia  natural 
en  donde  encuentran  sus  condiciones  para  vivir,  cómo  se  desarrollan,  qué  medios  f;>vorecen 
su  multiplicación  y  cuáles  son  los  desfavorables  y  en  cuáles  otros  su  vida  se  aniquila;  y  do 
este  conocimiento  detallado  é  individual  para  cada  germen,  de  cada  enfermedad,  se  sacan 
lógica,  necesarip.mente  los  medios  para  combatirla. 

Pero  hay  enfermedades  transmisibles,  mortíferas,  que  causan  la  ruina  de  comarcas  y 

})ueblos  enteros  y  cuyo  germen  ro  se  conoce  todavía.  Es  cierto,  pero  dtonces  aparecen 
os  finos,  los  delicados,  los  memorables  experimentos  de  Reed,  de  Carroll,  de  Agramonte, 
dando  forma,  color  y  vida  al  descubrimiento  hecho  por  el  genio  de  Finlay  y  descubren  ¿qué? 
¿el  germen  de  la  fiebre  amarilla?  No.  ¿Pues  qué  descubren?  Dascubren  el  modo  de  trans- 
mitirse la  enfermedad. 

Había  una  curiosidad  científica  sólo  conocida  de  los  naturalistas  y  era  esta:  Que  hay 
seres  vivos,  que  hay  organismos  que  para  completar  su  evolución,  para  alcp^nzar  los  fines  de 
su  vida,  necesitan  pasar  por  dos  organismos;  y  vienen  los  médicos  italianos  y  los  ingleses  á 
demostrar  que  la  plasmodia  descubierta  por  Laveran  en  la  sangre  de  los  palúdicos  es  uno 
de  esos  organismos  que  necesitan  pasar  por  otros  dos  seres  vivos  para  llegar  á  los  fines  de  su 
existencia;  y  que  de  esos  dos  seres  vivos  uno  es  el  hombre  y  el  otro  el  cueipo  de  un  mos- 
quito del  género  Anopheles;  y  de  una  vez  queda  confirmado  el  admirable  descubrimiento 
de  Laveran,  se  completa  la  etiología  de  la  malaria  y  se  conoce  su  modo  de  transmisión. 

Hé  aquí,  señores,  los  datos  que  la  ciencia  ha  puesto  á  nuestra  disposición  para  convertir 
en  científicas  las  medidas,  hasta  ahora  empíricas,  empleadas  para  defendemos  de  las  enfer- 
medades transmisibles. 

Después  de  saber  que  cada  enfermedad  de  las  que  el  hombre  puede  llevar  consigo  de  un 
punto  á  otro,  es  originada  por  un  germen  diferente  y  que  este  germen  tiene  condiciones 
diversas  de  existencia,  y  cuando  conocemos  al  agente  transmisor  de  la  peste,  al  de  la  mala- 
ria, al  de  la  fiebre  amarilla,  ¿podemos  detener  en  frente  de  un  puerto  al  buque  con  el 
hombre  que  trae  á  bordo  y  á  los  animales  que  quizas  siguen  produciendo  la  enfennedad  en  el 
buque?  Pero  analicemos  el  hecho  á  la  luz  de  los  conocimientos  actuales;  todo  el  buque  es 
peligroso?  todos  los  hombres  que  hay  en  el  buque  son  temibles?  todos  los  animales  que 
accidentalmente  lo  ocupan  son  ofensivos,  desde  el  punto  de  vista  de  la  transmisión  de  las 
enfermedades? 

Del  buque  no  es  peligrosa  sino  la  parte  que  estuvo  manchada  por  las  deyecciones  de  un 
colérico,  por  los  esputos  de  un  tuberculoso,  los  de  un  apestado;  no  es  peligi'oso  más  que  el 
lugar  donde  hay  ratas  infectadas  de  peste  ó  mosquitos  Anopheles  que  llevan  el  germen  de 
la  malaria  ó  Stegomyia  infectado  de  fiebre  amarilla.  Luego  si  está  en  nuestro  poder  desin- 
fectar el  lugar  del  buque  que  se  manchó  con  las  deyecciones  del  colérico,  con  los  esputos  del 
tuberculoso  ó  del  apestado;  si  nos  es  posible  destruir  las  ratas  y  ratones  enfermos  de  peste 
y  los  mosquitos  infectados  con  la  fiebre  amarilla  ó  que  llevan  el  gémien  de  la  malaria,  dirija- 
mos nuestra  acción  sobre  esos  lugares  ó  esos  animales ;  cambiemos  el  agua  de  la  sentina  que 
f)udiera  contener  larvas  de  los  insectos;  cubramos  los  depósitos  de  agua  potable  para  que 
os  mosquitos  no  puedan  poner  en  ellos  sus  huevos;  y  tan  pronto  como  estas  operaciones 
estén  hechas  dejemos  al  buque  libre;  ya  no  es  peligroso,  dejémosle  y  no  le  impongamos 
cuarentena  de  detención  porque  es  inútil;  y  si  es  inútil  para  nuestra  defensa  es  perjudicial 
á  los  intereses  del  comercio. 

Vamos  á  estudiar  la  cuestión  del  hombre,  del  temido  hombre  á  quien  se  imponía  cua- 
rentena. 


332  SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAL.. 

Desde  luego  no  todos  los  hombres  que  vienen  en  un  buque  están  enfermos.  Vamos  á 
inspeccionarlos  para  descubrir  á  los  que  estén  enfermos :  separémosles  de  los  demás  porque 
son  peligrosos  para  sus  inocentes  compañeros  de  á  bordo;  pero  hay  otros  que  sin  estar  segu- 
ramente atacados  de  tal  enfermedad  son  sospechosos  de  tenerla;  separémosles  igualmente 
y  tengámosles  en  obsers'ación ;  pero  fuera  del  buque.  Allí  serían  peligrosos  si  j^a  tienen  la 
enfermedad  y  serían  víctimas  si  no  la  tienen;  separémosles  pues.  La  inspección  nos  ha 
permitido  descubrir  que  los  demás  pasajeros  están  sanos,  pues  dejémosles  en  libertad. 
Mas  se  no$  dirá:  Algunos  de  estos  pisajeros  que  parecen  sanos  pueden  llevar  incubada  la 
euferraedad.  Sí,  es  verdad.  ¿Pero  sería  conve.iio;ite  dejarlos  en  ua  lugar  estrecho,  poco 
ventilado,  ei  los  cainarotes  y  donde  hay  acumulación?  ¿No  sería  mejor  sacarlos  y 
vijilarlos  afuera  del  buque  y  solarae.ite  por  el  númsro  de  días  que  dure  la  incubación  y 
en  un  lugar  especial  y  espacioso  en  donde  haya  un  personal  inteligente  que  los  vigile?  Pues 
hagámoslo  así;  paro  de  todos  modos  desocupemos  el  buque  para  que  se  desinfecte  de  los 
gérmenes  que  pueda  haber  en  su  suelo  y  de  los  mosquitos  infectados  que  pudiera  haber  en 
sus  techos. 

Si  pues  está  en  imestra  posibilidad  separar  y  aislar  á  los  enfermos  y  á  los  sospechosos  y 
vigilar  á  los  que  pueden  llevar  en  germen  la  enfermedad,  dejemos  libres  á  todos  los  otros 
que  ya  no  temerán  los  rigores  de  la  cuarentena  y  no  nos  engañarán  sobre  su  estado  de  salud, 
porque  ya  no  les  es  útil  engañarnos.  Desocupado  el  buque  ya  podemos  desinfectarlo  y  á. 
su  vez  dsjarlo  en  libertad. 

¿Cómo  ha  de  hacerse  la  inspección  de  tripulantes  y  pasajeros,  cómo  se  hará  la  desinfeccóin 
de  los  buques  á  propósito  de  cada  una  de  las  enfermedades  cuyo  germen  es  diferente  y 
cuyo  modo  de  transmisión  es  diverso?  Esto  lo  expliqué  detenidamente  en  el  discurso  que 
pronuncié  en  la  convención  anterior  y  propuse  una  serie  de  resoluciones  á  propósito  de  la 
fiebre  amarilla,  del  cólera  y  de  la  peste  y  otra  resolución  general  que  las  abarcaba  todas; 
resoluciones  que,  á  mi  juicio,  pueden  servir  de  base  á  una  discusión. 

Si  los  señores  delegados  lo  desean,  la  secretaría  de  la  Convención  podrá  dar  lectura  á  las 
resolucioaes  y  á  las  consideraciones  que  las  motivaran. 

¿Señores,  después  de  la  exposición  que  acabo  de  hacer  podrá  caber  duda  de  la  convenien- 
cia y  de  la  utilidad  de  suprimir  las  cuarentenas  como  se  hacía  hace  un  siglo  y  de  hacerlas 
como  lo  reclama  nuestro  estado  de  civilización,  como  lo  exijen  los  conocimientos  precisos 
sobre  tal  enfermedad;  como  nos  obligan  á  hacerlo  de  consuno  los  intereses  del  comercio  y 
de  la  libre  comunicación  de  los  hombres? 

Pero  hay  ideas,  señores,  ligadas  á  una  expresión,  á  un  vocablo,  que  mientras  exista  esa 
expresión,  ese  vocablo,  no  hay  modo  de  separarlo  de  la  idea  ó  concepción  á  la  cual  se  asoció 
hace  siglos. 

Señores,  hagamos  el  sacrificio  de  la  palabra  "cuarentena,"  borrémosla  de  nuestro  vocabu- 
lario actual  y  ya  no  nos  costará  trabajo  aceptar  las  medidas  que  vengo  proponiendo,  pero, 
lo  que  es  más,  ya  no  tendremos  miedo  de  aceptar,  en  nombre  de  nuestros  Gobiernos,  las 
resoluciones  adoptadas  e  i  la  convención  anterior,  la  cual  no  fué  más  que  el  preámbulo 
científico  de  la  que  ahora  nos  ha  hecho  reunir  en  este  suelo  hospitalario,  cuna  de  tantas 
inovacionss.  E  i  medio  de  este  pueblo  que  ha  roto  todos  los  lazos  convencionales  que  ligan 
aun  á  muchos  pueblos  con  las  preocupaciones  del  pasado,  con  las  tradiciones  de  lo  que  no 
es  útil,  ni  práctico;  pueblo,  que  lo  mismo  ha  declarado  su  independencia  política  que  la 
industrial;  lo  mismo  la  científica  que  la  artística;  que  se  ha  separado  de  los  caminos 
triviales  en  la  guerra  y  la  diplomacia. 

Á  vosotros,  señores  delegados,  que  representáis  aquí,  en  vuestras  respectivas  naciones 
el  porvenir  de  la  raza  latina  en  el  mundo  de  Colón;  á  vosotros  que  sois  los  porta-estandartes 
de  las  ideas  avanzadas  de  las  Repúblicas  que  os  han  enviado,  me  dirijo,  pidiendo  que  estos 
pueblos  jóvenes,  llenos  de  vida  y  de  nobles  aspiraciones  entren  con  paso  franco  y  resuelto 
en  la  nueva  vía. 

Dejemos,  señores,  las  antiguas  preocupaciones;  olvidemos  lo  que  significaba  la  palabra 
"  cuarentena;"  sustituyamos  esa  frase  anticuada  por  otra  que  represente  las  actuales  aspira- 
ciones sobre  higiene  pública.  Adoptemos  una  nueva  bandera  para  el  combate  contra  las 
enfermedades  transmisibles;  inscribamos  en  ella  como  lema,  "Resguardarlos  intereses  de 
la  Salud  Pública  sin  perjudicar  ó  perjudicando  lo  menos  posible  los  intereses  del  comercio 
y  de  la  libre  comunicación  de  los  hombres"  y  afiliados  á  la  doctrina  científica  y  apoyando 
nuestras  leyes  sanitarias  en  aquella  sublime  máxima,  "No  hagas  á  otro  lo  que  no  quieras 
para  tí,"  reduzcamos  las  exigencias  contra  nuestros  vecinos  á  las  que  desearíamos  que  ellos 
nos  impusieran. 

Si  firmamos  una  convención  que  por  una  parte  se  funda  en  la  ciencia  y  por  otra  en  la 
justicia,  habremos  celebrado  un  pacto  con  el  cual  probaremos  que  las  naciones  de  la  Amé- 
rica Latina  son  dignas  de  heredar  la  civilización  de  las  que  en  el  viejo  mundo  les  dieron  la 
vida;  y  que  el  árbol  que  arraigó  hace  dos  mil  años  en  el  Latió,  viene  ahora  á  depositar  sus 
frutos,  pero  ya  sazonados,  del  otro  lado  del  Atlántico,  borrando  la  inscripción  que  estaba 
grabada  en  la  salida  del  Mediterráneo,  "Non  plus  ultra."   Probemos,  señores,  que  tenemos 


SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL.  333 

á  la  ciencia  y  á  la  justicia  do  nuestra  parte  para  arrancar  de  su  sitio  osa  vieja  inscripción 
recordando  que  actualmontc  la  ciencia  y  la  justicia  flesconocen  las  fronteras  de  los  pueblos 
y  las  leiif^uas  diversas,  y  que  si  liemos  de  invocar  ci  piiniulo  será  solamente  para  traerá 
nuestra  memoria  sus  glorias  á  las  cuales  doljemos  aspirar. 

Cuando  el  pueblo  Norte  Americano  nos  llama  á  su  propia  casa;  pone  á  nuestra  dis- 
posición las  conquistas  que  sus  liijos  han  iiecho  en  las  ciencias  sanitarias;  cuando  nos  ha 
reunido  aquí,  con  autorizació  i  suficiente  de  imestros  respectivos  Oobierrxw  para  hawr  y 
firmar  convenios  y  i'e<^larnqntos  que  den  Unidad  á  las  medidíis  f|ue  asej^uren  á  la  vez  los 
intereses  de  la  salud  pública,  sin  perjudicar  ó  perjudi(5ando  lo  menos  posible  los  intereses 
del  comercio,  ¿podremos  contentarnos  como  la  vez  pasada  con  hacer  estudios  de  carácter 
«ientífico  como  si  asistiéramos  á  una  academia,  sin  cumplir  con  las  obligaciones  que  nos 
impone  1%  cláusula  quinta  de  la  Conferencia  Internacional  Panamericana,  es  decir,  sin 
aplicar  á  la  práctica  lo  que  la  ciencia  nos  ha  enseñado?  No,  no  es  posible;  esto  no  esta  de 
acuerdo  con  las  legítimas  aspiraciones  de  los  Gobiernos  que  nos  han  enviado  af|uí  para  dar 
una  solución,  la  mejor  resolución,  á  un  problema  que,  si  no  resolvemos  desde  luego,  apla- 
zará la  urgentísima  realización  de  un  gran  progreso,  en  beneficio  de  la  higiene  y  del  comercio, 
y  la  ocasión  de  estrechar  coa  un  lazo  nuevo  de  recíproco  interés,  la  amistad  de  los  pueblos 
del  Hemisferio  Occidental. 

P»*Señores  Delegados:  En  nombre  de  los  progresos  de  la  ciencia  sanitaria,  en  nombre  de  la 
■civilización,  en  uomlire  de  los  intereses  bien  entendidos  de  la  humanidad,  yo  os  suplico  que 
ajustes  una  Convención  Sanitaria  Internacional  de  las  Repúblicas  aquí  representadas,  y 
que  obtengáis  de  vuestros  Gobiernos  respectivos  la  sanción  legal  de  esta  Convención,  para 
■que  esta  reunión  alcance  el  objecto  para  el  cual  fué  convocada. 

WASHINGTON,  octubre  9  de  1905. 


INFORME  DEL  DELEGADO  DE  CHILE,  DR.  EDUARDO  MOORE. 

En  los  liltimos  dos  años  la  República  de  Chile  ha  sido  visitada  por  dos  enfermedades 
introducidas  de  afuera,  la  peste  bubónica  y  la  viruela. 

La  peste  bubónica  que  se  estacionó  largo  tiempo  en  las  costas-  del  Pacífico  de  Norte 
América,  invadió  el  litoral  de  algunos  Departamentos  del  Perú,  y  poco  tiempo  después 
Chile  (Iquique,  Pisagua,  Antofagasta  y  otros  lugares  de  menor  importancia  del  desierto  de 
Atacama).  Esta  epidemia  fué  atacada  con  energía,  y  hoy  existe  uno  que  otro  caso.  La 
enfermedad  declina  en  forma  que  se  divisa  su  pronta  terminación. 

La  viruela  existía  en  Chile  en  forma  esporádica,  pero  hace  un  año  y  medio  fué  importada 
de  Bolivia  por  intermedio  del  Ferrocarril  de  Antofagasta.  Esta  epidemia  ha  demostrado 
que  el  virus  exótico  es  de  una  energía  considerable,  pues,  apesar  de  la  inmensa  cantidad 
de  vacunados  antiguos,  la  viruela  ha  estallado  sin  hacer  diferencia  de  antiguos  vacunados, 
ni  edad,  ni  sexo.  El  trabajo  de  revacunación  se  ha  impuesto  en  grande  escala,  á  punto  de 
ser  casi  insuficiente  la  producción  nacional  de  vacuna,  y  por  lo  tanto  siendo  obligados  á 
importar  vacuna  de  las  Repúblicas  vecinas. 

Hasta  ahora  no  existe  en  el  país  ley  de  vacuna  obligatoria. 

Las  vacunaciones  y  revacunaciones  han  agotado  ya  casi  por  completo  la  epidemia. 

Dos  puntos  ha  establecido  en  Chile  la  invasión  de  la  viruela. 

1°.  Que  el  virus  variólico  que  existía  en  el  país  era  muy  atenuado,  pues  era  señalado  el 
caso  de  vhuela  que  existía,  y  estos  casos  eran  benignos,  atacando  rarísima  vez  á  los  antiguos 
vacunados,  antiguos  vacunados  que  eran  inmunes  con  la  antigua  vacuna  humana,  que  era 
la  única  existente  antes  de  veinte  años. 

2°.  Que  toda  epidemia  tenaz  y  mortífera  viene  de  afuera,  pues  el  virtis  actual  es  boliviano, 
y  una  gran  epidemia  que  azotó  anteriormente  las  provincias  australes  era  originario  de 
las  costas  del  Atlántico. 

Podi-íames  agregar  una  enseñanza  útilísima:  Existe  la  creencia  entre  algunos  sabios  que 
en  la  vacunación  de  brazo  á  brazo  la  inmunidad  es  completa,  ó  en  otros  términos,  que  los 
vacunados  de  este  modo  quedaban  inmunes  para  toda  la  vida,  y  bien,  las  dos  epidemias 
mortíferas  de  origen  exótico,  introducidas  en  Chile  han  estallado  sin  distinción,  atacando 
un  número  considerable  de  vacunados  antiguos,  que  lo  fueron  por  el  sistema  único  entonces, 
el  de  brazo  á  brazo. 

También  han  probado  estas  epidemias  que  la  protección  de  la  vacuna  animal  es  por  seis 
á  siete  años. 

MEDIDAS   SANITARIAS. 

Después  de  la  primera  Conferencia  Sanitaria  Panamericank,  Chile  ha  mejorado  su 
servicio  de  sanidad  pública. 

1°.  Se  trabaja  en  Santiago  en  la  pavimentación  radical,  aprobada  y  contrada. 
2°.  El  alcantarillado  de  la  Ciudad  de  Santiago  empezó  á  principios  de  este  año. 


834  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

3°.  Los  estudios  para  mejorar  las  obras  de  sanidad  de  Valparaiso,  especialmente  el 
alcantarillado,  están  por  terminaree,  así  como  acjuellos  cine  completarán  los  servicios  de 
agua  potable  y  ejecutarán  los  alcantarillados  de  las  ciudades  de  Talca  y  Concepción. 

4°.  Se  provee  de  agua  potable  á  casi  todas  las  ciudades  quu  aún  carecían  de  este  elemento, 
y  se  mejora  el  servicio  en  otras. 

OTRAS    OBRAS. 

Se  dá  á -contrata  el  gran  trabajo  de  la  formación  del  Puerto  de  Valparaiso,  aprobado  por 
ley  de  la  República.  Esta  obra  de  gran  importancia  costará  al  erario  nacional  más  de 
50,000,000  de  pesos. 

Están  terminados  los  estudios  para  mejorar  el  puerto  de  Constitución  sobre  el  Río  Maule. 

En  el  informe  que  presenté  en  1902  á  la  primera  conferencia  se  describió  ampliamente 
las  leyes  sanitarias  de  la  República. 


INFORME  DEL  DR.  JUAN  J.  TJLLOA,  DELEGADO  DE  COSTA  RICA. 

Desde  la  última  reunión  celebrada  por  esta  convención  el  año  1902  en  esta  misma  ciudad 
de  Washington  se  han  llevado  á  cabo  en  Costa  Rica  algunos  traba,jos  sanitarios,  y  su 
Gobierno  ha  seguido  prestando  mucha  atención  á  todos  los  asuntos  relativos  á  la  higiene 
pública. 

Como  tuve  el  placer  de  manifestarles  en  la  última  convención,  el  Gobierno  Nacional  tiene 
poderes  plenos  con  respectos  á  las  disposiciones  de  un  carácter  legal  relativas  el  estableci- 
miento de  todas  las  medidas  sanitarias  que  las  autoridades  consideren  importante  recomen- 
dar, y  las  cuales  se  ponen  en  vigor  después  de  haberse  consultado  la  opinión  de  la  Facultad 
Médica  de  Costa  Rica,  que  es  la  junta  consultora  más  alta  en  cuestiones  de  higiene. 

En  las  distintas  secciones  del  país  hay  las  necesarias  autoridades  de  policía  sanitaria, 
y  más  particularmente  en  los  puertos  de  mar,  en  cada  uno  de  los  cuales  hay  un  médico  al 
frente  del  departamento.  Este  fimcionario  está  investido  de  plenos  poderes  ejecutivos  para 
hacer  que  se  lleven  á  cabo  todos  los  reglamentos  y  disposiciones  sanitarios. 

Desde  que  la  teoría,  del  modesto  sago  cubano,  el  Dr.  Carlos  Finlay,  quedo  sentada 
como  doctrina,  principalmente  después  que  se  demostraron  sus  méritos  plenamente  por  la 
obra  habilísima  llevada  á  cabo  por  la  junta  del  ejército  de  los  Estados  Unidos,  ha  sido 
adoptada  por  la  mayoría  de  los  caudillos  de  la  ciencia  sanitaria  del  mundo,  obligando 
á  los  Gobiernos,  como  guardianes  públicos  del  bienestar  de  sus  respectivos  subditos,  á 
que  basaran  sus  medidas  preventivas  contra  la  fiebre  amarilla  en  el  hecho  probado  de  la 
propagación  de  este  mal  por  medio  de  la  picadm-a  de  un  mosquito  infectado,  de  la  especie 
Stegomyia  fasciata. 

Costa  Rica  ha  basado  todos  sus  medidas  profilácticas  contra  tan  justamente  temido 
enemigo,  como  es  la  fiebre  amarilla,  en  la  doctiina  de  Finlay,  copiando  en  pequeña  escala 
la  eficacísima  instalación  de  la  ciudad  de  la  Habana,  la  cual  tuve  el  placer  de  inspeccionar 
personalmente.  Desde  hace  dieciocho  meses  no  ha  occurrido  ni  un  caso  de  fiebre  amarilla 
en  Puerto  Limón,  y  tengo  la  seguridad  de  que  continuando  con  los  métodos  que  se  hallan 
actualmente  en  vigor,  en  lo  porvenir  quedaremos  libres  de  una  epidemia  de  esta  enferme- 
dad. Ningún  caso  de  esa  fiebre  se  ha  notificado  de  Puntarenas,  nuestro  puerto  del  Pacífico, 
en  donde  se  han  adoptado  medidas  semejantes  á  las  de  Puerto  Limón. 

Para  mí  es  una  dicha  muy  grande  el  poder  añadir  nuestra  experiencia  en  Costa  Rica 
como  una  prueba  en  apoyo  de  las  demostraciones  hechas  en  la  Habana,  y  más  adelante 
corroboradas  por  el  eficaz  trabajo  ejecutado  en  la  República  de  Méjico  bajo  la  dirección 
del  Doctor  Licéaga,  probando  ñiera  de  toda  duda  racional,  que  la  única  transmisión  de  la 
fiebre  amarilla  se  verifica  por  medio  del  intermediario  Stegomyia  fasciata. 

Tengo  el  placer  de  decir  que  las  medidas  adoptadas  en  Costa  Rica  contra  la  fiebre 
amarilla  están  basadas  en  las  lecciones  de  Finlay,  Guiteras,  Carroll,  Reed,  Agramonte, 
etc.,  parte  de  cujeas  obras  iwé  traducida  por  Don  Cleto  González  Viquez,  y  que  también 
fueron  las  fuentes  en  donde  me  instruí  antes  de  poder  preparar  las  memorias  que  dirigí  á 
mi  Gobierno  en  este  importante  asunto  después  de  la  interesante  reunión  que  celebró  el 
Congreso  Sanitario  Panamericano  en  el  ciudad  de  la  Habana  en  febrero  de  1901. 

La  adopción  de  las  medidas  sanitarias  basadas  en  las  enseñanzas  de  los  mencionados 
hombres  eminentes,  demostradas  completa  y  eficazmente,  han  colocado  nuestros  puertos 
en  un  estado  sanitario  muy  satisfactorio,  han  hecho  que  podamos  dar  amplias  garantías  á 
los  países  con  quienes  sostenemos  relaciones  comerciales,  y  nos  han  permitido  protestar 
contra  los  reglamentos  inadecuados  y  restrictivos  de  cuarentena. 

En  Costa  Rica  están  actualmente  en  vigor  las  leyes  de  cuarentena  contra  los  puertos  de 
Colón,  Panamá,  y  Nueva  Orleans,  á  causa  de  que  prevalece  en  ellos  la  fiebre  amarilla. 

Se  dictaron  medidas  de  cuarentena  muy  estrictas  contra  los  puertos  de  Colón  y  Panamá, 
con  motivo  de  dos  casos  de  peste  bubónica  que  fueron  notificados  desde  Ancón. 


SECUNDA    CONFEKIONCÍA    HANITAJ.UA    JNTEKJS' ACJONAL.  ^35 

ActualinenLo  no  existo  on  Costa  Ilica  epidornia  do  ninj^ún  gdnero;  corno  en  casi  todas  las 
ciudades  del  mundo  ocuiTcn  casos  de  fiebre  tiíoidda  y  de  tubercolosis,  pero  las  autoridades 
de  sanidad  dirijen  siempre  sus  accioncis  contia  ellos,  y  osyjorainos  liacer  que  disminuya  su 
número,  gracias  á  la  difusión  de  conocimientos  o.n  el  j)uoblo  y  la  mejoi'a  de  nuestros  sistemas 
de  alcantarillado  y  aguas,  cuya  mejora  se  está  estudiando  actualmente  y  que  se  ejectuará 
dentro  de  breve  tiempo. 

Muy  pronto  so  comenzarán  los  trabajos  para  completar  los  contratos  para  el  sistema  de 
alcantarillado,  y  para  la  extensión  y  refonna  del  sistema  de  aguas  de  San  José,  la  capital 
de  la  liopública.  ' 

El  Gobierno  ha  puesto  muclui  atención  en  la  ciudad  de  Limón,  nuestro  puerto  del  Atlán- 
tico, que  es  la  avenida  piincipal  de  nupstras  coiruinicaciones  con  el  mundo  extei'ior,  y  nuestra 
entrada  más  importante  para  el  comercio.  Alrededor  del  puerto  hay  una  bien  construida 
muralla  de  mar,  la  cual  ha  hecho  posible  el  relleno  de  una  gran  extensión  de  la  formación 
baja  de  coral  que  existía  antes  y  ((ue  era  un  foco  de  infección  debido  á  la  pud)-edumbrc  y 
descomposición  de  grandes  cantidades  de  toda  clase  de  mariscos.  Las  calic!s  de  la  ciudad 
están  pavimentadas  con  macadam;  hay  un  buen  servicio  do  aguas  y  un  sistema  do  alcan- 
tarillado bastante  regular,  el  cual  se  está  reformando  actualmente.  Yo  abrigo  la  convicción 
de  que  Puerto  Limón  es  uno  de  los  más  higiénicos  que  hay  al  Sur  de  los  Estados  Unidos  en 
el  Atlántico,  y  nuestro  Gobierno,  que  ve  la  importancia  de  su  mejora,  está  perí'eccionando  sus 
condiciones  continuamente. 

No  deseando  ocupar  vuestra  atención  con  otros  asuntos  que  son  realmente  extraños  al 
objeto  de  esta  Convención,  termino  aquí  mi  informe. 


INFORME  DBIi  DS.   E.   B.   BARNET,  DELEGADO  DE  CTJBA. 

Señor  Presidente,  Señores:  Como  delegado  de  la  República  de  Cuba,  tengo  el  honor  de 
presentar  á  esta  Conferencia  las  ordenanzas  sanitarias  acordadas  por  la  Junta  Superior  de 
Sanidad  de  la  Isla  de  Cuba,  para  el  régimen  sanitario  de  los  ayuntamientos  de  la  Piopública, 
de  conformidad  con  lo  prescrito  en  la  Orden  Militar  No.  159,  serie  de  1902,  del  extinguido 
Gobierno  interventor  de  los  Estados  Unidos. 

La  ley  orgánica  de  sanidad  que  rige  actualmente  en  Cuba  es  la  precitada  Orden  No.  159, 
la  que  establece  que  se  dictarán  por  la  Junta  Superior  de  Sanidad  reglas  generales  para  los 
servicios  de  todas  las  poblaciones  de  la  República,  y  esas  son  las  ordenanzas  que  entrego 
en  este  acto  y  que,  próximas  á  aprobarse  por  el  Gobierno  de  Cuba,  se  pondi'án  en  seguida 
en  vigor  para  llevar  á  cabo  el  fin  á  que  se  destinan. 

Como  lo  señala  la  Orden  No.  159,  estas  ordenanzas  sólo  tienen  carácter  general.  Cada 
ayuntamiento  deberá  después  de  la  promulgación,  dentro  de  un  plazo  que  le  señalará  el 
Ejecutivo,  modificarlas  y  adaptarlas  á  sus  condiciones  locales,  sometiendo  la  modificación  á 
la  aprobación  de  la  Junta  Superior  de  Sanidad.  Existen  actualmente  en  la  República  de 
Cuba  82  ayuntamientos,  pero  para  la  redacción  de  estas  ordenanzas  se  ha  tenido  en  cuenta 
la  importancia  de  una  ciudad  como  la  Habana,  á  reserva  de  que  cada  ayuntamiento  pro- 
ponga luego  las  reformas  de  que  he  hecho  mención. 

Estas  ordenanzas  son  un  trabajo  de  selección  y  adaptación.  Para  llevarlo  á  cabo  se  han 
tenido  á  la  vista  reglamentos,  ordenanzas,  disposiciones,  códigos  sanitarios,  etc.,  de  muchos 
países,  porque  en  materia  de  sanidad  no  es  posible  pretender  el  presentar  asuntos  originales 
ó  nuevos,  sino  guiarse  por  lo  que  la  práctica  y  la  experiencia  han  demostrado  en  otros  pueblos 
que  es  de  verdadera  necesidad  y  utilidad. 

Las  Ordenanzas  se  dividen  en  tres  partes.  La  primera  consta  de  cuatro  capítulos,  y 
viene  á  ser  una  especie  de  reglamento  derivado  de  la  Orden  No.  159,  ya  mencionada.  Esta 
parte  trata  de  disposiciones  generales,  juntas  locales  de  sanidad,  jefes  locales  de  sanidad, 
é  inspectores.     Tiene  más  bien  el  carácter  de  instrucciones  que  el  de  disposiciones. 

La  parte  segunda  es  la  realmente  dispositiva  y  comprende  27  capítulos  relativos  á  todos 
los  asuntos  sanitarios  de  una  comunidad. 

La  tercera  parte  se  concreta  á  las  infracciones  y  penalidades.  Clasifica  aquéllas  en  faltas 
leves  y  graves  según  su  importancia  sanitaria,  y  somete  la  infi-acción  al  juicio  del  juzgado 
correccional  para  la  aplicación  de  la  penalidad  correspondiente.  De  las  infracciones  que 
constituyen  delitos  contra  la  salud  pública,  se  da  conocimiento  á  los  tribimales  de  justicia. 

Las  ordenanzas  constan  en  conjunto  de  653  artículos. 

Como  toda  obra  humana,  y  realizada  en  un  país  nuevo  que  acaba  de  nacer  á  la  vida  de  la 
libertad,  y  donde  las  cuestiones  de  higiene  púbhca  eran  positivamente  desconocidas  en  la 
práctica,  estas  ordenanzas  tendi'án  cjuizás  muchos  errores  y  no  pocas  deficiencias.  Su 
reforma  y  perfeccionamiento  serán  obra  del  tiempo  y  la  experiencia,  y  servirán,  sin  duda, 

Sara  coadyuvar  á  continúe  ocupando  Cuba  tan  ventajoso  concepto  sanitario  entre  sus 
ermanas  las  Repúblicas  de  América. 


336  SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL. 

Ordenanzas  de  la  Junta  Superior  de  Sanidad  de  la  Isla  de  Cuba  para  el 
Régimen  Sanitario  de  los  Ayuntamientos  de  la  República. 

I. 

La  Junta  Superior  de  Sanidad  de  la  Isla  de  Cuba,  en  cumplimiento  de  lo  prescrito  en 
los  apartados  7,  (k)  y  (b)  de  las  secciones  1,  2,  y  4,  respectivamente,  de  la  orden  159,  serie 
de  1902,  ha  adoptado  las  ordenanzas  siguientes,  que  aprobadas  por  el  Ejecutivo,  regula- 
rizarán los  servicios  sanitarios  en  los  ayuntamientos  de   a  República. 

Coni'orme  á  lo  establecido  en  el  apartado  (b)  sección  4  de  la- citada  orden,  estas  reglas 
podrán  ser  modificadas  de  acuerdo  con  las  exigencias  locales  de  cada  ayuntamiento,  á 
petición  de  la  junta  local  de  sanidad,  con  la  aprobación  del  alcalde  y  la  resolución  defini- 
tiva de  la  Junta  Superior  de  Sanidad,  á  la  que  se  someterán  las  modificaciones  propuestas. 

De  acuerdo  con  lo  preceptuado  en  el  decreto  presidencial  N°  11,  del  20  de  mayo  de  1902, 
el  jefe  de  sanidad,  por  sí  ó  por  medio  del  secretario  de  la  Junta  Superior  de  Sanidad 
despachará  personalmente  con  el  secretario  de  gobernación  los  asimtos  de  la  junta  ó  del 
departamento  de  la  Habana  que  por  su  isiportancia  lo  requieran. 

PARTE  PRIMERA. 

ADMINISTRACIÓN  SANITARIA. 

Capítulo  II. 

JUNTAS  LOCALES  DE  SANIDAD. 

Artículo  1.  La  administración  sanitaria  de  cada  ayuntamiento  estará  á  cargo  de  una 
junta  local  de  sanidad,  compuesta  y  facultada  conforme  á  los  incisos  (a)  y  (c),  sección  4 
de  la  orden  1.59;  pero  en  los  municipios  donde  no  haya  oficial  de  cuarentenas  del  puerto 
6  jefe  de  la  sección  de  higiene  especial,  se  procurará,  para  el  mejor  servicio  técnico,  que 
el  nombramiento  de  uno  de  los  vocales  de  la  junta  recaiga  en  un  farmacéutico,  veteri- 
nario, ingeniero,  arquitecto  ú  otro  profesional.  Los  vocales  tomarán  posesión  de  sus 
cargos  cuando  su  nombramiento  haya  merecido  la  aprobación  de  la  Junta  Superior. 

Art.  2.  Las  juntas  locales  de  sanidad  redactarán  un  reglamento  para  su  régimen  interior 
que  someterán  á  la  aprobación  de  la  Junta  Superior. 

Art.  3.  Cada  junta  local  de  sanidad,  en  uso  de  las  facultades  de  que  está  investida, 
cuidará  con  esmero  de  cuanto  corresponda  á  la  salubridad  del  término  municipal  res- 
pectivo y  del  cumplimiento  estricto  de  las  leyes  y  reglamentos  vigentes  de  carácter  sani- 
tario, así  como  de  las  disposiciones  ó  instrucciones  de  laJunta  Superior  en  cada  caso  especial, 
con  sujeción  á  estas  ordenanzas. 

Art.  4.  Las  juntas  locales  de  sanidad  se  consideran  como  delegadas  de  la  Junta  Superior 
de  Sanidad  para  el  cumplimiento  estricto,  bajo  un  plan  sanitario  uniforme  de  la  misión 
que  les  está  confiada  de  velar  por  la  salud  pública. 

Art.  5.  Tendrán  á  su  cargo,  bajo  las  insti-ucciones  de  la  Junta  Superior,  sin  perjuicio 
de  lo  señalado  en  el  apartado  (e)  de  la  sección  2  de  la  orden  159,  serie  de  1902,  todos  los 
servicios  de  higiene  ó  sanidad  de  su  término  municipal,  vacunación  ó  inoculación  pre- 
ventivas, cementerios,  inhumaciones,  exhumaciones,  embalsamamientos  y  traslación  de 
cadáveres,  inspección  de  la  asistencia  médica  domiciliaria  ú  hospitalaria  en  sanatorios, 
asilos,  inclusas,  hospicios  benéficos,  hospitales,  casas  de  socorro,  cuarteles,  fortalezas, 
balnearios,  etc.,  en  cuanto  se  refiere  á  sus  condiciones  sanitarias. 

Art.  6.  Las  juntas  locales  de  sanidad  publicarán  las  instrucciones  populares  que  estimen 
oportunas  para  evitar  la  propagación  de  enfermedades,  sometiendo  previamente  aquéllas 
á  la  aprobación  de  la  Junta  Superior. 

Art.  7.  Visitarán  con  frecuencia  las  escuelas,  y  harán  retirar  de  ellas  á  los  alumnos  ó 
maestros  que  encontrasen  padeciendo  de  enfermedades  transmisibles,  prohibiéndoles  el 
reingreso  en  la  escuela  hasta  que  no  haya  desaparecido  todo  peligro  de  contagio. 

Art.  8.  Cuidarán  de  cjue  en  los  hospitales  y  asilos  se  observen  las  debidas  prácticas 
higiénicas,  sobre  todo  en  lo  que  respecta  á  la  separación  ó  aislamiento  de  los  enfermos 
contagiosos. 

Art.  9.  Harán  de  que  en  las  casas  de  vecindad,  hoteles,  posadas,  casas  de  huéspedes, 
cafés,  etc.,  se  cumplan  las  disposiciones  sanitarias  vigentes,  haciendo  responsable  de  las 
infracciones  al  encargado,  ál  propietario  ó  á  los  inquilinos,  según  los  casos. 

Art.  10.  Instruirán  á  las  cabezas  de  familia  que  tengan  en  sus  casas  atacados  de  enferme- 
dades contagiosas,  de  las  precauciones  c(ue  estén  obligados  á  tomar,  y  darán  parte  á  los 
directores  de  escuelas  de  los  alumnos  que  habiten  en  la  casa  infectada  y  deban  ser  ex- 
cluidos de  las  clases,  hasta  que,  terminado  el  caso,  ú  otro  que  le  siga,  se  desinfecte  aquélla. 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL,  í337 

Art.  11.  De  no  contar  en  el  lugar  con  los  medio.s  apropiaflos  para  practicar  análisis 
bacteriológicos,  enviarán  á  la  Junta  Superior  de  Sanidad  las  niuostras  de  esputos,  sangre, 
secreciones,  6  cualquier  otro  material  patológico  que  les  eptreguen  los  médicos  para  esta- 
blecer un  diagnóstico;  participándole  á  los  interesados  el  resultado  del  análisis  tan  pronto 
«orno  lo  recil)an. 

Art.  12.  De¡  las  bebidas  y  comestibles  sospechosos  de  falsificación,  adulteración  6 
alteración,  tomarán  tres  muestras  de  cada  artículo,  cuyos  envases  precintarán,  sellarán 
y  firmarán  con  el  interesado  de  manera  r|ue  no  sea  posible  substituir  el  contenido  sin 
dejar  señales  del  hecho;  y  entregarán  también  precintadas,  selladas  y  firmadas  una  muestra 
al  vendedor,  depositando  otra  en  la  junta  local  y  enviando  la  tercera  para  el  análisis  corre- 
spondiente, con  el  acta  6  informe  respectivos,  á  la  Junta  Superior  de  Sanidad. 

Art.  13.  Practicarán  las  inspecciones  domiciliarias,  casa  por  casa,  cada  vez  que  fuese 
necesario',  extendiendo  acerca  de  cada  una  de  ellas  un  informe  en  el  modelo  correspondiente, 
en  el  que  se  consignará,  principalmente,  el  número  de  ocupantes,  si  existe  ó  no  en  la  casa 
algún  caso  de  enfermedad  transmisible,  ó  si  ha  ocurrido  alguno  desde  un  año  á  la  fecha, 
condiciones  higiénicas  de  la  casa,  sus  inodoros,  sumideros,  desagües,  fosas,  etc. 

Art.  14.  Ordenarán  por  escrito  á  los  dueños  de  casas  las  obras  de  saneamiento  que 
deban  realizar  en  las  mismas,  dentro  de  un  plazo  determinado,  sin  perjuicio  de  conceder 
prórrogas  justificadas  y  que  no  dilaten  demasiado  la  ejecución  de  las  obra  . 

Art.  15.  Darán  cuenta  al  juzgado  correspondiente  de  los  casos  de  infracciones  que 
hayan  de  ser  penados,  acompañando  el  expediente,  en  calidad  de  devolución,  y  autorizando 
á  alguno  de  los  vocales  ó  empleados  para  sostener  la  acusación  respectiva. 

Art.  16.  Apercibirán  á  los  que  se  resistan  ó  demoren  en  cumplir  las  órdenes  sanitarias 
de  ser  llevados  ante  el  juzgado  competente  si  no  dan  cumplimiento  á  lo  dispuesto  en  el 
plazo  ó  prórroga  señalado. 

Art.  17.  Declararán  inhabitables,  dispondrán  la  clausura  consiguiente  y  propondrán  al 
ayuntamiento  la  demolición,  según  los  casos,  de  las  casas,  edificios,  etc.,  que  constituyan 
peligro  para  la  salud  ó  se  encontraren  en  estado  ruinoso ;  siendo  necesario  para  la  demolición 
el  reconocimiento  previo  por  el  arquitecto  municipal.         t 

Art.  18.  Recomendarán  á  los  ayuntamientos  respectivos  las  obras  que  estimen  nece- 
sarias para  el  saneamiento  de  sus  términos  municipales  y  que  los  vecinos  no  tengan  obli- 
gación expresa  de  realizar,  como  desecación  de  pantanos  en  terrenos  públicos,  desagúes 
de  charcas,  recogida  de  basuras,  limpieza  de  calles,  plazas  y  paseos,  higiene  de  los  mata- 
deros y  cementerios  y  cuantas  más  hubieren  de  hacerse  en  lugares  públicos. 

Igualmente  recomendarán  á  los  municipios  el  fomento  de  parques,  paseos,  arbolado, 
etc.,  para  la  higien  zación  de  las  poblaciones. 

Art.  19.  Cuando  las  obras  de  saneamiento  recomendadas  constituyan  una  necesidad 
urgente  y  el  ayuntamiento  se  negare  á  realizarlas  con  oportunidad,  darán  conocimiento 
de  ello  á  la  Junta  Superior  de  Sanidad,  á  los  efectos  del  primer  extremo  del  inciso  (e)  sección 
3  de  la  orden  159. 

Art.  20.  Informarán  á  la  Junta  Superior  de  Sanidad  de  las  obras  de  saneamiento  que 
en  sus  términos  municipales  respectivos  corresponda  realizar  á  la  Provincia  ó  al  Estado. 

Art.  21.  Remitirán  oportunamente  cada  año  á  la  Junta  Superior  un  proyecto  de  los 
gastos  que  exijan  las  atenciones  sanitarias  del  ayuntamiento,  y  que  deban  consignarse  en 
los  prepuestos  municipales. 

Ajit.  22.  Llevarán,  además,  del  libro  de  actas  y  de  otros  que  juzguen  necesarios,  un 
registro  de  todos  los  trabajos  que  ejecuten,  así  como  de  otro  de  los  médicos,  farmacéuticos, 
dentistas,  parteras  y  veterinarios  del  término  municipal,  conforme  al  modelo  que  les 
suministre  la  Junta  Superior. 

Art.  23.  Enviarán  cada  año,  en  el  mes  de  enero,  á  la  Junta  Superior  de  Sanidad  y 
valiéndose  de  los  modelos  que  ésta  habrá  de  facilitarles,  un  informe  relativo  al  estado 
sanitario  de  sus  municipios,  necesidades  que  en  ellos  adviertan,  manera  de  efectuar  los 
servicios,  infracciones  que  hayan  observado  y  penalidades  impuestas;  y  enfermedades 
infecciosas  y  epidemias  sobrevenidas,  particularidades  interesantes  que  hayan  presentado 
las  mismas,  accidentes  ocurridos  y  cuantos  más  datos  les  pida  la  propia  Junta  Superior. 

Art.  24.  Suministrarán  oportunamente  á  la  Junta  Superior,  los  cuadros  estadísticos  de 
sanidad  y  demografía  que  se  les  pidan,  ajustados  á  los  modelos  que  para  el  efecto  se  les 
proporcionen. 

Art.  25.  Informarán  en  cualquier  tiempo  á  la  Junta  Superior  de  Sanidad  acerca  de  las 
causas  permanentes  de  enfermedades  que  ocurran  en  sus  localidades,  con  indicación  de  las 
medidas  que  juzguen  convenientes  para  extinguirlas . 

Art.  26.  Velarán  porque  no  se  carezca  en  la  localidad  de  material  de  desinfección,  y  que 
las  farmacias  ó  botiquines  estén  provistos  de  las  substancias  antisépticas  de  uso  común  y  las 
expendan  á  precios  normales,  dando  parte  á  la  junta  Superior  de  Sanidad,  en  caso  contrario. 

Art.  27.  Formarán  ó  tendrán  planos  exactos  y  detallados  del  término  municipal  corres- 
pondiente, para  hacer  en  eUos  señales  gi-áficas  de  las  enfermedades  ocurridas  y  otros 
asuntos  dignos  de  anotación. 

1112a— 06 22 


336  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Art.  2S.  Remitirán  mensualinente  á  la  Junta  Superior  de  Sanidad  un  extracto  de  los 
acuerdos  tomados  en  las  sesiones  celebradas  durante  el  mes  anterior. 

Art.  2;).  Proporcionaván  á  los  inspectores  de  la  Junta  Superior  todos  los  informes  y  datos 
que  soliciten  para  el  mejor  desempeño  de  sus  cargos. 

Art.  30.  El  cargo  de  miembro  de  la  junta  local  de  sanidad  es  incompatible  con  el  concejal 
del  ayuntamiento,  6  empleado  del  mismo  que  no  sea  de  carácter  puramente  técnico  ó 
facultativo. 

Art.  31.  La  junta  elegirá  de  entre  sus  vocales  un  secretario,  él  que  podrá  lenei-  un  oficial 
á  sus  órdenes  para  el  despacho  de  los  asuntos. 
* 

Capítulo  III. 

JEFKS  LOCALES  DE  SANIDAD. 

Aet.  32.  El  jefe  local  de  sanidad  será  un  módico  de  experiencia  y  aptitudes  reconocidas, 
pagado  y  nombrado  por  el  ayuntamiento,  con  la  aprobación  previa  de  la  Junta  Superior  de 
Sanidad.  En  caso  de  que  en  primera  y  segunda  propuestas  no  merecieren  los  nombrados 
por  el  ayuntamiento  la  aprobación  de  la  junta,  ésta  nombi-ará  á  quien  considere  con  mejores 
aptitudes  para  el  cargo. 

Art.  33.  El  jefe  local  de  sanidad  será  el  presidente  de  la  junta  y  el  encargado  de  ejecutar 
los  acuerdos  de  la  misma. 

Art.  34.  Someterá  á  la  aprobación  de  la  Juota  Superior  el  nombraniiento  y  cesantía  de 
los  empleados  de  la  junta  local. 

Art.  35.  Rendirá  al  Jefe  Superior  de  Sanidad  cuantos  informes,  datos  estadísticos,  docu- 
mentos, etc.;  le  pida  aquél  referentes  á  la  sanidad  del  término  municipal. 

Art.  36.  En  el  desempeño  de  su  cai'go  el  jefe  local  de  sanidad  se  ajustará  á  las  instruc- 
ciones que  reciba  del  Jefe  Superior  de  Sanidad. 

Art.  37.  Dará  las  órdenes  oportunas  para  la  detención  preventiva  y  aislamiento  de  cual- 
quier individuo  afectado  de  eiifermedad  contagiosa,  hasta  tanto  no  ofrezca  peligro  alguno 
para  la  salud  pública  de  conformidad  coa  lo  estatuido  en  el  apartado  (/)  sección  3  de  la 
orden  159,  serie  de  1902. 

Art.  38.  Rendirá  á  la  junta  local  de  sanidad  un  inl'onne  mensual  y  otro  anual  de  todas 
sus  operaciones. 

Capítulo  IV'. 

INSPECTORES. 

Art.  39.  Los  inspectores  de  sanidad  se  considerarán  como  delegados  de  confianza,  del 
jefe  de  sanidad;  ocuparán  las  horas  de  servicio  en  atender  exclusivamente  á  sus  deberes,  y 
estarán  siempre  dispuestos  á  cumplir  las  órdenes  que  reciban. 

Art.  40.  Estarán  provistos  de  un  documento  y  de  una  placa  metálica  que  acrediten  su 
empleo,  y  uniformados,  si  lo  acordare  así  la  junta  de  sanidad.  En  virtud  del  cargo  que 
desempeñan,  serán  respetuosos  y  corteses  para  con  las  pei'sonas  con  quienes  intervengan  en 
los  asuntos  del  servicio;  evitarán  las  discusiones  y  darán  por  escrito  todos  sus  informes. 

Art.  41.  Harán  en  cada  informe,  que  será  detallado,  exacto  y  verídico,  las  recomenda- 
ciones que  estimen  necesarias  para  remediar  las  infracciones  que  observen,  absteniéndose 
por  completo  de  dar  informaciones  ú  órdenes  directas,  verbales  ó  escritas,  á  los  interesados. 

Art.  42.  Procurarán  estar  bien  enterados  de  todo  lo  cjue  se  relacione  con  el  estado  sani- 
tario de  sus  distritos,  para  que  puedan,  en  cualquier  momento,  facilitar  los  informes  que  se 
les  pida  por  la  junta  ó  el  jefe  local  de  sanidad. 

Art.  43.  Vestirán  correctamente  y  permanecerán  alejados  durante  las  horas  hábiles  de 
todo  centro  de  reunión  ó  de  vicio. 

Art.. 44.  Permanecerán  en  sus  distritos  dm-ante  las  horas  de  servicio,  á  menos  que  reciban 
órdenes  expresas  para  otros  asuntos  oficiales.  Tampoco  podrán  dedicarse  á  la  atención  de 
intereses  particulares  durante  dichas  horas. 

ÁMT.  45.  Anunciarán  su  cargo  y  el  objeto  de  su  visita  al  penetrar  en  una  casa  ó  lugar,  y 
practicarán  con  esmero  y  minuciosidad  la  inspección  que  corresponda,  á  fin  de  Cjue  las 
órdenes  á  que  den  origen  sus  informes  no  sufran  después  modificaciones  en  la  oficina  al 
comprobarse  deficiencias,  inexactitudes  ó  falsedades. 

Art.  46.  Comunicarán  en  el  acto  al  jefe  de  sanidad  si  encontraren  injustificada  resisten- 
cia para  la  inspección  por  parte  del  propietario  de  la  casa  ó  de  los  inquilinos,  para  que  por 
aquél  se  reclame  el  auxilio  de  la  policía,  después  de  agotados  los  medios  persuasivos. 

Art.  47.  Tendrán  la  mayor  discreción  y  reserva  para  cuanto  observaren  en  las  casas;  no 
emplearán  las  facultades  de  su  cargo  con  malicia  para  perjudicar  ó  favorecer  á  tercero,  ni 
para  asuntos  que  interesen  á  ellos  mismos  ó  á  sus  familiares. 

Art.  48.  Pedirán  permiso  á  la  junta  local  de  sanidad  respectiva  cuando  necesiten  sepa- 
rarse temporalmente  del  cargo  por  enfermedad,  ausencia  ú  otra  causa  particular. 


SEGUNIJA    CONKJOKKNOIA    HANITAKIA     INTKRNA(JH)N AL.  íír}'.) 

ORDENANZAS  SANITARIAS. 

(JAl'ÍTUíX)    I. 
ABA8TEOIMII0NTO   UK    AOUA. 

Art.  49.  Las  juulas  locales  (Jo  sanidad  atend(5ián  con  partic-ular  csmci'í)  á  la  adecuada 
provisión  do  agua  para  la  localidaiJ,  tanto  en  Jo  que  n?specta  á  »n  cantida(J  como  á  sus 
cualidades  bio-químicas,  ya  soa  obtenida  de  acueductos,  inananLiaics,  ríos,  pozos,  aJjibes, 
cubas  ó  cualquiera  otra  ciase  de  depósitos  naturales  ó  artificiales;  y  dispondiíln  las  medidas 
que  sean  necesarias  para  conservar  la  pureza  y  salubridad  del  agua  destinada  (i  bebida  y  á 
todoS;Usos  domésticos. 

Art.  .50.  En  las  poblaciones  donde  haya  acueductos  (jue  proporcionen  agua  potable  de 
buena  calidad  y  en  cantidad  suficiente,  con  un  servicio  reglamentado  y  módico,  será  obli- 
gatoria la  instalación  de  plumas  independientes  en  todas  las  casas  y  edificios  y  pisos  de 
éstos  que  se  arrienden  por  separado;  y  se  ordenará  la  supresión  de  todos  los  pozos,  aljibes, 
ú  otros  depósitos,  á  menos  que  se  destinen  excJusivamente  á  usos  industriales,  siendo  obli- 
gatorio en  este  caso  el  solicitar  un  permiso  escrito  de  la  junta,  que  podrá  ó  no  concederlo. 

Akt.  ,51.  Será  obligatorio  para  la  administración  de  los  acueductos  hacer  que  el  agua 
llegue  hasta  los  lugares  más  elevados  do  la  población  durante  todas  las  horas  del  día. 

Akt.  52.  Cuando  la  especialidad  del  caso  lo  exija,  se  ordenará  el  uso  de  filtros,  ú  otros 
medios  de  purificación,  para  mejorar  el  agua  de  que  se  haga  uso  en  escuelas,  asilos,  cafés,  y 
demás  lugares  públicos. 

Art.  53.  En  las  poblaciones  que  por  carecer  de  acueductos  se  permita  el  uso  de  pozos  3- 
aljibes,  deberán  tener  éstos  cubiertas  y  paredes  imperaieables,  y  sus  aberturas  protegidas 
por  telas  metálicas  á  prueba  de  mosquitos.  Los  tubos  colectores  serán  también  imper- 
meables, y  se  evitará  que  conduzcan  las  primeras  aguas  llovedizas.  Las  paredes  de  los 
pozos  y  aljibes  distarán  10  metros,  por  lo  menos,  de  cualquier  pozo  negro,  sumidero, 
depósito  de  estiércol,  fosa  de  abonos,  etc.  Sobre  la  cubierta  de  los  aljibes  y  pozos  no  se 
permitirán  cultivos  de  ninguna  clase. 

Akt.  54.  La  extracción  de  agua  de  los  pozos  y  aljibes,  aunque  estén  tapados,  no  será 
permitida  sino  por  medio  de  bombas,  á  fin  de  evitar  con  toda  seguridad  la  entrada  de 
mosquitos. 

Art.  55.  En  las  poblaciones  en  que  sea  de  imprescindible  necesidad  proveerse  para  el 
consumo  doméstico  de  las  aguas  de  un  río,  se  eligirá  el  sitio  donde  no  puedan  éstas  contami- 
narse fácilmente,  y  se  prohibirán  los  baños,  lavado  de  ropas,  descarga  de  excusados  ó  caños, 
desagües  de  alambiques,  ingenios,  fábricas,  mataderos,  cementerios,  etc.,  aguas  arriba  del 
lugar  de  la  toma. 

.  Art.  56.  Cualquiera  venta  pública  de  agua  para  el  consumo  ordinario  donde  no  haya 
acueducto,  necesitará  la  autorización  de  la  junta  local  de  sanidad,  reglamentado  é  inspec- 
cionado asiduamente  el  servicio,  exigiéndose  que  los  recipientes  estén  bien  tapados  y  de 
material  apropiado  para  la  mejor  limpieza,  como  de  vidrio  é  hierro  ó  barro  vidriado  ó 
esmaltado. 

Art.  57.  No  se  permitirá  el  consumo  público  de  agua  para  bebida  que  no  sea  potable. 

Art.  58.  En  la  fabricación  de  hielo  y  aguas  gaseosas,  se  emplearán  aguas  perfectamente 
purificadas,  y  todas  las  operaciones  de  la  fábrica  se  practicarán  con  la  mayor  limpieza. 

El  hielo  destinado  al  consumo  doméstico  deberá  ser  límpido,  sin  sabor  alguno  y  exento 
de  todo  peligro  de  contaminación. 

Art.  59.  No  le  será  á  nadie  permitido  ensuciar  ó  perjudicar,  haciendo  sus  aguas  insalu- 
bres ó  impropias  para  el  consumo,  el  caudal  de  un  río  ó  arroyo,  aunque  pase  por  su  terreno 
y  que  sea  utilizado  aguas  abajo  para  usos  domésticos  ó  de  los  ganados. 

Art.  60.  Incurrirán  en  responsabilidad  criminal  todos  los  que  directa  ó  indirectamente 
hicieren  nocivas  á  la  salud  las  aguas  destinadas  al  consiuno. 

Art.  61.  Cuando  la  junta  local  de  sanidad  tenga  sospecha,  por  haberse  presentado 
algima  enfermedad  que  lo  justifique,  de  que  un  acueducto,  pozo,  aljibe,  río,  etc.,  está 
contaminado,  deberá  hacer  analizar  las  aguas  inmediatamente  y  disponer  los  medios  de 
cómo  ha  de  hacerse  uso  de  ellas  sin  que  ofrezcan  peligro,  ó  prohibir  su  consumo,  según 
el  caso. 

Capítulo  II. 

ALIMENTOS   Y   BEBIDAS. 

Abt.  62.  Los  alimentos  y  bebidas  que  se  introduzcan  en  la  población  ó  se  destinen  á  la 
venta  deben  estar  en  completo  estado  de  pureza  ó  frescura,  de  sazón  ó  conservación,  y 
corresponder  siempre  por  sus  componentes  y  caracteres  al  nombre  con  que  se  les  venda, 
expresado  claramente  en  el  rótulo  de  su  envase. 


340  SEGUNDA   CONFERENCIA   SANITARIA    INTERNACIONAL. 

Akt.  63.  Se  considerará  adulterado  un  alimento  ó  bebida  cuando  contenga  una  ó  más 
substancias  extrañas  á  su  composición  natural  conocida  y  aceptada;  cuando  se  le  haya 
substraído  alguno  ó  varios  de  sus  componentes  en  totalidad  ó  en  parte,  6  cuando  no  corres- 
ponda por  su  naturaleza,  composición  ó  calidad  al  nombre  con  que  se  le  venda. 

Akt.  64.  Se  considerará  que  una  substancia  es  nociva  ó  perjudicial  á  la  salud  y  que, 
por  consiguiente,  no  es  licito  en  ningún  caso  mezclarla  con  los  alimentos  ó  bebidas,  no  sólo 
cuando  esté  demostrado  que  es  dañina  al  organismo  humano,  sino  también  cuando  la 
ciencia  conserva  dudas  acerca  de  su  innocuidad,  ya  sea  en  sus  efectos  imuediatos  ó  tardíos. 

Art.  65.  Se  considerarán  alterados  los  alimentos  ó  bebidas — 

1°.  Cuando  se  hallen  es  estado  de  descomposición  pútriSa; 

2°,  Cuando  estén  agrios,  picados,  rancios  ó  hayan  sufrido  algima  otra  modificación  que 
que  cambie  notablemente  su  sabor  ó  su  poder  nutritivo  ó  los  haga  nocivos  á  la  salud. 

Aet.  66.  Los  alimentos  ó  bebidas  adulterados,  alterados  ó  falsificados  así  como  los  que 
sean  substituidos  por  otros,  ó  que  resulten  distintos  de  lo  que  expresen  los  rótulos  de  sus 
envases,  deberán  ser  decomisados  en  definitiva,  procediéndose  desde  luego  á  su  depósito 
ó  á  lo  que  hubiese  lugar,  según  lo  permitiese  la  naturaleza  de  los  mismos,  y  sin  perjuicio 
de  la  responsabilidad  personal  de  sus  expendedores  ó  fabricantes. 

Art.  67.  Se  prohibe  la  venta  de  cualquier  alimento  ó  bebida  al  que  se  le  haya  substraído 
en  todo  ó  en  parte  un  constituj^ente  de  valor  alimenticio,  ó  se  le  haya  mezclado  con  otras 
substancias,  si  no  se  especifica  claramente  su  composición  en  el  rótulo  del  envase  y  se  le 
advierte  al  comprador. 

Art.  68.  Se  prohibe  la  venta,  entrada  ó  almacenaje  en  la  población,  sea  cual  fuere  el 
establecimiento  ó  mercado  en  que  se  efectúe,  de  carnes,  pescados,  aves,  caza,  frutas,  vege- 
tales, leche,  bebidas,  vinos,  licores,  etc.,  que  no  se  encuentren  en  perfectas  condiciones 
para  el  consumo,  comprendiéndose  también  la  de  conservas  cuyos  envases  estén  deteriorados 
ó  sus  cubiertas  levantadas  ó  protuberantes. 

Art.  69.  Se  prohibe  la  venta  en  la  vía  pública  de  carnes,  pescados,  pastas,  dulces,  etc., 
que  no  estén  debidamente  cubiertos  y  protegidos  contra  el  polvo,  los  insectos  y  el  contacto 
de  las  manos:  y  en  los  establecimientos  la  de  pastas,  dulces,  fiambres,  golosinas,  etc.,  que 
no  estén  guardados  en  vitrinas  cerradas,  recomendándose  para  su  manejo  el  uso  de  instru- 
mentos apropiados,  en  lugar  del  de  las  manos. 

Art.  70.  Queda  prohibido  emplear  en  la  coloración  de  cualquier  substancia  alimenticia 
los  colores  minerales  en  cuya  composición  entren  á  formar  parte  el  plomo,  antimonio,  cobre, 
cromo,  arsénico  ó  mercurio;  entre  los  colores  orgánicos,  la  goma-guta  y  el  acónito  napelo; 
las  materias  colorantes  derivadas  de  la  hidla  y,  en  general,  todas  aquellas  que  puedan  ser 
nocivas  á  la  salud. 

Como  excepción  se  permite  emplear  para  la  coloración  de  bombones,  pastillas,  dulces, 
helados  pastas  y  refrezcos,  los  colores  derivados  de  la  hulla,  con  tal  que  estas  materias 
colorantes  estén  exentas  de  antimonio,  arsénico,  bario,  plomo,  cadmio,  cromo,  cobre, 
mercurio,  uranio,  zinc,  estaño,  goma-guta,  coralina  y  ácido  pícrico. 

Art.  71.  Queda  prohibido  emplear  hojas  de  papel  de  estaño  plumbífero  para  envolver 
frutas,  confituras,  chocolate^,  quesos,  salchichones  y  cualquiera  otra  substancia  alimenticia. 

Las  hojas  de  estaño  destinadas  á  este  uso  deberán  estar  constituidas  por  una  aleación 
que  contenga,  por  lo  menos,  97  por  ciento  de  estaño  dosificado  al  estado  de  ácido-meta- 
estánico. 

Esta  aleación  no  deberá  contener  más  de  medio  por  ciento  de  plomo  y  xoiñxí  d®  arsénico. 

Art.  72.  Igualmente  se  prohibe  emplear  en  el  estañado  ó  reestañado  de  los  vasos  y 
utensilios  que  sirvan  para  los  usos  culinarios,  los  baños  que  no  contengan  una  composición 
análoga  á  la  indicada  en  el  artículo  anterior. 

Asimismo  se  prohibe  el  uso  de  vasijas  y  utensilios  de  estaño,  destinados  á  contener  6 
preparar  substancias  alimenticias,  fabricados  con  una  aleación  que  contenga  más  del  10 
por  ciento  de  plomo  ó  de  otros  metales  que  se  encuentran  ordinariamente  aleados  al  estaño, 
no  debiendo  contener  más  de  yo'ío o  de  arsénico. 

Art.  73.  No  deberán  colocarse  en  el  interior  de  los  bombones,  dulces,  y  en  general,  de 
toda  substancia  alimenticia,  objetos  de  metal  ó  de  aleaciones  cuya  naturaleza  pueda 
formar  compuestos  nocivos  á  la  salud.  Las  hojas  metálicas  empleadas  para  dorar  ó  platear 
los  bombones  y  pastillas  deberán  de  ser  de  oro  ó  plata  finas. 

Art.  74.  Cualquiera  que  tenga  noticias  de  la  existencia  de  substancias  alimenticias 
puestas  á  la  venta  en  condiciones  de  insalubridad  ó  deterioró  está  en  el  deber  de  participarlo 
al  jefe  local  de  sanidad. 

Art.  75.  Se  prohibe  fabricar,  vender  ó  ceder,  así  como  autorizar  que  se  fabriquen,  vendan 
6  cedan,  aUmentos  ó  bebidas  nocivas  á  la  salud,  ya  sea  el  efecto  tóxico  ó  nocivo  inmediato 
6  tardío. 

Art.  76.  Los  establecimientos  destinados  á  la  venta  ó  depósito  de  toda  clase  de  alimentos, 
frutas,  legumbres,  bebidas,  etc.,  se  mantendrán  en  perfecto  estado  de  ventilación  y  de 
limpieza,  especialmente  los  pisos,  paredes,  mostradores,  cocina,  inodoros,  vertederos,  urina- 
rios, etc. 


SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAL.  1^41 

Art.  77.  Quoda  prohibido  el  empinar  substancias  venenosas  6  nocivas  ó,  la  salud  para 
teñir,  pintar  ó  colorear  comestibles  ó  brsbidas,  así  como  (il  de  las  mismas  en  el  papel  para 
envolverlos;  y  se  proliibu  igualmente  el  empleo  de  substancias  venenosas  6  nocivas  para 
pintar,  barnizar,  estañar  ó  vidriar  vasijas  y  artefactos  do  cualquier  clas'í  (jfue  pu;;dan  con- 
taminar los  comcstibliís  ó  bebidas,  incluyéndose  en  esta  prohibición  los  juguetes  y  otros 
objetos  dedicados  á  los  niños. 

Se  prohibe  asimismo  cmpkíar  para  la  coloración  de  los  pap:>les,  carton  !s  ú  otros  envases 
usados  para  envolver  cualquier  substancia  alimenticia  los  colores  en  cuya  composición 
entren  á  formar  parte  el  plomo,  antimonio,  cobre,  cromo,  arsénico,  m-^rcurio,  goma-guta 
ó  acónito  napelo. 

Art.  78.  Se  entiendo  por  vino  el  líquido  resultante  de  la  fermentación  del  zumo  de  la 
uva,  sin  adición  de  substancias  extrañas  á  los  componentes  del  mismo. 

Art.  79.  Es  vino  artificial  el  que  no  procede  de  la  fermentación  del  zumo  de  la  uva. 

Art.  80.  Queda  prohibido  el  empleo  en  la  fabricación  da  toda  clase  de  bebidas  alcohólicas 
por  fermentación,  y  la  adición  á.  los  vinos,  de  las  materias  siguientes: 

1°.  Todas  las  sales  metálicas,  los  ácidos  minerales  ú  orgánicos  y  los  perfumes,  éteres  y 
esencias  diversas. 

2°.  Todas  las  substancias  antisépticas. 

3°.  Toda  otra  substancia  extraña  á  la  composición  natliral  de  los  vinos  y  bebidas  alcohó- 
licas por  fermentación. 

Art.  81.  Se  considerarán  adulterados,  y  nocivos  ó  no  á  la  salud,  según  los  casos,  los  vinos 
y  bebidas  alcohólicas  que  contengan — 

1°.  Más  de  2  gramos  de  sulfato  de  potasa  por  litro. 

2°.  Más  de  1  gramo  de  cloruro  de  sodio  por  Htro. 

3°.  Exceso  de  agua  ó  alcohol. 

4°.  Materias  colorantes  extrañas,  cualquiera  que  sea  su  procedencia. 

Art.  82.  Las  bebidas  alcohólicas  por  fermentación  no  deberán  contener  ninguna  otra 
substancia  colorante  que  la  de  su  propia  naturaleza. 

Art.  83.  Los  expendedoi-es  de  vinos  adulterados  ó  artificiales  no  nocivos  á  la  salud 
incurrirán  en  pena  de  decomiso  y  pago  del  análisis  y  de  la  multa;  y  de  los  que  resulten 
nocivos  se  dará  conocimiento  á  los  tribunales  de  justicia. 

Art.  84.  Se  prohibe  la  venta  de  vinagres  de  vino  que  contengan  menos  de  5  por  ciento 
de  riqueza  en  ácido  acético. 

Art.  85.  Los  vinagres  procedentes  de  alcohol,  cerveza,  sidra,  etc.,  se  expenderán  mani- 
festándose en  el  rótulo  del  envase  el  producto  de  que  proceden.  Ninguno  de  estos  vinagres 
deberá  tener  una  riqueza  menor  de  3  por  ciento  en  ácido  acético. 

Art.  86.  Se  considerará  como  adulterado  todo  vinagre  que  contenga  substancias  extrañas 
á  su  composición  natural. 

Art.  87.  Queda  prohibida  la  adición  á  las  harinas  de  trigo  de  cualquiera  substancia  que 
tienda  á  aimientar  su  peso  ó  volmnen  natural. 

Art.  88.  El  pan  común  que  se  destina  á  la  venta  pública  ha  de  ser  fabricado  con  harina 
de  trigo  sin  mezcla  alguna,  y  bien  amasado  y  bien  cocido.  Queda  prohibido  el  empleo  de 
cualquier  substancia  extraña  á  la  fabricación  natural  y  conocida  del  pan. 

Art.  89.  De  cualquiera  otro  pan  cuya  masa  no  sea  formada  exclusivamente  de  harina 
de  trigo,  levadura,  sal  común  y  agua,  habrá  de  expresarse  claramente  su  composición  en 
el  acto  de  la  venta. 

Art.  90.  Las  panaderías  deberán  estar  establecidas  en  locales  de  buena  luz  y  ventilación 
y  adecuados  para  su  perfecta  limpieza.  Los  pisos,  paredes,  artesas,  etc.,  se  mantendrán 
en  completo  estado  de  aseo.  No  se  permitirán  dormitorios,  excusados,  caballerizas,  ani- 
males, etc.,  en  el  local  de  las  tahonas  ni  en  comunicación  directa  con  éste. 

Se  prohibe  á  todo  el  que  padezca  de  alguna  enfermedad  cutánea  ó  transmisible,  intervenir 
personalmente  en  la  elaboración,  despacho,  etc.,  del  pan. 

El  transporte  del  pan  se  efectuará  con  la  mayor  Hmpieza  y  protegido  contra  el  polvo,  los 
insectos  y  el  contacto  de  las  manos. 

Art.  9L  Se  prohibe  para  la  calefacción  de  los  hornos  de  panaderías,  dulcerías,  reposterías, 
etc.  el  uso  de  maderas  y  otros  combustibles  que  hayan  estado  pintados,  sufrido  cualquier 
preparación  química  ó  impregnados  de  materias  que  resulten  nocivas  á  la  salud. 

Art.  92.  Las  pastas  alimenticias  conocidas  con  el  nombre  de  "pastas  para  sopas  "  serán 
vendidas  indicándose  en  el  envase  la  clase  de  harina  empleada  en  la  fabricación  del  producto. 

Art.  93.  Sólo  se  permite  colorear  las  pastas  alimenticias  para  sopas  con  azafrán  puro 
ó  con  bija. 

Art.  94.  Se  prohibe  la  venta  de  especias  dedicadas  á  alimentos  ó  condimentos,  tales 
como  canela,  azafrán,  clavos  de  especia,  etc.,  que  sean  adiolteradas  ó  aumentadas  en  su  peso, 
volumen  y  composición  naturales,  á  no  ser  que  se  haga  dentro  de  las  prevenciones  estable- 
cidas en  el  artículo  67  de  estas  ordenanzas. 

Art.  95.  Se  prohibe  asimismo  vender  ó  denominar  con  el  vocablo  de  "mantequilla" 
todo  producto  que  sea  fabricado  exclusivamente  con  leche  ó  crema  procedente  de  la  leche, 


342  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

ó  con  una  y  otra,  con  ó  sin  sal  j  colorantes  y  que  en  su  composición  entre  más  de  15  por 
ciento  de  agua. 

Art.  96.  Cualquier  substancia  alimenticia  que  por  su  aspecto  ó  sabor  pueda  ser  conñindida 
con  la  mantc  quilla,  6  que  sea  preparada  para  el  mismo  uso,  no  podrá  ser  vendida  sino  bajo 
la  denominación  de  "oleomargarina,"  si  lo  fuere;  yen  otro  caso,  llenándose  para  su  venta 
las  condiciones  establecidas  por  el  artículo  de  estas  ordenanzas  y  bajo  la  pena' de  comiso 
y  multa  consiguiente,  cuando  el  lucho  no  fuese  constitutivo  de  delito. 

Art.  97.  Los  envases,  cajas,  latas,  pap.^les  y  recipientes,  cualesquiera  que  sean,  que 
contengan  oleomargarina,  para  su  venta  ó  depósito,  al  por  mayor  ó  al  detalle,  deberán 
llevar  impresa  en  español  y  en  caracteres  romanos  bien  visibles  de  un  tamaño,  á  lo  monos, 
de  media  pulgada  cuadrada,  la  palabra  "Oleomargarina." 

La  puesta  á  la  venta  sin  la  especificación  anterior,  ú  otra,  significará,  para  los  fines  de  la 
inspección  sanitaria,  que  lo  que  se  expende  es  mantequilla. 

Art.  98.  Los  comerciantes  ó  industriales  que  expendan  bajo  las  denominaciones  de 
"manteca,"  "manteca  compuesta,"  ó  cualesquiera  otras  substantias  que  sin  ser  manteca 
pura  de  cerdo  se  asemejen  á  la  misma  ó  puedan  confundirse  con  ella  por  su  sabor  ó  aspecto, 
quedarán  obligados  á  informar  al  comprador  ó  consumidor,  al  tiempo  de  la  venta,  que 
dichas  substancias  no  son  "manteca  de  cerdo"  y  á  poner  en  los  envases  que  las  contengan 
un  rótulo  que  diga  en  castellano,  con  caracteres  romanos  de  media  pulgada  cuadrada  por 
lo  menos,  impresos  de  un  modo  inteligible  y  duradero  y  en  el  lugar  más  visible  de  los  mismos: 
"Manteca  artificial." 

Art.  99.  Sólo  podi'á  venderse  con  el  nombre  de  "aceite  de  comer"  el  extraído  de  la 
oliva  exento  de  toda  mezcla. 

Los  demás  aceites  que  se  empleen  como  almientos  y  que  no  resulten  nocivos  podrán 
vendei-se  siempre  que  se  exprese  en  el  rótulo  de  los  envases  que  los  contengan,  con 
caracteres  romanos  impresos  en  español  de  un  modo  inteligible  y  duradero  y  en  el  lugar 
más  visible  de  aquéllos,  su  naturaleza  ó  procedencia:  prohibiéndose  la  venta  como  alimento 
de  los  aceites  de  cualquier  clase  que  se  encuentren  alterados  ú  oxidados  (rancios). 

Art.  100.  La  fabricación  de  toda  clase  de  bebidas  ha  de  verificarse'  con  ingredientes  de 
buena  calidad,  empleándose  vasijas  nmy  limpias  que  no  sean  de  cobre,  ni  de  ninguna  otra 
materia  que  pueda  hacerlas  nocivas. 

Tampoco  se  permitirá  el  uso  de  vasijas  ni  utensilios  de  cobre  para  la  preparación  de 
ningún  comestible. 

AiiT.  101.  Se  prohibe  el  empleo  de  la  sacarina  en  bebidas  y  substancias  alimenticias. 

Art.  102.  Se  prohibe  vender  leche  aguada,  descremada  ó  adulterada  de  cualquier  otra 
manera,  y  la  procedente  de  animales  eni'ermos  ó  que  hayan  sido  alimentados  con  residuos 
de  industrias  ó  productos  en  fermentación. 

Art.  103.  Para  los  efectos  de  estas  ordenanzas  se  entenderá  por  leche  adulterada: 

1°.  La  leche  que  tenga  más  de  S8.5  á  100  de  agua;  menos  de  11.5  á  100  de  materias 
sólidas  y  menos  de  2.7  á  100  de  manteca,  ó  que  contenga  alguna  substancia  extraña  á  su 
composición  natural. 

2°.  La  leche  de  animales  ordeñados  quince  días  antes  y  ocho  días  después  del  parto. 

3°.  La  leche  procedente  de  animales  enfermos  ó  alimentados  con  residuos  industriales 
y  productos  en  fermentación. 

4°.  La  leche  á  la  que  se  le  ha  extraído  parte  ó  el  todo  de  su  crema. 

5°.  La  leche  obtenida  de  anmiales  albergados  en  lu  gares  estrechos  ó  insalubres. 

6°.  La  leche  á  la  que  se  le  ha  agregado  agua,  otro  líquido,  leche  condeusada  ó  cualquiera 
otra  substancia  extraña,  ó  que  se  cncuentie  "cortada"  ó  descompuesta. 

7°.  La  leche  procedente  de  localidades  donde  exista  escarlatina,  tifus,  fiebre  tifoidea, 
cólera,  difteria  ú  otras  enfermedades  transmisibles. 

8°.  La  leche  extraída  de  animales  alimentados  con  plantas  venenosas  ó  que  hayan 
ingej'ido  substancias  tóxicas. 

Art.  104.  Para  los  efectos  de  la  inspección  será  sospechosa  toda  leche  cuya  densidad 
sea  menor  de  2.5°  (1.025),  apreciados  con  el  lacto-densímetro  de  Quevenne  á  una  tem- 
peratura de  1-5°  C.  aproximadamente. 

Art.  105.  La  leche  destinada  á  la  venta  no  se  guardará  ó  almacenará  en  habitaciones 
que  se  utilicen  como  doniiitorio  ó  para  otro  objeto  cualquiera. 

No  se  permitirá  transvasar  la  leche  en  la  Ana  pública,  ferrocarriles  ó  estaciones,  excepto 
al  entregársela  al  comprador  en  el  acto  de  la  venta. 

Art.  106.  Sólo  será  permitida  la  venta  de  leche  destinada  al  consumo  público,  cuando 
al  ser  envasada  en  botellas,  botijos  i'i  otras  vasijas,  éstas  hayan  sido  sometidas  á  las 
operaciones  siguientes: 

1°.  Las  botellas,  botijas  y  vasijas  se  lavarán  primero  con  una  solución  caliente  de  jabón, 
lejía  ú  otra  substancia  alcalina,  y  después  con  agua  caliente,  antes  de  llenarlas  de  leche. 

2°.  La  leche  deberá  envasarse  en  locales  que  no  se  deliquen  á  viviendas,  dormitorios  ú 
otros  usos  domésticos  ó  estén  próximas  á  las  caballerizas. 


SEGUNDA    CONFERENCIA    HANJl'AítlA    INTEllNACIONAL.  343 

3».  Las  vasijas  quo  contengan  locho  destinada  á  la  venta  pública  estarán  provistas  de 
una  tapa  apropiada  para  resguardar  la  locho  dxil  polvo  y  do  otras  i/npurozas. 

Art.  107.  Las  vasijas  quo  so  empleen  para  la  loche,  iian  do  estar  muy  limpias,  tener  laa 
juntas  lisas  y  no  estar  moliosas  ni  áspoias  en  su  intcrioi-.  So  prohiben  las  do  cobro  sin 
estañar,  latiín,  zinc,  «metal  con  esnuilto  de  plomo  ó  loza  ¡nal  barnizada. 

AiiT.  108.  Si  no  se  quisiei-a  tapar  la  kichí!  mientras  permanezca  en  el  establo  ó  lechería 
deberá  ponerse  tela  íina  sobre  la  abortui'a  de  las  vasijas. 

La  limpieza  de  las  vasijas  se  verificará  lo  más  pronto  posible  después  do  vaciadas  con 
agua  hiervioudo,  jabón  y  coi)illo;  se  enjuaguarán  con  agua  hei-vida  solamente  y  so  pondrán 
boca  abajo  al  sol,  poro  no  sobro  la  tierra. 

Art.  lOÍ).  La  lecho  almacenada  para  la  venta  se  depositará  siempre  en  un  refrigerador  ó 
nevera  Oon  una  temperatura  quo  no  exceda  de  10°  C. 

Art.  110.  La  nevera  so  lavará  dos  voces  á  la  semana,  por  lo  menos,  con  agua  de  lejía 
caliente. 

Art.  111.  La  cañería  de  desagüe  de  la  nevera  eii  (juc  se  guarde  la  leche  no  deberá  conectar 
directamente  con  los  caños  ni  con  la  cloaca. 

Art.  112.  En  las  leclierías  y  otros  eatablocimientos  en  que  se  expenda  leche  las  medidas 
y  utensilios  usados  para  la  misma  so  limpiarán  perrcctamente,  después  de  la  venta,  con  agua 
liirviendo,  á  la  que  se  le  haya  aúadido  lejía,  en  la  proporci(5n  de  una  cucharada  por  litro. 

Art.  113.  Se  agitará  debidamente  el  contenido  de  la  vasija  al  venderse  la  leche  y  antes 
de  extraer  la  cantidad  deseada,  para  que  las  últimas  porciones  que  se  extraigan  contengan 
tanta  crema  como  las  primeras. 

Art.  114.  No  se  echará  hielo  en  la  leche  como  medio  de  conservación  de  ésta,  en  vez  de 
colocarla  en  la  nevera. 

Art.  115.  Los  carros  destinados  al  transporte  de  leche  deberán  ser  de  material  imper- 
meable ó  de  madera  pintados  al  óleo,  y  conservarse  en  perfecto  estado  de  limpieza. 

En  cada  carro  se  consignará  en  su  exterior  el  objeto  del  mismo  con  caracteres  permanentes 
y  legibles  á  distancia,  así  como  su  número,  y  sitio  de  donde  procede. 

Los  vendedores  do  leche  en  caballerías  ú  otros  medios  de  traasportc  están  obligados  á 
conservar  los  serones,  alforjas,  etc.,  dedicados  á  este  uso,  en  perfecto  estado  de  limpieza. 

Queda  prohibido  transportar  en  los  carros,  serones,  aLforjas,  etc.,  destinados  al  expendio 
de  leche,  otras  materias  ó  substancias,  con  excepción  de  quesos  frescos,  mantequilla  ú  otros 
productos  de  la  leche. 

Los  conductores  de  leche  están  obligados  á  llevar  consigo  durante  las  horas  de  su  tráfico, 
la  licencia  que  los  autorice  para  el  ejercicio  de  la  industria,  la  que  exhibirán  á  los  inspectores 
de  sanidad  cuando  se  les  pida. 

Art.  116.  Los  carros  y  caballerías  destinados  al  transporte  de  la  leche  deberán  estar 
inscriptos  en  los  registros  que  á  ese  efecto  se  lleven  en  las  juntas  locales  de  sanidad. 

Art.  117.  Todos  los  que  se  dediquen  al  expendio,  transporte  y  manipulación  de  la  leche 
destinada  á  la  venta  pública  deberán  estar  provistos  de  un  certificado  del  jefe  local  de 
sanidad  en  que  se  acredite  su  estado  de  salud.     Estos  certificados  serán  renovados  cada  año. 

Art.  lis.  Los  expendedores  de  toda  clase  de  ieche  serán  provistos,  conjuntamente  con 
la  licencia  industrial,  que  exijan  las  disposiciones  municipales,  de  una  hoja  impresa  que 
contenga  las  reglas  de  estas  ordenanzas  que  se  refieren  al  expendio  de  la  misma,  y  que  serán 
facilitados  3^  unidos  de  uu  modo  permanente  por  la  junta  de  sanidad. 

Art.  119.  Sólo  será  permitido  usar  para  establo  de  vacas  de  leche,  edificios  que  tengan 
por  lo  menos  30  metros  cúbicos  de  espacio  por  cada  animal,  buena  luz  y  ventilación,  cana- 
lizado el  piso  convenientemente,  bien  techado,  provisto  deagua  pura  y  de  todo  lo  necesario 
para  mantener  las  vacas  ú  otros  animales  de  leche  en  buenas  condiciones  de  salud  é  higiene, 
conforme  al  reglamento  especial  de  vaquerías  ó  lecherías.  Estos  establos  deberán  estar 
situados  precisamente  fuera  de  la  zona  urbana  de  las  poblaciones  y  no  se  permitirá  en  ellos 
la  instalación  ó  ejercicio  de  ninguna  otra  industria  ó  comercio. 

Art.  120.  Los  dueños  ó  encargados  de  establos  de  vacas  ú  otros  animales  de  leche  quedan 
obligados  á  mantener  limpios  todos  los  lugares  del  establecimiento,  así  como  á  llevar  las 
vacas  al  campo  entre  las  horas  comprendidas  desde  las  cuatro  de  la  tarde  á  las  ocho  de  la 
noche  y  á  no  traerlas  á  sus  establos  sino  entre  las  cuatro  y  las  seis  de  la  mañana  siguiente. 

Art.  121.  A  toda  persona  que  tenga  una  enfermedad  cutánea  ó  transmisible,  ó  haya 
estado  en  contacto  con  algún  enfermo  de  ellas,  se  le  prohibe  ordeñar  las  vacas  ú  otros  ani- 
males, vender  leche,  manejar  las  vasijas,  medidas  ú  otros  recipiefltes  de  la  lechería,  y 
ayudar  en  esas  operaciones,  hasta  que  todo  peligi-o  de  contagio  haya  desaparecido.  Deberá 
■edemas  estar  lim.pio  y  libre  de  suciedades  físicas  de  cualquier  clase. 

Art.  122.  Se  prohibe  vender  ó  usar  para  la  fabricación  de  alimentos  ó  para  mezclarla 
con  otra  la  leche  procedente  de  vacas  enfermas.  No  se  permitirá  tampoco  su  uso  para 
ningún  objeto,  aunque  sea  para  la  alimentación  de  otros  aniuiales. 

Art.  123.  Se  prohibe  introducir,  almacenar  ó  vender  leche  condensada  adulterada. 
Para  los  efectos  de  estas  ordenanzas  se  entenderá  por  "Leche  condensada,"  leche  puia  á  la 


344  SEGUNDA   CONFERENCIA    SANITARIA   INTERNACIONAL. 

cual  se  haya  substraído  una  parte  de  su  agua;  ó  á  la  cual  se  la  haya  despojado  de  una  parte 
del  agua  y  añadido  azúcar.  El  término  "adulterada"  se  refiere  en  el  último  de  los  casos 
citados  á  una  leche  condensada  en  que  la  cantidad  de  manteca  es  inferior  al  25  por  cienta 
de  las  materias  sólidas  contenidas  en  ella  y  á  la  que  se  le  haya  añadido  cualquier  substancia 
extraña,  con  excepción  de  azúcar,  empleada  como  elemento  de  conser\'ación. 

Art.  124.  Toda  leche  destinada  á  la  venta  quedará,  sujeta  á  la  vigilancia,  en  cualquier 
tiempo  y.  lugar  y  en  todas  las  circunstancias  que  fueren  necesarias,  de  los  inspectores  de 
sanidad,  quienes  estarán  autorizados  para  tomar  muestras  en  cantidad  que  no  exceda  de 
medio  litro  por  cada  vasija,  con  objeto  de  someterla  al  análisis  correspondiente.  Al  tomarse 
la  muestra,  debe  agitarse  la  leche  suficientemente  para  que  las  pequeñas  partículas  de  grasa 
queden  diseminadas  por  igual  en  el  líquido. 

Akt.  125.  Los  inspectores  emplearán  en  sus  ensayos  el  lactodensímetro  de  Quevenne 
para  apreciar  el  peso  específico,  y  llevarán  un  libro  registro  bien  detallado  de  todas  las 
muestras  ensavadas. 

Art.  126.  Tan  pronto  como  existan  sospechas  de  que  una  leche  está  adulterada  se 
ordenará  una  inspección  al  establo,  lechería  ó  lugar  de  donde  proceda,  cjuedando  á  juicio 
del  inspector  exigir  ó  no  que  se  le  muestren  las  vacas,  de  donde  haya  sido  traída. 

Art.  127.  El  expendedor  de  leche  que  no  cumpla  estrictamente  las  reglas  establecidas 
para  la  venta  de  este  artículo  quedará  incurso  en  la  multa  y  el  decomiso  consiguiente,  salvo 
que  la  infracción  constituya  delito,  en  cuyo  caso  el  inspector  dará  cuenta  al  jefe  de  sanidad 
para  lo  que  proceda. 

Art.  128.  Las  lecherías  y  los  establos  de  vacas  estarán  bien  ventilados  y  se  mantendrán  ea 
las  mejores  condiciones  de  limpieza,  y  sus  pisos  se  fregarán  diariamente. 

En  los  establos  habrá  para  cada  animal  un  pesebre  y  un  bebedero,  quedando  prohibido-s 
los  pesebres  y  bebederos  comunes. 

Art.  129.  No  se  consentirá  ninguna  vaca  enferma  en  los  establos,  y  las  sanas  estarán 
separadas  unas  de  otras,  se  les  dará  buenos  alimentos  y  agua  pura  y  fresca,  y  se  les  bañará 
diaiiamente. 

Art.  130.  Se  ventilará  el  local  de  los  establos  y  se  regará  el  piso  antes  de  ordeñar  las 
vacas  para  evitar  que  el  polvo  caiga  en  la  leche. 

Art.  131.  La  operación  de  ordeñar  deberá  hacerse  con  el  más  escrupuloso  aseo,  proce- 
diendo el  ordeñador  á  lavai-se  las  manos  y  lavar  también  la  ubre  del  animal  que  se  ordeñe 
y  á  enjugarlas  con  paño  limpio,  evitando  que  caigan  en  la  leche  pelos  ó  cualquiera  otra 
subs  tancia  que  la  ensucie. 

Art.  132.  No  se  permitirá  ordeñar  vacas  ú  otros  animales  cuyas  ubres  presenten  alguna 
erupción  se  encuentren  inflamadas  ó  tengan  alguna  otra  enfermedad. 

Art.  133.  Si  durante  la  operación  de  ordeñar  se  obtuviese  leche  sanguinolenta,  amarillosa 
ó,  en  general,  de  color  y  sabor  distintos  de  la  natural,  se  arrojará  ésta  limpiándose  cuidadosa- 
mente la  vasija  que  la  haya  contenido,  suspendiendo  la  operación  de  ordeñar  y  poniendo  en 
observación  la  vaca  hasta  comprobar  su  estado  de  salud  y  por  el  inspector  de  sanidad  se 
autorice  que  sea  ordeñada  nuevamente. 

Art.  134.  Si  por  cualquier  motivo  la  leche  se  ensuciara,  no  será  permitido  colarla,  sino 
que  será  arrojada,  limpiándo.se  en  el  acto  la  vasija  que  la  contenía. 

Art.  135.  Las  vaquerías  de  fincas  rústicas  destinadas  á  la  extracción  de  leche  para  la 
venta  pública,  fabricación  de  quesos,  etc.,  habrán  de  ajustarse,  en  io  posible,  para  .sus 
opera  clones  á  las  reglas  anteriores,  quedando  sometidas  á  la  inspección  frecuente  de  la 
junta  local  de  sanidad. 

Art.  136.  Los  establos  de  vacas,  las  lecherías  y  vaquerías,  quedan  obligados  á  tener  en 
lugar  visible  del  establecimiento  un  ejemplar  impreso,  proporción  por  la  junta  local  de 
sanidad,  del  reglamento  especial  por  que  deben  regirse. 

Art.  137.  Queda  prohibido  el  uso  de  substancias  presei-vativas,  tanto  para  la  leche 
como  p^ra  los  demás  alimentos. 

Art.  138.  La  fabricación  de  queso  de  mano  no  curado  deberá  hacerse  con  leche  ó 
crema  de  buena  calidad  y  procedentes  de  animales  sanos  y  para  la  elaboración  se  sujetará 
el  fabricante  á  las  precauciones  higiénicas  que  sean  procedentes  y  que  hayan  obtenido  la 
aprobación  del  jefe  local  de  sanidad. 

Se  prohibe  la  venta  de  queso  fresco  ó  de  mano  por  vendedores  ambulantes  ú  otros  que  no 
tengan  la  mercancía  en  un  refrigerador  y  al  abrigo  del  polvo,  á  fin  de  evitar  .su  decomposición 
y  la  producción  de  substancias  tóxicas. 

Art.  139.  Toda  substancia  orgánica  susceptible  de  fácil  descomposición,  destinada  á  ali- 
mento que  haya  de  usarse  en  estado  fresco,  será  coacervada  en  un  refrigerador. 

Art.  140.  Los  granos  ó  polvos  que  se  venden  con  el  nombre  de  café,  deberán  ser  exclusiva- 
mente constituidos  por  este  fruto.  Se  prohibe  la  venta  de  café  mezclado  con  subtancias 
extrañas,  así  como  la  do  su  polvo  privado,  por  la  infusión  en  agua,  de  los  elementos  que  le 
comunican  su  aroma,  sabor  y  propiedades  peculiares. 

Art.  141.  El  producto  preparado  y  vendido  con  el  nombre  de  chocolate  será  el  obtenido 
solamente  de  las  semillas  del  cacao  pulverizadas  y  mezcladas  con  proporciones  variables  de 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  345 

azúcar,  aromatizado  ó  no.  La  proporción  máxima  de  azúcar  ha  de  ser  de  60  por  ciento;  una 
cantidad  mayor  deberá  ser  expresa  y  claramente  declarada  en  el  rótulo  del  envase  6  cubierta. 
Art.  142.  Los  dueños  6  oncarg;ados  de  establecimientos  de  víveres  ó  bebidas,  están  obli- 
gados á  recibir  la  visita  del  inspector  de  sanidad;  y  en  caso  de  negativa  incurrirán  en  multa 
por  la  primera  vez,  y  en  las  demás  penas  que  les  imponga  el  juzgado  en  el  caso  do  reincidencia. 

Capítulo  IIL 

OONSTRÜOOIÓN  DE  EDIFICIOS  EN  I.A  POBLAOIÓN — VENTILACIÓN — DllENA.JE   K  INSTALACIONES 

8ANITAKIAS. 

Art.  143.  El  terreno  en  que  haya  de  erigirse  una  casa  ó  edificio  será  previamente  saneado, 
y  si  fuere  necesario  terraplenar  antes  de  la  edificación,  se  emplearán  al  efecto  materiales  que 
no  sean  contumxces.  Guindo  se  vaya  á  empezar  cualquiera  excavación  ó  remoción  de 
tierras  ó  materiales,  se  dxrá  aviso  anticipado  al  jefe  de  sanidad,  áün  de  que  dicte  las  órdenes 
necesarias  para  la  desinfección  del  terreno. 

Art.  144.  La  edificación  ha  de  descansar  en  suelo  firme,  sobre  una  capa  de  cemento  ú 
otro  material  adecuando.  Toda  habitación  baja  estará  aislada  de  la  tien-a  por  una  capa  de 
asfalto  ó  de  cemento  de  un  espesor  mínimo  de  15  centímetros. 

Para  impedir  que  ascienda  la  humedad  á  través  de  las  paredes,  si  fuere  necesario  se 
aislarán  éstas  por  medio  de  capas  de  cemento,  asfalto,  pizarra  ú  otra  substancia  impermeable. 
Esta  capa  aisladora  se  colocará  á  unos  15  centímetros  por  bajo  de  la  rasante  del  piso. 

Art.  145.  Para  establecer  contra  una  pared,  medianera  ó  no  un  establo,  caljallerizas, 
almacén  de  sal  ó  depósito  de  substancias  corrosivas,  se  deberán  dejar  15  centímetros,  por  lo 
menos,  de  espacio  entre  el  muro  y  la  construcción  proyectada. 

Art.  146.  Se  prohibe  instalar  techos  de  cristales  ó  de  cualquiera  otra  materia,  en  los 
patios  y  patines  interiores  de  los  edificos  por  encima  del  puntal  de  la  planta  baja  de  los 
mismos,  á  no  ser  que  dichos  techos  sean  movibles  ó  se  hallen  provistos  de  ventiladores  de 
caras  verticales,  cuyo  vano  no  sea  inferior  al  tercio  de  la  superficie  del  patio  ó  patín  y  de 
cincuenta  centímetros  de  altura. 

Art.  147.  En  las  calles  donde  no  exista  alcantarilla,  é  ínterin  ésta  se  construye,  deberá 
tener  cada  casa  ó  edificio  un  pozo  negro  para  recoger  únicamente  las  materias  fecales ;  pero 
una  vez  constmida  la  alcantarilla  general  de  la  calle,  los  propietarios  quedarán  obligados  á 
hacer  las  acometidas  á  la  misma  y  á  cegar  el  pozo  negro.  Los  dueños  de  los  edificios  ó  casas 
existentes  en  calles  alcantarilladas,  procederán  á  hacer  las  acometidas  á  las  mismas  dentro 
de  los  seis  meses  siguientes  á  la  publicación  de  estas  reglas. 

Art.  148.  No  se  permitirá  la  constmcción,  reconstrucción  ó  modificación,  total  ó  parcial, 
para  su  objeto  presente  ó  para  otra  cualquiera  ulterior,  de  ninguna  casa  ó  edificio  que  pueda 
constituir  un  peligro  para  la  vida  ó  la  salud,  y  por  falta  de  seguridad,  ya  por  defecto  de  venti- 
lación, luz,  drenaje,  instalaciones  sanitarias  ú  otros  requisitos  análogos. 

Art.  149.  Para  la  constmcción,  reconstrucción  ó  refonna,  total  ó  parcial,  de  una  casa  ó 
edificio,  así  como  para  colocar,  cambiar  ó  modificar  sus  instalaciones  sanitarias,  será  preciso 
obtener  licencia  del  ayuntamiento,  sujetándose  á  los  requisitos  exigidos  en  las  ordenanzas 
de  constmcción  respectivas  y  en  las  especificaciones  del  departamento  de  ingenieros  ó  del 
arquitecto  municipal  donde  no  existiera  aquel  departamento.  Antes  de  conceder  la  licen- 
cia, el  ayuntamiento  remitirá  el  expediente  á  la  junta  local  de  sanidad,  para  su  dictamen,  le 
cual  se  basará  en  estas  ordenanzas,  y,  caso  de  que  resulte  desfavorable,  se  señalarán  en  el 
mismo,  en  un  plazo  no  mayor  de  veinte  días,  los  defectos  y  la  manera  apropiada  de  corre- 
girlos. Contra  el  informe  de  la  junta  local,  podrán  los  interesados  acudir  á  la  Superior  del 
ramo  para  la  resolución  definitiva.  Si  el  informe  de  la  junta  local  es  favorable,  se  concederá 
la  licencia  á  la  mayor  brevedad  posible,  á  no  ser  que  falten  otros  requisitos  legales  por 
cumplir. 

Art  150.  Para  habitat,  poner  en  alquiler,  ó  utilizar  de  cualquier  otra  manera,  una  casa 
ó  edificio  de  nueva  planta  constraído,  reconstniído  ó  refonnado,  en  todo  ó  en  parte,  será 
requisito  necesario  la  inspeción  previa  y  un  certificado  favorable  de  la  junta  local  de  sanidad, 
limitándose  la  inspección  á  comprobar  el  cumplimiento  de  las  coduiciones  exigidas  en  el 
plano  y  proyecto  aprobados.  Contra  el  dictamen  desfavorable  de  la  junta  local,  puede  el 
interesado  interponer  recurso  de  alzada  ante  la  Superior,  que  resolverá  en  definitiva. 

Art.  151.  No  se  permitirá  utilizar  como  alojamiento  ó  como  dormitorio  ninguna  casa, 
edificio  ó  parte  de  éste,  que  no  reúna  las  debidas  condiciones  de  capacidad,  dotación  de 
agua,  ventilación,  luz,  evacuación  de  aguas  residuas  y  excretas  y  demás  requisitos  de  lim- 
pieza y  salubridad  indispensables. 

Art.  152.  Toda  casa  &  edificio  de  nueva  planta  se  construirá  dejándose  de  superficie 
descubierta,  ó  patios  interiores,  el  15  por  ciento,  por  lo  menos  del  área  edificada,  de 
modo  que  permita  la  ventilación  y  entrada  de  la  luz  en  todas  las  habitaciones. 

Amt.  153.  En  las  casas  ó  edificios  existentes  destinados  á  viviendas,  que  no  reúnan  las 
circunstancias  establecidas  en  el   artículo  precedente,  se  abrirán   huecos  de  ventilación, 


4-l:()  SEGUNDA   CONFERENCIA    SANITARIA   INTERNACIÓN.^.. 

si  carecen  de  ellos,  y  no  siendo  esto  posible,  se  ejecutarán  obras  que  produzcan  ventilación 
supletoria. 

Art.  154.  Toda  habitación  deberá  tener  huecos  de  puerta  ó  ventana  que  den  directamente 
á  calle,  jardín,  patio  ó  pasillo  abierto.  Las  puertas  que  den  á  los  patios  tendrán  respií'a- 
deros  en  lo  alto,  protegidos  ó  no  con  marcos  movibles  de  vidrio. 

AüT.  155.  Toda  habitación  deberá  tener,  por  lo  menos,  una  capacidad  de  36  metros  cúbi- 
cos, y  una  superficie  en  puertas  y  ventanas  no  menor  de  3  metros  cuadrados,  aumentándose 
ésta  en  proporción  de  lí  metros  cuadrados  por  cada  30  metros  más  de  cubicación. 

Art.  156.  El  piso  de  las  habitaciones  bajas  será  más  elevado  que  el  del  patio  y  el  de  éste 
más  que  el  nivel  de  la  calle.  No  se  concederán  más  excepciones  que  las  que  expresamente 
autorice  por  escrito  la  junta  de  sanidad  después  de  haberse  llenado  los  requisitos  que  ésta 
señale  en  cada  caso  con  sujeción  á  estas  Ordenanzas. 

Art.  157.  Los  pisos  de  las  habitaciones  bajas,  así  como  el  de  los  patios,  serán  de  cemento, 
de  lósela  de  cemento  comprimido  ú  otro  material  impermeable;  colocándose  además  debajo 
de  la  soladura  una  capa  continua  también  impermeable. 

Art.  158.  Las  paredes  de  cualquiera  casa  ó  edificio  serán  construidas  de  modo  que  no 
puedan  impregnai-sc  de  la  humedad  del  suelo,  haciendo  uso  para  evitarlo  de  materiales 
impermeables. 

Art.  159.  En  las  casas  ó  edificios  de  aquellas  localidades  en  que  sea  permitido  el  uso  de 
pisos  de  madera  en  las  habitaciones  bajas,  el  espacio  comprendido  entre  el  suelo  y  el  piso 
de  las  habitaciones  tendrá  ventilación  hacia  el  exterior. 

Art.  160.  No  se  permitirá  construii-  fosa  de  excusado,  ni  sumidero  debajo  del  piso  de 
ninguna  habitación.  Estos  depósitos  se  situarán  en  los  lugares  más  céntricos  de  los  patios 
ó  jardines,  ventilados  y  bañados  por  el  sol. 

Art.  161.  Las  casetas  de  los  inodoros  ó  excusados  se  situarán  en  los  patios,  pasillos,  ó 
corredores,  ú  otros  lugares  bien  claros  y  ventilados  y  nunca  en  haljitacioues  que  sirvan  de 
dormitorios,  y  separados  de  los  cuartos  habitables,  cocina,  despensa,  etc.  por  tabiques 
completos. 

Art.  162.  Los  tubos  bajantes  de  desagües  de  tejados,  azoteas,  inodoros,  vertederos, 
etc.  serán  de  hierro  fundido,  y  no  estarán  embutidos  en  los  muros  sino  instalados  por  fuera 
de  las  paredes. 

Art.  163.  En  todas  las  casas  ó  edificios  habrá  por  lo  menos,  ua  excusado  por  cada  veinte 
personas,  y  con  todos  los  requisitos  necesarios  para  evitar  emanaciones  é  infiltraciones. 

Art.  164.  El  propietario,  apoderado,  encargado  ó  representante  de  cualquiei-  casa,  edi- 
ficio ó  vivienda,  será  siempre  el  responsable  en  primer  téimino  de  la  conservación  en  buen 
estado  de  las  instalaciones  sanitarias  de  la  finca,  sin  perjuicio  de  la  acción  que  corresponda 
ejercer  contra  el  inquilino,  según  los  casos. 

Art.  165.  Las  accesorias  de  cualquiera  casa  ó  edificio  tendrán  las  debidas  condiciones  de 
ventilación,  luz  y  agua;  y  excusado  y  vertedero  propios,  instalados  coa  todos  los  requisitos 
sanitarios;  ó  en  otro  caso  el  propietario  se  obliga  á  permitir  que  los  inquilinos  de  aquéllas 
hagan  uso  de  los  excusados  y  vertederos  comunes  del  mismo  pLso  de  la  casa,  en  la  propor- 
ción ya  establecida  con  el  número  de  personas. 

v^iT.  166.  Las  accesorias  destinadas  á  la  venta  de  carne,  leche,  frutas,  dulces,  etc.,  tendrán 
sus  servicios  sanitarios  completamente  aislados  de  la  tienda;  no  estarán  en  comunicación 
directa  con  el  resto  del  edificio ;  tendrán  en  la  parte  más  elevada  de  la  puerta  un  resphadero 
de  cuarenta  ó  cincuenta  centímetros  de  altura,  por  lo  menos,  por  todo  el  ancho  de  aquélla 
y  sólo  le  será  permitido  dormir  en  ellas,  pero  únicamente  en  una  habitación  anexa,  á  los 
encargados  de  su  custodia  ó  vigilancia  y  en  ningún  caso  á  familias. 

Art.  167.  Todo  propietario  de  casa  de  una  población  donde  exista  acueducto  y  cañería 
de  éste  en  la  calle,  está  en  la  obligación  de  instalar  en  la  casa  plumas  de  agua  en  cantidad 
proporcionada  al  número  de  habitantes  de  la  casa;  y  servicio  independiente  de  agua  para 
cada  piso  que  se  alquile  por  separado. 

Art.  168.  No  se  permitirá  la  construcción  de  pozos,  aljibes,  ú  otro  depósito  de  agua  en 
cualquiera  casa  ó  edificio  de  nueva  planta  por  cuya  calle  pase  cañería  del  acueducto,  á  no 
ser  para  usos  industriales,  con  autorización  de  la  Junta  de  Sanidad  y  sujetos  á  los  requisitos 
que  ésta  señale.  Quedan  exceptuados  los  tanques  para  usos  domésticos,  siempre  que  se 
tengan  en  las  condiciones  señaladas  por  la  junta  de  sanidad. 

Art.  169.  En  los  lugares  donde  sea  permitida  la  excavación  de  pozos  negros,  se  situarán 
éstos  á  distancia  mayor  de  diez  metros,  por  lo  menos,  de  los  pozos  de  agua,  aljibes,  fuentes 
ú  otras  provisiones  de  agua.  Igual  prescripción  regirá  para  una  fosa  de  abonos,  un  depósito 
de  inmundicias,  etc. 

Art.  170.  Queda  prohibida  la  instalación  de  cañerías  de  agua  para  el  consumo  doméstico 
á  través  de  caños,  cloacas  ú  otros  desagües.  » 

Art.  171.  No  se  permitirá  la  construcción  ni  la  apertura  de  templos,  teatros,  circos, 
casa-cunas,  hoteles,  hospitales,  asilos  y  otros  edificios  de  reunión,  sin  informe  favorable  de 
la  junta  local  de  sanidad  con  vista  de  los  planos,  memoria  y  demás  antecedentes  de  la  obra. 


■SEGUNDA    CONFERENCIA    tíANTTAKIA    INTKKNAíMímAL.  347 

Art.  172.  Los  teatros,  circos,  templos,  saltis  do  espectáculos,  liotclcs,  posadas,  asilos,  etc. 
iian.de  reunir,  á  más  de  los  re<|uisitos  generales,  los  especiales  HÍgui(íntcs:  (a)  Ventilaci<5n 
suficiente  y  adecuada  al  número  de  concurrentes  ó  alojados;  (b)  medios  de  extinf^uir  los 
incendios  y  salidas  fáciles  y  rápidas  de  ios  espectadores;  (c)  provisión  abundante  de  agua 
y  número  proporcional  de  retretes  y  urinarios;  y  (d)  limpieza  esmerada  <m  todas  las  depen- 
dencias. 

Art.  173.  Los  cuarteles  y  prisiones  so  construirán  pi'cvio  inJ'ornK!  favoral)lc  déla  Junta 
Superior  de  Sanidad. 

Art.  174.  Cualquier  sujeto  está  obligado  á  dcnutuuar  al  Jefe  de  Sanidad  la  realización 
en  un  edificio  de  todo  acto  ú  obra  que  pueda  resultai'  peligroso  ó  perjudicial  á  la  salud 
pública. 

Capítulo  IV. 

HOTELES,  POSADAS,  CASAS  DE  IIUKSPEDES,  CASAS  DE  DORMIR,  CAI''K8,  RESTAURANTS    FONDAS 

Y    CANTINAS. 

Art.  175.  No  se  establecerá  ningún  hotel,  posada,  mesón,  casa  de  huéspedes,  casa  de 
dormir,  café,  restaurants,  foida,  cantina  ó  bodega,  sin  que  el  dueño  ó  encargado  someta  el 
establecimiento  á  líis  condiciones  exigidas  por  el  jefe  do  sanidad  mediante  licencia  por 
escrito.  Para  los  existentes  en  la  actualidad,  se  concede  á  sus  dueños  ua  plazo  máximo  de 
seis  meses,  á  contar  desde  la  promuIgació)i  de  estas  ordenanzas,  para  que  se  ajusten  á 
dichas  condiciones,  so  pena  de  multa  y  clausura  del  establecimiento. 

Art.  176.  Todo  hotel,  posada,  casa  de  huéspedes  y  casa  de  dormir,  llevará  un  libro 
registro  con  los  nombres,  procedencia,  días  de  entrada  y  salida,  y  número  del  cuarto  que 
ocupen,  de  cada  una  de  las  personas  que  alojen  y  de  las  que  estén  al  servicio  del  estableci- 
miento. 

Art.  177.  Queda  prohibido  alojar  en  los  hoteles,  posadas,  casas  de  huéspedes  y  casas  de 
dormir,  mayor  número  de  personas  del  que  corresponda  á  la  capacidad  de  las  habitaciones, 
en  la  proporción  de  20  metros  cúbicos  de  espacio  por  cada  individuo. 

Art.  178.  Todo  cuarto  ó  habitación  estará  numerada  con  caracteres  permanentes. 

Art.  179.  No  se  permitirá  en  los  cuartos  ó  habitaciones  mayor  número  de  camas  que  el 
correspondiente  á  la  referida  proporción,  á  menos  que  existan  otros  medios  adecuados  para 
mayor  y  apropiada  ventilación,  que  estén  aprobados  por  la  junta  de  sanidad  y  mediante 
concesión  escrita  en  que  se  especifique  el  número  de  camas  que  se  permita  por  estas  cir- 
cunstancias especiales. 

Art.  180.  Toda  habitación  de  donnir  deberá  tener  40  metros  cúbicos  de  capacidad,  por 
lo  menos,  y  puertas  y  ventanas,  no  menores  estas  últimas  de  un  metro  cuadrado,  que  la 
pongan  en  comunicación  con  el  aire  exterior,  salvo  que  se  emplee  otro  medio  apropiado  que 
suministre  amplia  ventilación. 

Art.  181.  Todas  las  habitaciones  estarán  en  el  mejor  estado  de  limpieza,  así  como  los 
muebles,  utensilios,  ropas  de  cama,  etc.  Las  paredes  de  cal  serán  blanqueadas  una  vez  al 
año,  por  lo  menos. 

AjaT.  182.  Las  basuras  y  desperdicios  se  irán  depositando  en  receptáculo  de  zinc  ú  otro 
material  impermeable,  conforme  al  modelo  y  número  señalado  por  la  jvmta  de  sanidad,  y 
serán  extraídos  diariamente. 

-  Art.  183.  Los  hoteles,  posadas,  mesones,  casas  de  huéspedes  y  casas  de  dormir  tendrán 
los  mingitorios,  excusados,  fregaderos,  vertederos,  baños,  caños,  etc.,  en  perfecto  estado 
de  servicio  y  aseo.  Habrá  un  baño  y  un  inodoro  ó  excusado  por  cada  veinte  personas. 
Los  excusados  ó  inodoros  estarán  en  locales  de  capacidad  suficiente,  bien  ventilados  y  con 
luz  bastante,  natural  ó  artificial ,  durante  todo  el  día  y  la  noche.  Las  paredes  hasta  un  met  ro 
de  altura,  por  lo  menos,  y  los  pisos  de  los  baños,  retretes,  urinarios,  vertederos  y  fregaderos, 
serán  impermeables  y  se  conservarán  constantemente  en  el  mejor  estado  de  limpieza. 

Art.  184.  Todos  los  establecimientos  mencionados  tendrán  dotación  de  agua  suficiente 
á  proporcionar  100  litros  diarios,  cuando  menos,  por  persona. 

Art.  185.  Los  cafés,  restaurants,  y  cantinas  tendrán  urinarios  ó  inodoros  ó  excusados, 
sin  que  despidan  malos  olores,  con  sus  lavamanos  correspondientes,  para  el  seiTicio  público, 
todo  en  perfecta  fimción  y  aseo,  en  núniero  proporcionado  á  la  importancia  del  estable- 
cimiento y  con  la  aprobación  previa  y  el  plano  y  sistema  de  los  mismos  de  la  junta  de  sanidad. 

Art.  186.  Los  establecimientos  á  que  se  refieren  los  tres  artículos  anteriores  tendrán 
escupideras,  en  la  proporción  de  una  por  cada  veinte  personas,  en  los  pasillos,  corredores, 
etc.,  del  modelo  y  con  la  solución  desinfectante  que  indique  la  junta  de  sanidad.  En  los 
cafés  el  número  de  escupideras  será  igual,  por  lo  menos,  al  de  las  mesas  en  servicio. 

Art.  187.  El  dueño  ó  encargado  de  un  hotel,  posada,  fonda,  mesón,  casa  de  huéspedes  ó 
casa  de  dormir,  está  obligado  á  dar  parte  al  jefe  de  sanidad  de  todo  enfermo  que  haya  en  la 
caso  sin  asistencia  médica:  así  como  de  todo  caso  de  enfermedad  transmisible  que  en  la 
misma  exista. 


348  SEGUNDA   CONFERENCIA   SANITARIA   INTEENACIONAL. 

Art.  188.  Cualquier  eüfermo  de  enfermedad  transmisible  que  se  encuentre  alojado  en  un 
hotel,  posada,  fonda,  casa  de  huéspedes,  ca«ia  de  domiir,  etc.,  será  trasladado  á  un  hospital 
de  aislamiento,  cuando  así  lo  crea  necesario  el  jefe  de  sanidad. 

Art.  189.  El  dueño  ó  encarsrado  de  un  hotel,  posada,  fonda,  casa  de  huéspedes,  casa  de 
dormir,  mesón,  restaurant,  café,  cantina  ó  bodega  que  no  dé  cumplimiento  á  cualquiera  de 
las  disposiciones  de  este  capítulo  incurrirá  en  responsabilidad,  y  si  encontrare  resistencia 
por  parte  de  algún  alojado  para  su  observancia,  6  que  faltare  á  ellas  dará  cuenta  en  seguida 
al  jefe  de  sanidad. 

Capítulo  V. 

CASAS   DE   ^^.CINDAD   Ó   CIUDADELAS. 

Art.  190.  Para  los  efectos  de  estas  ordenanzas,  se  entenderá  por  casa  de  vecindad  o  ciuda- 
áeZa,  cualquiera  casa,  edificio  6  parte  de  éste,  destinado  á  domicilio  ó  vivienda  de  tres  ó  más 
familias  que  vivan  independientes  unas  de  otras,  con  derecho  c  )mún  á  los  pasillos,  escaleras, 
patios,  baños,  azoteas,  inodoros  ó  excusados,  y  que  cocinen  por  separado  en  la  misma  ca.sa. 

Art.  191.  Toda  casa  de  vecindad  tendrá  á  su  frente  un  encargado,  responsable  inmediato, 
del  cumplimiento  de  las  siguientes  obligaciones,  sin  perjuicio  de  la  acción  que  proceda 
contra  el  propietario. 

Art.  192.  Llevar  un  libro  registro  en  el  que  se  anoten  nombre,  apellido,  naturalidad, 
edad,  estado  y  procedencia  de  cada  uno  de  los  inquilinos  de  la  casa,  expresando  el  día  de  su 
ingleso  en  la  misma  y  cuartos  que  ocupen,  así  como  los  traslados  que  efectúen  de  habita- 
cioi^es  en  la  propia  casa  ó  cuando  cesen  de  ocuparlas. 

Art.  193.  Dar  parte  en  el  término  de  veinticuatro  horas  al  jefe  de  sanidad  de  todo  enfermo 
en  la  casa  que  no  tenga  asistencia  médica.  , 

Art.  194.  Interrogar  al  facultativo  que  visite  al  enfermo  si  se  trata  de  alguna  enfermedad 
transmisible,  y  en  la  afirmativa  dar  parte  inmediatamente  al  jefe  de  sanidad. 

Art.  19-5.  Obligar  á  los  inquilinos  á  que  sólo  viertan  las  basuras  en  depósitos  de  hierro 
galvanizado,  suministrado.^  por  el  propietario,  y  conforme  al  modelo  y  número  que  fije  la 
junta  de  sanidad. 

Art.  196.  Cuidar  de  que  los  patios  y  corredores  se  hallen  siempre  en  el  mayor  estado  de 
limpieza,,  para  lo  cual  no  permitirá  que  á  los  mismos  se  arrojen  basuras  ó  aguas  sucias. 

Art.  197.  Impedir  que  en  la  casa  se  depositen  muebles  inutilizados  ó  trastos  viejos. 

Art.  198.  Tener  cuidado  de  que  todos  los  tragantes  de  los  caños  tengan  agua  y  puesta 
siempre  su  tapa,  é  inspeccionarlos  con  frecuencia  para  asegurarse  de  que  funcionan  debi- 
damente, así  como  las  sifas,  trampas,  etc.,  de  los  vertederos,  fregaderos  y  demás  instala- 
ciones sanitarias 

Art.  199.  Vigilar  constantemente  los  inodoros  y  urinarios  para  que  estén  siempre  en 
completo  estado  de  limpieza  y  función  y  evitar  que  se  obstruyan,  así  como  cuidar  de  que  en 
el  suelo  los  mismos  no  se  dopositen  orines  ni  otras  suciedades. 

Art.  200.  Inspeccionar  los  cuartos  todos  de  la  casa  para  cuidar  de  que  en  el  interior  de 
ellos  se  observen  el  aseo  y  la  limpieza  correspondientes;  y  al  notar  que  algún  inquilino  no 
tiene  limpia  su  habitación,  amonestarlo  en  seguida,  y  comunicar  la  falta  al  jefe  de  sanidad, 
si  se  repitiere. 

Art.  201.  Conservar  el  patio  de  tal  manera  que  no  se  fonnen  charcos  en  el  mismo ;  y  cuidar 
de  que  los  pozos,  aljibes,  tanques  ú  otros  depósitos  de  agua  de  la  casa  estén  debidamente 
cubiertos  con  tapas  ó  tela  metálica  á  prueba  de  mosquito. 

Art.  202.  Impedir  que  pernocten  en  ninguna  habitación  de  la  casa  mayor  número  de 

{)ersonas  del  que  corresponda  á  la  capacidad  de  aquélla,  y  en  el  número  que  tenga  dispuesto 
a  junta  de  sanidad,  indicado  en  tablillas  que  se  conservarán  fijas  en  el  interior  de  cada 
habitación.     Todas  las  habitaciones  estarán  mmieradas  con  caracteres  permanentes. 

Art.  203.  Efectuar  la  limpieza  esmerada  de  toda  habitación  que  se  desocupe  en  la  casa 
antes  de  que  vuelva  á  ser  alquilada,  conservándola  con  la  puerta  clausurada;  y  comunicar 
en  seguida  á  la  junta  de  sanidad  para  la  desinfección  correspondiente,  si  hubiese  habido  en 
eUa  algún  caso  de  enfermedad  de  las  que  es  obligatorio  dar  parte. 

Art.  204.  En  toda  casa  de  vecindad  habrá  en  los  patios,  corredores  y  pasillos  una 
escupidei-a  por  cada  veinte  inquilinos.  Las  escupideras  se  colocarán  en  soportes  especiales 
á  un  metro  de  altura  del  suelo,  y  será  deber  del  encargado  mantenerlas  aseadas  y  con  la 
solución  antiséptica  que  disponga  la  junta  de  sanidad. 

Art.  205.  Por  cada  veinte  inquilinos  ha  de  haber  un  baño,  un  inodoro  ó  excusado  y  un 
vertedero,  todos  con  pisos  y  paredes  impermeables,  éstas  hasta  li  metros  de  altura,  por 
lo  menos. 

Art.  206.  Toda  casa  de  vecindad  estará  provista  de  agua  suficiente  para  proporcionar  los 
100  litros  de  agua  diarios,  á  lo  menos,  por  persona. 

Art.  207.  Las  paredes  todas  de  la  casa,  así  como  los  techos,  puertas  y  ventanas,  han  de 
estar  absolutamente  limpias,  bien  blanqueadas  y  pintadas,  y  sin  grietas  ni  hendiduras. 
Las  paredes  todas  serán  blanqueadas  una  vez  al  año,  por  lo  menos.  ^ 


SEGUNDA    CONFERENCIA    SANJTARIA   INTERNACIONAL.  849 

Art.  208.  No  se  permitirá  que  se  coloquen  telas  ó  papeles  en  los  huecos,  luceta.s  ó  venta- 
nillas de  las  habitaciones,  que  dificulten  la  entrada  de  la  luz  6  del  aire  en  el  interior  de  las 

mismas. 

Ajrt.  209.  Las  bateas  (')  depósitos  destinados  á  lavar  deberán  tener  por  soportes,  aros  ó 
pies  do  amigo  de  metal,  empotrados  on  la  pared,  y  no  en  barriles,  cajas  ú  otra  cla.se  de 
«nvasos.  Las  paredes  do  los  lugares  destinados  á  lavar  ostaj'án  repolladas  hasta  IJ  metros 
de  altura,  por  lo  menos,  con  material  iiiipormcable. 

Art.  210.  Queda  prohibido  el  coiñnar  6  lavar  en  ol  interior  de  las  habitaciones.  En 
cada  casa  do  vecindad  do  nueva  construcción  existiián  dos  departamentos  especiales, 
inhabitados  y  comunes;  uno  {)ara  lavadero  y  otro  para  cocina. 

Art.  2 U.  Queda  prohibido  dividir  las  habitaciones  por  medio  de  tabiques,  barbacoas, 
etc.,  cualquiera  quo  sea  ci  material  que  so  emplee  para  ello. 

Art.  212.  La  habitación  más  pequeña  en  toda  la  casa  de  vecindad  no  podrá  tener  menos 
de  9  metros  cuadrados  de  área  y  4  metros  de  altura. 

Art.  213.  Quedan  prohibidos  en  las  casas  do  vecindad  los  establecimientos  industriales  ó 
comerciales;  y  en  tal  virtud  no  podrá  instalarse  en  el  edificio  de  las  mismas  tiendas  de 
ninguna  clase,  exceptuándose  tan  sólo  aquéllas  casas  de  más  de  un  piso  con  entrada  y 
servicios  sanitarios  independientes  de  la  parte  destinada  á  vecindad  y  previa  la  autorización 
do  la  junta  do  sanidad. 

Art.  214.  En  las  casas  de  vecindad  no  existirán  caballerizas,  ni  se  tendrán  en  parte  alguna 
de  ellas  animales  de  ningún  género,  con  excepción  do  pájaros  en  jaula. 

Art.  215.  El  enfonno  atacado  de  alguna  enfermedad  transmisible  que  se  encuentre  en 
una  casa  de  vecindad  será  trasladado  á  un  hospital  de  aislamiento,  cuando  así  lo  crea 
necesario  el  jefe  de  sanidad. 

Art.  216.  Si  el  encargado  de  la  casa  de  vecindad  encontrare  resistencia  por  parte  de 
algún  inquihno  para  la  observancia  de  estas  ordenanzas,  ó  si  algimo  faltare  á  las  mismas, 
dará  cuenta  en  seguida  al  jefe  de  sanidad. 

Art.  217.  Toda  casa  de  nueva  construcción  no  podrá  dedicarse  á  vecindad  sin  que  sus 
planos  al  efecto  no  hubiesen  sido  aprobados  por  la  junta  de  sanidad.  Tampoco  podrá 
destinarse  en  lo  sucesivo  para  casa  de  vecindad  ninguna  casa  de  las  que  existen  actualmente 
dedicada  á  otro  objeto,  sin  la  autorización  previa  de  la  junta  de  sanidad. 

Art.  218.  Los  encargados  de  las  casas  de  vecindad  están  obligados  á  facilitar  á  los 
inspectores 'de  sanidad  cuantos  datos  sohciten  respecto  á  ellas,  así  como  á  acompañarles  en 
sus  respectivas  visitas  de  inspeción. 

Art.  219.  En  la  entrada  de  toda  casa  de  vecindad  se  fijarán  las  reglas  contenidas  en  este 
capítulo,  en  hoja  impresa  proporcionada  por  la  junta  de  sanidad. 

Capítulo  VI. 

CASAS   PRIVADAS    T    CASAS   EN    GENERAL. 

Art.  220.  Las  casas,  edificios,  construcciones,  etc.,  quedan  sujetas  para  todos  sus  locales 
3^^  dependencias  á  inspección  sanitaria  de  la  junta  de  sanidad,  y  sus  dueños,  encargados, 
representantes,  arrendatarios,  inquilinos,  moradores,  etc.,  estarán  obligados  á  permitir  y  á 
facilitar  cualquiera  inspección  á  los  oficiales  ó  agentes  debidamente  autorizados  por  la  junta 
local  de  sanidad,  y  pesimismo  á  realizar  ó  permitir  la  ejecución  de  las  obras  sanitarias  orde- 
nadas para  la  casa,  que  se  dispusieren  como  consecuencia  de  la  inpección. 

Art.  221.  Cada  casa  ó  vivienda  debe  reunir  las  condiciones  higiénicas  necesarias  para 
que  no  constituya  un  peligro  ó  amenaza  para  la  salud  ó  la  vida  de  sus  habitantes  y  vecinos. 

Art.  222.  Toda  casa,  ó  piso  de  la  misma  que  se  alquile  por  separado,  deberá  tener  la 
dotación  de  agua  suficiente  para  las  necesidades  domésticas  de  sus  moradores,  á  razón  de 
100  litros  diarios  por  persona,  por  lo  menos. 

Art.  223.  Los  propietarios  ó  inquilinos,  según  los  casos,  están  obligados  á  tomar  las 
precauciones  necesarias  para  evitar  que  de  los  caños,  sumideros,  letrinas,  inodoros  ó  excu- 
sados, etc.,  de  la  casa  se  exhalen  gases  ú  otros  olores  molestos. 

Akt.  224.  Los  caños  ó  tubos  de  desagüe  han  de  estar  suficientemente  ventilados,  con  todos 
los  requisitos  necesarios  para  facilitar  la  salida  de  los  residuos  líquidos,  evitar  las  filtra- 
ciones en  paredes  y  pisos  y  dar  salida  á  los  gases  en  forma  que  no  afecten  á  la  salud  de 
los  moradores  y  vecinos;  y  al  efecto  se  sujetará  la  construcción,  instalación  ó  reforma  de 
los  mismos  á  las  especificaciones  de  ingeniería  que  se  determinen  en  la  licencia  correspondi- 
ente. Iguales  especificaciones  se  requieren  para  los  inodoros,  pozos  negros,  vertederos, 
sumideros,  fregaderos,  bajantes  y  demás  instalaciones  sanitarias. 

Art.  225.  Se  prohibe  la  construcción  de  caños  ó  tubos  de  desagüe,  de  ventilación  ó  chi- 
meneas que  molesten  ó  perjudiquen  á  las  casas  vecinas  y  al  propio  edificio  en  que  estén 
eonstraidos.     A  los  ya  construidos  deberán  aplicárseles  los  preceptos  de  esta  regla. 

Akt.  226.  En  las  poblaciones  que  tengan  acueducto  y  cloacas  ó  alcantarillado,  todas  las 
casas  estarán  provistas  de  inodoros  de  los  modelos  adoptados  por  la  Junta  Superior  de 


850  SEGUNDA   CONFERENCIA   SANITARIA    INTERNACIONAL. 

Sanidad,  con  exclusión  de  cualquier  otro  sistema  de  letrinas.  Donde  no  haya  acueducto  ni 
alcantarillado,  se  construirán  pozos  negros  con  arreglo  á  las  especificaciones  respectivas 
de  ingeniería  y  ¡1  distancia  no  menor  de  10  metros  de  los  pozos  de  agua,  aljibes,  habita- 
ciones y  cocinas;  á  menos  que  se  adopte,  con  la  aprobación  de  la  junta  de  sanidad,  algún 
otro  sistema  para  la  recogida  y  extracción  de  las  excretas. 

Art.  227.  Los  pozos  negros  y  sumideros  se  construirán  de  manera  que  no  puedan  ser 
inundados  por  las  aguas  pluviales. 

Art..  228.  Solamente  en  los  lugares  donde  no  haya  cloacas  ó  alcantarillas  en  la  calle 
respectiva,  po.drá  ser  permitida  la  construcción  ó  existencia  de  sumideros  y  pozos  negros 
en  las  casas. 

Art.  229.  El  inquilino  ó  dueño  de  cada  casa  verterá  en  los  pozos  negros  y  sumideros  cal 
viva,  cloruro  do  calcio,  sulfato  de  hierro,  creolina  ó  algún  otro  desinfectante,  cuando  así  se 
lo  disponga  la  junta  de  sanidad  por  motivos  especiales. 

Art.  230.  Los  pisos  de  los  excusados,  baños,  fregaderos,  vertederos,  etc.,  serán  de  mate- 
rial impermeable ;  y  sus  paredes  estarán  revestidas  del  mismo  material,  si  son  de  manipostería 
hasta  metro  y  medio  de  altura,  por  lo  menos,  y  pintadas  al  óleo,  si  son  de  madera. 

Art.  231.  Todo  dueño  de  casa  está  obligado  á  cuidar  de  que  los  pozos  negros  j  sumideros 
ni  se  llenen  ni  se  derramen  al  exterior,  mandándolos  á  limpiar  oportunamente.  Si  así  no 
lo  verificaren,  la  junta  de  sanidad  dispondrá  que  por  el  servicio  público  de  limpieza  se  veri- 
fique ésta  por  cuenta  del  dueño  de  la  casa,  sin  perjuicio  de  la  multa  correspondiente. 

.\rt.  232.  Los  pozos,  aljibes,  tanques,  tinajones  ú  otros  depósitos  do  agua  estarán  dis- 
puestos de  tn\  manera  que  no  comuniquen  humedad  á  las  habitaciones  ni  reciban  filtraciones 
de  caños  y  pozos  negi-os,  y  estarán  constantemente  cubiertos  con  tapa  ó  tela  metálica 
inaccesible  á  los  mosquitos  para  impedir  en  ellos  la  presencia  de  larvas  (gusarapos). 

Sólo  serán  permitidos  los  sm'tidores  ó  fuentes  que  funcionen  constantemente  con  agua 
corriente. 

Art.  233.  No  se  permitirá  en  el  interior  de  las  casas,  ni  en  los  patios,  azoteas,  etc.,  depó- 
sito de  basuras,  inmundicias,  desechos,  aguas  estancadas,  ó  cualesquiera  otras  meterías 
perjudiciales  á  la  salud. 

Art.  234.  Los  envases  destinados  para  depositar  basuras  y  desperdicios,  se  situarán  tan 
distantes  como  sea  posible  de  las  habitaciones  de  la  casa  y  no  tendrán  agujeros  ó  hendiduras 
que  den  salida  á  parte  del  contenido. 

Art.  235.  Se  prohibe  la  cría  ó  ceba  de  cerdos  dentro  de  la  zona  lu-banizada  de  la  población^ 
sin  limitación  de  calles;  y  sólo  á  la  distancia  mínima  de  200  metros  del  perímetro  de  la 
misma,  serán  permitidos  los  criaderos  y  engordaderos. 

Art.  236.  En  las  piezas  destinadas  á  cocina,  ó  á  estufas  y  braseros  permanentes,  deberán 
instalarse  campanas  y  chimeneas  que  den  salida  fácil  al  humo  y  gases  procedentes  de  la 
combustión,  cosntruídos  de  forma  que  no  molesten  ó  perjudiquen  á  los  moradores  ó  vecions 
de  la  casa.  Los  braseros  ó  anafes  deben  situarse,  para  su  uso,  en  lugares  que  no  perjudiquen 
ó  molesten  á  los  moradores  y  vecinos. 

Art.  237.  Todas  las  habitaciones,  dependencias,  patios,  techos  y  azoteas,  ó  instalaciones 
sanitarias  de  una  casa  ó  edificio,  se  consei-varán  constantemente  en  el  mejor  estado  de 
limpieza.  Las  paredes  deberán  mantenerse  sin  desconchados  ni  hendiduras,  y  debidamente 
blauquedas,  ó  pintadas  así  como  las  puertas  y  ventanas;  los  pisos  y  techos  se  conservarán 
en  buen  estado  para  que  no  se  produzca  humedad  en  el  interior  de  las  habitaciones,  y  donde 
sea  necesario  para  prevenir  dicha  humedad,  se  exigirá  para  los  techos  la  instalación  de 
canales  y  tubos  bajantes  apropiados. 

Art.  238.  Sólo  se  permitirán  las  caballerizas  en  lugares  perfectamente  ventilados,  con 
pisos  y  paredes  impermeables,  y  que  llenen  además  las  condiciones  del  reglamento  especial 
de  establos. 

Art.  239.  Queda  prohibido  el  uso  para  dormitorios  y  viviendas  de  los  sótanos  y  cuartos 
semisubterráneos,  ni  sera  permitida  la  existencia  de  puerta  ó  abertura  que  comunique  al 
sótano  con  alguna  habitación  de  dormir.  Igual  prohibición  se  establece  para  los  entre- 
suelos y  barbacoas  para  el  mismo  objeto  si  no  tuviesen  una  altura  mínima  de  2Í¿  metros  y 
huecos  al  aire  libre  que  permitan  la  ventilación  suficiente. 

Art.  240.  No  se  permitirá  en  las  habitaciones  la  acumulación  de  animales  dom  sticos,. 
como  perros,  gatos,  conejos,  aves  de  corral,  palomas,  pájaros,  etc. 

Art.  241.  Si  como  resultado  de  la  inspección,  una  casa  ó  parte  de  ella  se  declara  insalubre, 
el  jefe  de  sanidad  lo  notificai-á  al  dueño  ó  inquilino,  según  el  caso,  dándole  el  plazo  necesario 
para  hacer  las  obras,  reparaciones  ó  mejoras  que  se  le  dispongan.  A  la  terminación  del 
plazo,  se  verificará  una  reinspección  para  comprobar  si  la  orden  ha  sido  cumplida.  En  casa 
contrario,  y  si  no  se  han  expuesto  por  escrito  las  causas  justificadas  y  poderosas  que  hayan 
imposibilitado  la  observancia  de  la[orden,  se  trasladará  el  expediente  al  juzgado  correspon- 
diente para  la  imposición  de  la  penalidad  debida,  y  se  señalará  otro  plazo  sujeto  á  igual 
f)rocedimiento.  Y  si  después  de  im  tercer  plazo  perentorio  no  se  ejecutara  la  orden  será 
a  casa,  ó  la  parte  de  ella  que  corresponda,  declarada  inhabitable  y  se  procederá  por  medio 


SI'^dUNDA    CONi-'KUKMCIA    SANITARIA    INTKIJXACIONAT..  /j51 

de  la  policía  á  su  dcsalojajnionto  y  clausura  en  el  término  de  treinta  días.     La  clausura 
dui'ará  hasta  (juo  se  ejecuten  las  obras  dispuestas. 

Art.  242.  Toda  casa,  edificio  ó  parto  de  éste,  destinada  á  vivienda,  dormitoijo,  fábrica, 
establecimiento,  etc.,  que  constituya  un  pelif^ro  permanente  para  la  salud  6  la  vida  de  sus 
moradores  y  convecinos,  y  no  sea  susceptible  de  ser  colocada  en  las  debidas  condiciones 
higiénicas,  se  declarará  inhabitable  ó  peligrosa  mediante  expediente  justificativo  y  .se  pro- 
cederá á  su  desalojamiento  y  clausura  por  orden  de]  jefe  de  sanidad,  en  un  j)Ihzo  fie  tremta 
días,  por  medio  de  la  policía. 

Capítulo  VII. 

ESCUELAS  Y   COLEGIOS. 

ÁiiT.  243.  No  deberá  procederse  á  la  instalación  de  una  escuela  6  colegio  sin  el  informe 
previo  y  favorable  de  la  junta  local  de  sanidad  acerca  de  la  situación,  condicones  higi- 
énicas, servicios  sanitarios,  y  capacidad  del  local  con  relación  al  níimcro  de  alunmos  y 
mobiliario  escolar. 

Akt.  244.  Las  piezas  destinadas  á  aulas  serán  secas,  con  buena  luz  y  suficiente  venti- 
lación y  con  extensión  superficial  proporcional  al  número  de  alumnos,  á  razón  de  1.50 
metros  planos  por  persona. 

Art.  245.  En  toda  casa  escuela  ó  colegio  debe  asistir  un  inodoro  ó  excusado  por  cada 
treinta  aknnnos,  por  lo  menos,  y  los  urinarios  que  se  estimen  necesarios. 

Art.  246.  Todas  las  instalaciones  sanitarias  de  la  casa  escuela  ó  colegio  se  coaservarán 
sin  inteiTupción  en  el  mejor  estado  de  limpieza  y  aseo,  así  como  los  locales  y  dependencias, 
patios,  pisos,  paredes,  etc. 

Aet.  247.  Los  establecimientos  de  esta  clase  quedan  sujetos  á  la  inspección  de  la  junta 
de  sanidad,  tanto  en  lo  que  respecta  á  la  casa  cuanto  al  estado  de  salud  de  los  alumnos, 
maestros  y  empleados. 

Art.  248.  Todo  alumno  de  una  escuela  ó  colegio  debs  estar  vacunado,  y  de  la  infrac- 
ción de  esta  regla  son  responsables  los  padres,  tutores  ó  encargados  de  los  alumnos,  así 
como  el  director  ó  maestro,  según  los  casos;  é  igual  disposición  se  establece  respecto  al 
director,  maestro  y  demás  empleados  subalternos. 

Art.  249.  El  director  que  observe  que  algún  alumno,  profesor,  sirviente,  etc.,  padece 
de  alguna  enfermedad  transmisible,  ó  que  sepa  que  habita  en  algún  lugar  en  que  exista 
enfermedad  transmisible,  lo  separará  temporalmente  de  la  escuela  y  dará  parte  antes  de 
veinticuatro  horas  al  jefe  de  sanidad. 

x\rt.  250.  No  se  permitirá  el  reingreso  en  la  escuela  de  ningún  alumno,  maestro,  sii-viente, 
etc.,  separado  de  la  misma  á  causa  de  enfermedad  transmisible,  que  se  encuentre  en  el 
saso  del  artículo  anterior,  hasta  no  obtener  la  autorización  correspondiente  del  jefe  de  sanidad. 

Las  prescripciones  de  este  artículo  y  del  anterior  próximo  regirán  iguaknente  para  las 
escuelas  nocturnas  y  las  sabatinas  ó  dominicales.  ^ 

Art.  251.  La  clausura  temporal  ó  definitiva  de  una  escuela  ó  colegio,  por  enfeiTnedad" 
transmisible  de  alumnos,  maestros  ó  empleados,  ó  por  condiciones  insalubres  del  edificio, 
se  dictará  por  la  junta  local  de  sanidad  por  medio  de  la  junta  de  educación  respectiva 
para  su  ejecución,  sin  perjuicio  de  notificarla  á  la  junta  Superior  de  Sanidad. 

Art.  252.  No  podrá  desempeñar  cargo  alguno  en  las  escuelas  ó  colegios  ningún  indi- 
viduo que  padezca  enfermedad  crónica  transmisible. 

Capítulo  VIII. 

FÁBRICAS   Y   TALLERES. 

Art.  253.  A  toda  licencia  para  la  instalación  de  cualquier  fábrica  ó  taller  deberá  pre- 
ceder informe  favorable  de  la  junta  de  sanidad,  emitido  con  estudio  de  la  memoria  en  que 
se  exprese  la  naturaleza  del  establecimiento,  situación,  condiciones  técnicas  apropiadas  á 
su  objeto  industrial,  seguridad,  estabilidad,  luz,  ventilación,  instalaciones  sanitarias, 
capacidad,  clase  y  número  máximo  de  máquinas  ó  aparatos  que  hayan  de  funcionar,  así 
como  el  número  de  operarios  y  demás  empleados  del  establecimiento. 

Art.  254.  Toda  fábrica  ó  taller  deberá  tener  por  cada  individuo  una  superficie  de  2 
metros  cuadi'ados  y  un  volumen  cúbico  de  12  metros,  por  lo  menos. 

Art.  255.  Los  locales  para  talleres  han  de  estar  en  lugares  secos,  con  buena  luz  y  venti- 
lación, y  con  todas  las  demás  condiciones  higiénicas  necesarias  á  la  salud  y  la  vida  de  los 
obreros  y  empleados. 

Art.  256.  En  las  fábricas  ó  talleres  que  por  la  índole  de  los  trabajos  se  produzcan  indis- 
pensablemente gases,  polvos  ó  líquidos  de  desechos,  molestos  ó  nocivos  para  los  obreros, 
empleados  ó  vecinos  del  establecimiento,  se  adoptarán  todos  los  mediosa  propiados  para 
recogerlos  y  esparcirlos  sin  que  constituyan  peligro  alguno,  por  los  procedimientos  que  se 
estimen  necesarios  y  que  apruebe  la  junta  local  de  sadidad. 


352  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Aet.  257.  Los  dueños  de  fábricas,  talleres,  establecimientos,  casas,  etc.,  donde  se  instalen 
chimenas,  ó  existan  ya  instaladas,  estarán  obligados  á  construírias  ó  á  reformarlas,  respec- 
tivamente, de  modo  que  el  humo  no  penetre  en  las  casas  ó  habitaciones  convecinas. 

Art.  258.  Ningún  taller,  fábrica  ó  establecimiento  industrial  podrá  verter  sus  aguas  ó 
materiales  de  desecho  en  los  arroyos,  canales,  ríos,  etc.,  de  cuyas  aguas  se  haga  uso  para  la 

Eesca  y  el  consumo  doméstico  y  de  los  ganados,  á  no  ser  que  aquéllas  se  conserven  ó  se  puri- 
quen  antes  completamente  mediante  procedimiento  ad  hoc  aprobado  por  la  Junta  Supe- 
rior de  Sanidad. 

Art.  259.  No  se  permitirá  emplear  en  los  talleres  ó  fábricas  á  niños  menores  de  14  años 
cumplidos,  debidamente  comprobada  la  edad.  Tampoco  se  emplearán  en  el  manejo  de 
máquinas  ó  aparatos  peligrosos  á  menores  de  18  años. 

i\jRT.  260.  tíu  las  fábricas  o  talleres  industriales  donde  haya  máquinas  ó  se  elaboren 
substancias  peligrosas,  y  el  número  de  sus  obreros  exceda  de  200,  .será  obligatorio  tener 
un  médico  permanentemente  durante  las  horas  laborables,  para  proveer  en  los  casos  de 
accidentes  personales. 

Art.  261.  En  las  fábricas  ó  talleres  deberán  existir  escupideras  en  número  proporcionado 
al  de  trabajadores,  las  cuales  se  mantendrán  en  la  mayor  limpieza,  lavándolas  diariamente 
con  agua  hir\'iendo  ó  una  solución  desinfectante.  La  junta  local  de  sanidad  indicará  el 
modelo,  número  y  solución  desinfectante  que  habrán  de  contener  las  escupideras  y  con  la 
que  haj-an  de  ser  lavadas. 

Art.  262.  Las  fábricas  y  talleres  contarán  con  número  suficiente  de  buenos  inodoros, 
en  la  proporción  del  5  por  ciento  de  individuos,  por  lo  menos;  y  urinarios  y  lavatorios, 
para  los  obreros  y  empleados,  en  estado  de  perfecta  función  y  limpieza. 

Art.  263.  Los  dueños  ó  encargados  de  fábricas  6  talleres  no  consentirán  en  los  mismos 
obreros  ó  empleados  atacados  de  enfermedades  transmisibles. 

Art.  264.  Las  fábricas  de  tabacos  se  sujetarán  además  á  las  siguientes  prescripciones: 

(a)  Construir  las  mesas  de  trabajo  de  manera  que  los  obreros  no  queden  frente  á  frente, 
sino  de  espaldas. 

(6)  Colocar  en  las  mesas  de  trabajo  un  depósito  pequeño  de  hierro  esmaltado,  para  el 
agua  y  el  engrudo,  que  habrá  de  utilizarse  al  pegar  los  tabacos,  á  fin  de  no  emplear  la  saliva 
ni  en  esa  operación  ni  en  la  de  colocarle  los  anillos  y  usar  la  chaveta,  y  no  los  dientes,  para 
limpiar  las  perillas  de  los  tabacos. 

(c)  Tener  una  canal  de  madera  pulimentada  en  la  parte  anterior  de  cada  mesa,  6  bien  un 
paño,  donde  caigan  las  partes  sobrantes  del  material  en  la  elaboración  de  los  tabacos. 

(d)  Mantener  bien  blanqueadas  y  limpias  las  paredes  y  fregar  las  mesas  de  trabajo  una 
vez  por  semana,  cuando  menos. 

(e)  Mantener  limpios,  lavándolos  convenientemente,  los  paños  que  se  utilicen  delante  de 
las  mesas  para  recoger  los  materiales  de  desechos. 

(/)  No  permitir  que  se  escupa  en  los  suelos. 

(g)  Colocar  las  escupideras  al  lado  de  cada  obrero  y  no  recogerlas  mientras  el  obrero  esté 
en  el  trabajo. 

(h)  Baldear  diariamente  los  pisos  de  las  galeras  ó  salones  de  trabajo,  no  permitir  que  se 
barran  sin  ser  humedecidos  antes  y  mantenerlos  siempre  limpios. 

(i)  Cuidar  los  pavimentos  de  manera  que  en  ellos  no  haya  grietas. 

(j)  Tener  divididas  las  hojas  de  las  ventanas  de  los  salones  de  trabajo  de  manera  que  la 
parte  superior  de  las  mismas,  por  lo  menos,  quede  abierta  y  favorezca  la  ventilación. 

(k)  Disponer  que  en  los  locales  destinados  á  la  elaboración,  haj^a  para  cada  obrero  un 
espacio  no  menor  de  20  metros  cúbicos,  á  fin  de  evitar  el  hacinamiento. 

(Z)  No  permitir  que  se  elabore  tabaco  en  las  habitaciones  en  que  se  duerma. 

(to)  No  vender  los  residuos  de  tabaco  que  en  la  elaboración  del  mismo  caigan  sobre  el  piso. 

(n)  Arrojar  antes  de  que  entren  en  descomposición  las  aguas  que  hayan  servido  para 
mojar  el  tabaco. 

Art.. 265.  Toda  fábrica,  taller  y  en  general,  establecimiento  industrial,  rústico  ó  urbano, 
en  que  tengan  que  emplearse  aparatos  mecánicos,  máquinas,  etc.,  se  instalarán  de  manera 
que  las  piezas  que  por  el  movimiento  que  desarrollan  ó  por  otra  circunstancia  constituyan 
un  peligro,  estén  cubiertas  ó  revestidas  de  mallas  alambradas  ó  cualquier  otro  artificio, 
que  las  separe  de  los  obreros  ó  manipuladores,  y  en  forma  que  prevenga  cualquier  descuido 
de  los  mismos.  Las  calderas  generadoras  de  vapor  ó  cualquier  otro  elemento  de  fuerza 
motriz,  se  conservarán  en  las  mejores  condiciones  de  seguridad  y  á  prueba  de  explosiones, 
y  los  edificios  del  establecimiento  industrial  habrán  de  ofrecer  por  su  construcción  y  sol- 
idez suficiente  garantía  de  seguridad  para  la  vida  de  los  obreros  y  empleados. 

Los  pozos,  trampas,  aberturas,  etc.,  habrán  de  estar  cerrados. 

Las  precedentes  prescripciones  son  aplicables  igualmente  á  los  teatros,  circos,  almacenes 
y  demás  establecimientos  análogos  en  los  cuales  se  haga  uso  de  aparatos  mecánicos.  . 


SEGUNDA    CONFEKICNOIA    SANITARIA    INTERNACIONAL.  358 

Capítulo  IX. 

FÁBRICAS,    INDUSTRIAS    Y    ESTABLUCIMIKNTOS    IMÍLIOHOSOS,  INHALUURKH    6    INCÓMODOS. 

Art.  266.  Las  fábricas,  depósitos  ó  establecimientos  industriales  insalubres,  incómodos 
y  pelif^rosos,  no  podrán  instalarse  en  lo  sucesivo  sino  con  arreglo  á  los  siguientes  requisitos 
de  sitiiiición,  y  (u)nl'orme  á  la  clasificación  correspondiente  y  á  lo  establecido  en  el  regla- 
mento respectivo: 

(a)  Distantes  do  habitacioiKis  particulares,  caminos  y  paseos. 

(&)  En  los  suburbios. 

(c)  En  cualquiera  parte  de  la  ciudad,  pero  sujetos  á  continua  inspección  y  á  las  disposi- 
ciones gubernativas. 

Art.  207.  Aparte  de  las  demás  exigencias  de  construcción,  ingcni(;ria,  etc.,  por  parte  del 
ayuntamiento,  no  se  concederá  licencia  para  la  instalación  de  ninguna  de  estas  fábricas  ó 
establecimientos  sin  informe  previo  favorable  de  la  junta  de  sanidad  con  vista  de  dodas  las 
circunstancias  al  objeto;  y  no  se  pondrán  en  explotación  sino  despulís  de  haber  acreditado 
la  junta  de  sanidad  que  han  sido  cumplidos  todos  los  requisitos  sanitarios  ó  de  liigiene  exi- 
gidose  n  la  concesión  de  la  licencia  de  instalación.  En  caso  de  inconfoimidad,  los  intere- 
sados podrán  acudir  en  alzada  ante  la  Junta  Superior  de  Sanidad. 

Art.  268.  Se  harán  constar  en  la  licencia  ó  autorización  que  se  conceda  para  la  instala- 
ción y  explotación  de  una  fábricp,,  taller  ó  industria  los  productos  á  que  se  dedica,  así  como 
el  método  general  de  fabricación  que  ha  de  seguir;  y  en  los  depósitos  ó  almacenes  la  cantidad 
máxima  de  artículos  que  puedan  contener. 

.  Art.  269.  Cuando  una  de  estas  fábricas  ó  establecimientos  haya  suspendido  sus  tareas 
por  más  de  un  año  ó  hubiere  de  trasladarse  á  otro  lugar,  tendrá  que  seguir  los  mismos 
trámites  que  uno  nuevo  para  su  reinstalación  y  apertura. 

Art.  270.  Cuando  lo  exijan  los  intereses  de  la  salud  pública  podrá  hacerse  retirar  de  la 
población  cualquier  establecimiento   previos  los  trámites  legales. 

Art.  271.  Los  departamentos  de  las  fábricas  ó  industrias  en  que  se  elaboren  substancias 
orgánicas  de  fácil  putrefacción,  tendrán  el  piso  completamente  impermeable  y  estarán 
provistos  de  agua  limpia  en  cantidad  abundante  para  frecuentes  lavados. 

Art.  272.  No  se  permitirá  que  permanezcan  almacenadas  en  las  fábricas  ó  industrias 
substancias  orgánicas  por  más  de  veinte  y  cuatro  horas,  sin  procederse  á  las  labores  propias 
de  su  aprovechamiento,  á  menos  que  estén  conservadas  para  impedir  su  putrefacción.  Los 
residuos  se  recogerán  todos  los  días  para  llevarlos  fuera  del  establecimiento  ó  quemarlos 
debidamente. 

Art.  273.  Se  prohibe  cocer  ó  preparar  restos  ó  desperdicios  de  la  matanza  de  reses,  como 
industria  ó  comercio,  en  la  parte  urbanizada  de  la  población,  así  como  el  moler  ó  triturar 
huesos  ó  conchas,  extraer  grasas,  desollar  animales  muertos  ú  otras  operaciones  industriales 
que  produzcan  malos  olores  ú  ofrezcan  peligro  á  la  salud. 

Art.  274.  Se  prohibe  alquilar  ó  ceder  habitaciones  para  residencia  ó  dormitorio  en  las 
casas  ó  edificios  en  que  haya  establecimientos  ó  fábricas  peligrosas  ó  insalubres,  y  en  ningún 
caso  se  permitirá  su  asociación  á  una  casa  de  vecindad. 

Art.  275.  En  lo  sucesivo  no  se  permitirá  tampoco  el  que  se  instale  un  taller  de  lavado  sin 
que  la  casa  en  que  se  pretenda  establecer  sea  previamente  reconocida  por  la  junta  de  sani- 
dad y  se  obtenga  el  informe  favorable. 

Arí.  276.  Los  trenes  de  lavado  que  no  empleen  el  vapor,  someterán  las  ropas  á  la 
inmersión  en  agua  hirviendo  durante  una  hora  á  lo  menos. 

Art.  277.  La  junta  local  de  sanidad  dictará  en  cada  caso  las  especificaciones  de  los 
servicios  sanitarios  que  deben  tener  las  casas  en  que  se  instalen  talleres  de  lavado  (tanques 
cementados,  drenaje  perfecto,  etc.). 

Art.  278.  Los  establos  para  toda  clase  do  animales  S3  comprenderán  entre  los  estableci- 
miento» insalubres,  sujetos  á  un  reglamento  especial  y  deberán  estar  situados  en  los  suburbios. 

Art.  279.  No  se  concederá  hcencia  para  la  instalación  y  apertura  de  ningún  establo 
que  no  haya  obtenido  informe  favorable,  para  uno  y  otro  fin,  cíe  la  junta  de  sanidad. 

Art.  280.  Las  condiciones  sanitarias  que  se  requieren  para  la  concesión  de  licencia  para 
la  instalación  y  apertura  de  un  establo,  y  á  las  que  deberán  ajustarse  en  un  todo  los  insta- 
lados actualmente,  son  las  siguientes: 

(a)  El  establecimiento  estará  situado  fuera  ¿e  la  zona  urbanizada  de  la  población. 

(h)  Los  edificios  destinados  á  establos  serán  de  mampostería,  ladi'illo  ó  hierro,  con  una 
elevación  de  5  á  6  metros,  y  con  huecos  de  ventilación  suficiente  á  razón  de  uno  por  cada 
cuatro  animales. 

(c)  Las  cuadras  estarán  en  galerías  de  4  metros,  por  lo  menos,  de  altura. 

(d)  Las  galerías  que  tengan  un  solo  pesebre  adosado  á  la  pared,  no  podi-án  tener  menos 
de  cuatro  metros  de  ancho  en  toda  su  longitud;  y  en  las  naves  para  canoas  ó  pesebres  al 
centro  no  podrán  tener  menos  de  4  metros  de  anchura,  también  en  toda  su  longitud. 

11  12a— 06 23 


354  SEGUNDA    CONFERENCIA    SANTTAETA    INTERNACIONAL. 

(e)  Las  paredes  estarán  revestidas  de  cemento  ú  otro  material  imp-niiL-able  enlucido 
y  bien  liso 

(/)  Los  ptines  para  el  forraje  s;Tán  de  hierro  j»- las  canoas  ó  pesebres  podrán  construirse 
de  mad?ra. 

(g)  Los  pisos  de  las  cuadras  s(>rán  precisamente  de  cemento,  con  un-  declive  de  2^  %, 
por  lo  mtnos,  _y  con  surcos  lisos  para  que  los  líquidos  corran  fácilmente  á  la  atarjea  que 
debe  existir  á  lo  larpo  de  todo  el  borde  de  las  cuadras  hacia  el  patio. 

(h)  La  atarjea  será  construida  con  fondo  de  forma  elíptica  y  perfectamente  pulida. 

(i)  Para  evitar  qu;'  los  animales  r<  sbalon  en  las  cuadras  ó  se  resfrien  al  acostarse  sobre 
el  piso  de  cemento,  est?  será  cubierto  con  tablones  de  mad'ra  de  una  y  media  á  2  pulgadas 
de  grurso,  en  toda  su  longitud  y  anchura,  que  puedan  levantars'\  sobre  alfagías,  que  dejen 
espacio  suficiente  entre  el  piso  de  cemento  y  el  tablón,  para  que  puedan  correr  con  facilidad 
los  orines  á  la  atarjea. 

(j)  Cada  animal  estará  separado  de  su  vecino  á  distancia  conveniente.  En  las  cuadras 
6  caball'.  rizas  deberán  ponerse^  barreras  ó  divisiones  adecuadas  con  una  separación  de  un 
metro  50  c  ntímetros  de  una  á  otra,  por  lo  menos. 

(t)  Los  depósitos  de  forraje  de  todas  clases  estarán  construidos  de  mampostería,  ladrillo 
ó  hierro. 

(1)  Todo  establo  deberá  tener  un  departamento  apropiado  para  enfermería,  indepen- 
diente de  los  demás,  en  los  cuales  sólo  podrán  permanecer  animales  atacados  de  enfermedades 
no  transmisibles  á  la  especie  humana. 

(ttí)  Si  el  establecimiento  no  tuviere  caño  de  acoraetimi -rito  á  la  alcantarilla  por  no 
existir  ésta,  se  llevarán  las  excretas  á  una  fosa  de  la  capacidad  que  en  cada  caso  se  deter- 
mino: esta  fosa  será  construida  con  material  impermeable  y  deberá  vaciarse  cada  vez 
que  lo  n(  cesite,  trasladándose  las  materias  á  los  vertederos  de  la  ciudad. 

(ti)  El  local  de  las  cuadras  ó  galerías,  tendrá  el  número  de  ventiladores  ó  ventanas  que 
sea  necesaria. 

(o)  Los  abrevaderos  se  construirán  de  material  impermeable,  con  fácil  salida  para  sU 
perfecta  limpieza,  y  á  razón  de  uno  para  cada  animal. 

Art.  281.  Se  prohibe  en  los  establos  la  existencia  ó  la  construcción  de  viviendas,  excepto 
las  destinadas  exclusivamente  á  los  empleados  de  los  mismos,  proprios  á  las  labores  del 
establecimiento;  cjuedando  también  prohibida  la  asociación  de  otros  establecimientos  que 
no  tengan  relación  con  aquéllos,  y  los  que  la  tengan  se  limitarán  á  hacer  trabajos  de  fra- 
gua, talabartería  ó  pintura  únicamente  para  el  entretenimiento  ó  pequeñas  necesidades 
del  taller  donde  existan. 

Art.  282.  Los  establos  tendrán  en  el  interior  el  servicio  de  agua  suficiente  para  hacer  la 
limpieza  general,  por  lo  menos  dos  veces  al  día. 

Art.  283.  El  estiércol  y  las  basuras  de  los  establos  se  trasladarán  diariamente  á  los 
vertederos  de  la  población,  con  sujeción  á  cuanto  se  dispusiere  para  el  servicio  público  de 
recogida  y  extracción  de  basuras. 

Art.  284.  El  estiércol  se  depositará  en  recipientes  apropiados  con  forro  metálico  en  su 
interior,  cjue  se  limpiarán  y  desinfectarán  diariameníe. 

Art.  285.  Los  pisos  de  los  patios,  talleres  y  demás  departamentos  destinados  á  desahogo 
de  los  trenes,  serán  perfectamente  rellenados  de  piedra  de  buena  calidad  ó  cascajo  fino  ó 
macadán  para  evitar  la  caída  de  los  animales. 

Art.  286.  Los  animales  enfermos  no  podrán  ser  dedicados  á  ningima  clase  de  trabajo. 

Art.  287.  Los  dueños  de  los  establos  quedan  obligados  á  tener  á  su  servicio  un  veteri- 
nario que  visite  el  ganado  una  vez  por  semana,  á  lo  menos. 

Art.  288.  Cada  vez  que  los  veterinarios  municipales  ó  los  inspectores  de  sanidad  giren 
visita  á  los  establos,  lo  consignarán  con  su  firma  en  el  libro  que  para  ese  objotq  se  llevará 
en  cada  establo. 

Art.  289.  De  la  existencia  de  todo  animal  confirmado  ó  sospechoso  de  padecer  enfer- 
medad transmisible  á  la  especie  humana  so  dará  parte  al  jefe  local  de  sanidad  por  el  veteri- 
nario que  lo  asista  ó  en  su  defecto,  por  el  dueño  del  animal  ú  otro  sujeto  inteíresado. 

Art.  290.  Cuando  se  extraiga  de  establo  á  un  animal  atacado  de  enfermedad  transmisible, 
el  veterinario  municipal  cuidará  de  que  se  practique  la  perfecta  desinfección  de  los  locales 
que  dentro  del  establo  considere  infectados  y  se  asegurará  en  caso  de  muermo  de  que  los 
arreos  del  animal  enferma)  han  sido  desinfectados  totalmente. 

^írt.  291.  Las  cuadras  de  las  casas  y  establecimientos  particulares,  se  ajustarán  á  las 
condiciones  d.-terminadas  en  estas  ordenanzas  para  su  construcción  é  higieme. 

Art.  292.  En  las  poblaciones  donde  no  haya  cloacas  ó  alcantarillado  todos  los  establos 
deberán  tener  caños  de  desagüe  á  una  fosa  ó  sumidero  do  capacidad  suficiente  para  que 
de  ninguna  manera  se  vean  en  el  caso  de  tener  que  verter  aguas  sucias  á  la  calle. 

Art.  293.  Los  establos  que  no  tengan  las  bestias  en  colgadizos  abiertos  tendi'án  tuberías 
de  ventilación  que  sobresalgan  2  metros,  por  lo  menos,  de  la  cubierta  del  edificio.  Dichos 
tubos  podrán  tenor  registros  para  gi-aduar  la  corriente  del  aire. 

Art.  294.  Los  útiles  de  los  establos,  como  los  cubos  ó  depósitos  de  agua,  esponjas,  depó- 
sitos de  forraje,  etc.,  deberán  tenerse  en  perfecta  limpieza. 


SEGUNDA    (X)NKKJiIíN(!ÍA    SANITAlílA    INTIOÍINACTONAL.  855 

Art.  295.  El  baldeo  do  los  cslablo.s  (Icl)"^  haci'i's'',  por  lo  iiT-noH,  dos  vecen  diaria.s. 

Art.  296.  Todas  las  bestias  dfi  los  ('Htat)los  sf.rán  sometidas  á  la  prueba  de  la  rnaleiria. 

Art.  297.  Los  establecimientos,  d'tix'tsitos  ó  fábricas  pelifírosas,  insalubres  6  inc('>ii)odo.s, 
so  conservarán  constantomcnt(!  en  pcrrecto  cstatlo  de  limpieza,  de  modo  que  sus  op.  raciones 
no  resulten  perjudiciales  í  la  salud  pública. 

Capítulo  X. 

MATADEROS    Y    MA'rANZA. 

Art.  298.  Para  la  construcción  do  un  matadero  so  exigirá  como  rc(jui.sito  previo  un 
informo  favorable  do  la  junta  local  de  sanidad,  aprobado  por  la  Junta  Superior,  con  vista 
de  la  memoria,  planos  y  demás  documentos  del  proyecto. 

Art.  299.  No  será  permitida  la  construcción  do  habitaciones,  ó  el  uso  de  1t?s  que  existan 
en  los  mataderos,  para  vivienda  ó  dormitorio  de  pei'sona  alguna,  ano  ser  mediante  permiso 
especial  y  por  escrito  de  la  Junta  Superior  de  Sanidad. 

Art.  300.  Cada  ayuntamiento  tendrá  un  matadero  público,  propiamente  establecido, 
con  los  departamentos,  personal,  servicio  técnico  y  material  de  inspección  necesarios,  pi.sos 
impermeables,  agua  en  abundancia,  drenaje  suficiente  y  demás  condiciones  higiénicas. 

Art.  301.  Quedan  prohibidos  los  mataderos  privados  para  el  consumo  de  carnes  en  fincas 
ó  fábricas  que  no  estén  debidamente  autorizados  y  sometidos  á  los  requisitos  que  se  les  señale 
por  la  junta  local  de  sanidad. 

Art.  302.  Cada  matadero  se  regirá  para  su  administración  interior  por  un  reglamento 
especial,  sometido  á  la  aprobación  de  la  Junta  Superior  de  Sanidad  en  todo  lo  que  se  relacione 
con  el  régimen  sanitario  del  mismo. 

Art.  303.  La  matanza  de  reses  para  el  consumo  público  se  verificará  solamente  en  los 
mataderos  oficiales  de  las  poblaciones. 

Art.  304.  Se  prohibe  la  matanza  en  los  patios  de  las  casas  urbanas. 

Se  prohibe  igualmente  la  matanza  particular  ó  domiciliaria  en  las  fincas  rústicas  ó  pueblos 
de  escasa  importancia  á  no  ser  para  el  consumo  del  que  la  verifique  y  mediante  certificado 
favorable  del  reconocimiento  de  la  res  por  un  facultativo  oficial. 

Art.  305.  Toda  res  que  haya  de  destinarse  al  consumo  público  deberá  ser  reconocida  en 
pie,  momentos  antes  de  ser  sacrificada;  y  después  de  muerta,  sus  visceras  y  carnes,  por  el 
veterinario  ó  faculte tivo  autorizado  para  ello  en  defecto  de  aquél;  la  res  que  como  conse- 
cuencia de  estas  recomendaciones  no  resulte  completamente  sana  será  rechazada,  así  como 
también  las  partes  de  la  misma  cuyo  uso  no  se  estime  conveniente. 

Art.  306.  Los  animales  destinados  á  la  matanza  han  de  estar  perfectamente  limpios  y  se 
tendrán  en  los  corrales  de  los  mataderos  ó  en  cualquier  otro  lugar  próximo  á  los  mismos 
y  apartado  de  la  población,  bajo  sombra,  con  seis  horas,  por  lo  menos,  de  anteiioridad.  El 
aseo  de  los  corrales  será  esmerado,  efectuándose  su  limpieza  cada  veinticuatro  horas,  por  lo 
menos;  serán  de  capacidad  proporcionada  al  número  de  reses,  estarán  bien  ventilados, 
tendrán  agua  y  abrevaderos  suficientes  para  el  ganado  y  demás  condiciones  que  se  estimen 
necesarias. 

Art.  307.  Los  encargados  ó  en  su  defecto  los  guardas  de  los  corrales  darán  cuenta  inme- 
diatamente al  veterinario  respectivo  de  la  existencia  de  cualquier  animal  que  les  inspire 
sospechas  de  estar  enfermo. 

Art.  308.  No  se  permitirá  la  matanza  de  animales  flacos,  preñados,  golpeados,  cansados, 
sofocados,  heridos,  afectados  de  úlceras,  fiebres  ó  cualquiera  otra  enfermedad  que,  á  juicio 
del  veterinario,  los  haga  impropios  para  el  consumo. 

Art.  309.  Todos  los  animales  destinados  á  la  matanza  han  de  poder  entrar  por  sus  pies 
en  los  mataderos  excepción  hecha  de  los  que  por  extremada  gordura  no  puedan  hacerla  por 
si  mismos.     Queda  prohibido  el  aprovechamiento  de  fetos  para  el  consumo  público. 

Art.  310.  El  edificio  del  matadero  de  mantenerse  constantemente  limpio  y  ventilado,  sin 
que  queden  en  él  después  de  la  matanza  porciones  de  carnes,  desechos,  sangre  ni  suciedad 
alguna.  Todos  los  desperdicios  se  destruirán  ó  retirarán  á  lugares  en  que  no  puedan  causar 
daño  á  la  salud  pública. 

Art.  311.  Las  carnes  se  conducirán  á  los  lugares  destinados  á  la  venta  en  las  mejores 
condiciones  de  limpieza  j  en  carros  pintados  al  óleo,  cubiertos,  forrados  interiorraente  de 
latón  ó  hierro  galvanizado,  con  rejillas  ó  persianas  de  ventilación,  destinados  exclusivamente 
al  objeto,  y  provistos  de  garfios  pulimentados  para  colgar  las  carnes.  Bajo  ningún  concepto 
se  permitirá  la  conducción  de  carnes  de  los  mataderos  de  otra  manera. 

Art.  312.  Dos  transportadores  de  carnes  deberán  estar  vestidos  con  aseo  y  no  se  les  per- 
mitirá practicar  la  carga  y  descarga  sino  están  resguardados  por  un  cubre  ropas  impermeable. 

Art.  313.  No  se  permitirá  el  transporte  ó  conducción  de  los  desechos  ó  desperdicios  de 
los  mataderos  por  las  calles  de  la  población  sino  mediante  las  condiciones  exigidas  por  la 
junta  da  sanidad. 


35f»  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Art.  314.  Para  insuflar  la  piel  do  los  aniíiiales  muertos,  con  objeto  de  facilitar  el  desuello, 
se  emplearán  aparatos  adecuados,  quedando  prohibida  la  insuflación  por  medio  de  la  boca. 

Art.  315.  Queda  prohibido  usar,  aunque  sólo  sea  con  carácter  temporal,  el  local  de  un 
matadero,  para  ningún  otro  objeto  que  el  de  su  destino. 

Capítulo  XI. 

MERCADOS. 

Art.  316.  Para  la  construcción  ó  alteración  de  un  mercado  se  exigirá  como  requisito 
previo  el  informe  favorable  de  la  junta  local  de  sanidad,  con  vista  de  la  memoria,  planos  y 
demás  documentos  del  proyecto. 

Art.  317.  Todo  mercado  ha  de  tener  capacidad  proporcional  á  las  necesidades  del 
comercio  de  la  localidad;  estará  provisto  de  agua  en  abundancia  para  la  atención  de  todos 
los  servicios;  y  con  pisos  de  material  impenneable  y  declive  necesario  para  evitar  estanca- 
miento; y  sus  pilares  serán  de  altura  y  anchura  entre  sí,  suficientes  para  proporcionar 
amplia  ventilación,  con  respiraderos  en  los  tedios,  y  si  éstos  fueren  de  láminas  metálicas, 
estarán  l)as.  ante  separados  de  los  muros  para  impedir  el  excesivo  calor. 

Art.  318.  En  los  mercados  que  en  lo  adelanLe  se  construyeran  no  se  pei'mitirá  el  uso  de 
ninguno  de  sus  locales  para  habitaciones  ni  dormitorios,  ni  se  consentirá  la  fabricación  de 
viviendas  para  residencia  de  personas  ó  familias  En  los  existentes,  en  que  se  tolere  la 
habitación  y  por  deerminadas  cii'cunstancias  no  sea  de  derecho  exigible  el  precepto  pro- 
hibitivo de  estas  ordenanzas,  se  sujetarán  las  viviendas  y  dormitorios  á  los  requisitos 
necesarios  que  demanda  la  higiene  y  sanidad  pública. 

Art.  319.  En  el  reglamento  especial  para  el  orden  administrativo  de  cada  mercado, 
deberán  ¡asertarse  las  reglas  que  las  juntas  locales  de  sanidad  establezca  para  el  régimen 
.sanitario  del  mismo. 

Los  vendedores  observarán  todas  las  disposiciones  relativas  á  mantener  sus  puestos  en  las 
mejores  condiciones  higiénicas. 

Aet.  320.  Se  prohibe  en  los  mercados  la  venta  de  alimentos  cocidos  de  cualquiera  clase,  á 
excepción  de  patas  y  tripas  shnplemente  hervidas  y  sin  otra  preparación,  pero  no  se  con- 
sentirá en  ellos  hacer  uso  de  anafes,  fogones  ni  braseros. 

Art.  321.  Sólo  será  permitida  la  venta  de  carnes  y  pescados  en  hielo  ó  salados  cuando 
procedan  del  sobrante  de  la  venta  diaria  de  los  frescos. 

Art.  322.  Las  casillas  destinadas  en  los  mercados  á  la  venta  de  carnes  llenarán  las  condi- 
ciones siguientes:  1*.  Tendrán  ban-a  de  hierro  ó  de  acero  provista  de  ganchos  para  colgar  las 
carnes,  peifectamente  pulimentados  ó  esmerilados,  en  el  mejor  estado  de  Ihnpieza;  2*,  una 
llave  de  agua  de  suficiente  calibre  colocada  sobre  vertedero  comunicado  por  medio  de  siía  con 
la  alcantarilla  del  mercado,  en  las  poblaciones  donde  sea  posible  realizarlo;  3"^,  tragante  de 
cierre  hidráulico  en  el  piso  en  el  mismo  caso  que  la  anterior;  4"^,  se  conservaián  pintadas, 
precisamente  al  óleo,  ciddando  de  tenerla  siempre  el  ocupante  en  el  más  perfecto  estado  de 
limpieza:  .5'^,  cierre  de  tela  metálica  con  malla  que  no  permita  la  entrada  de  insectos,  sin 
dificultar  la  ventilación;  6^,  mostrador  de  mármol  blanco  y  pulimentado  y  mesa  del  mismo 
m'aterial  con  soporte  de  hierro;  7^,  colocación  de  las  carnes  de  manera  que  no  puedan  ser 
tocadas  por  los  marchantes. 

Art.  323.  Se  prohibe  el  uso  de  hachas  y  de  picadores  de  madera,  debiendo  ser  cortadas  las 
carnes  y  los  huesos  con  cuchillos  y  sierras,  respectivamente,  de  hoja  y  mango  de  metal  y 
completamente  lisos. 

^írt.  324.  Los  expendedores  de  carnes  y  de  pescado  usarán  durante  las  horas  de  la  venta 
un  mandil  limpio  de  género  blanco,  y  al  terminar  las  operaciones  de  venta  lavarán  las 
paredes,  mostradores  y  demás  partes  de  las  casillas  ó  mesillas  que  hayan  estado  en  contacto 
con  los  artículos  de  expendio. 

Art.  32.5.  La  venta  de  carne  cesará  á  las  once  del  día. 

La  que  resultare  sobrante  deberá  colocarse  en  el  refrigerador  ó  salarse  perfectamente, 
única  fonna  en  que  podrá  expenderse  al  siguiente  día. 

Se  prohibe  el  empleo  de  toda  substancia  "preservativa"  que  no  sea  la  sal  común  (cloruro 
de  sodio)  para  la  conservación  de  las  carnes  destinadas  al  consumo. 

Art.  326.  Los  menudos  se  colocarán  en  el  refrigerador  desde  su  llegada  á  las  casillas. 

Art.  .327.  La  venta  de  pescado  y  mariscos  terminará  á  las  diez  de  la  mañana  en  verano 
y  á  las  once  en  invierno,  retirándose  el  sobrante  después  de  salado  ó  colocándolo  en  el 
refrigerador. 

Art.  328.  Los  cangrejos,  langostas,  jaibas  y  demás  crustáceos  deberán  venderse  precisa- 
mente vivos. 

Art.  329.  Se  prohibe  la  venta  de  ostras  durante  los  meses  de  mayo  y  agosto  inclusive,  y  se 
arrojará  imnediatamente  la  que  por  su  olor,  falta  de  líquido  propio  ú  otro  carácter  cualquiera 
indique  haUarse  en  mal  estado. 


SEGUNDA    CONFERENCIA    SANTTAIIIA    INTERNACIONAL.  857 

Art.  330.  No  se  permitirá  la  venta  de  pescado  escamado,  desollado,  descabezado,  mutilado 
ó  privado  do  aletas  ó  do  eiiiilfiiiiera  otra  parto  del  fuerpo  por  la  eual  no  pueda  detenninarse 
su  esjieeie,  oxc,ej)tuán(lüH(!  lii  c.laHe  (jue  se  acostiinibra  vender  en  ruedas. 

Art.  331.  Se  jji'oliibe  la  vv.nt»,  ckí  pescados  suHec;í)til)!es  de  padecei-  eiffuatera,  como  son:  El 
jucíi,  jurel,  tii~iosa  prieta,  sibí  amarillo,  coronado,  picuda,  aguají  bonasí-ga'to,  bonasí-caí  dcnal, 
cubera,  morena  verde,  erizos  ó  puerco-esjjines,  tamboics,  jabón  y  diablo  y  cualfjuier  otro 
que  se  declare  como  dañino  por  la  Junta  Superior  de  Sanidad. 

Art.  332.  Los  vendedoi-es  de  pescado  vestirán  con  limpieza  y  usarán  mandil  blanco 
durante  las  horas  de  la  venta,  y  lavarán  diariamente  las  mesas,  mostradores,  carretillas, 
tableros  y  demás  útiles  de  su  comercio. 

7\jiT.  333.  Las  vasijas  que  usen  los  expendedores  para  el  lavado  de  las  verduras,  vianda.s  y 
hortaliza^  serán  de  hierro  esmaltado  ó  de  otro  material  impemieable. 

Art.  334.  Se  prohibe  la  venta  de  frutas  podridas,  malsanas  ó  en  mal  estado. 

Art.  335.  Se  prohibe  la  venta  de  conejos  domésticos  muertos. 

Art.  336.  Las  aves  de  corral  que  se  expendan  muertas  y  las  de  caza  habrán  de  estar 
limpias  de  entrañas  y  completamente  frescas,  quedando  obligados  sus  expendedores  á  con- 
servarlas en  refrigeradores,  j  observándose  rigurosamente  para  las  últimas  las  disposiciones 
sobre  la  veda  de  caza  en  las  épocas  que  la  ley  de  la  materia  determina. 

Akt.  337.  Todos  los  demás  animales  puestos  á  la  venta  para  la  alimentación,  como  lecho- 
nes,  cabritos,  conejos,  etc.,  han  de  estai'  sanos,  gordos,  Ihnpios  y  en  condiciones  de  no  inspirar 
repugnancia  alguna. 

Akt.  338.  Queda  prohibido  tirar  ó  echar  desperdicios  en  el  suelo,  dentro  ó  fuera  de  las 
casillas.  Todos  ellos  se  recogerán  en  receptáculos  de  hierro  galvanizado  con  tapa,  que  se 
colocarán  en  el  interior  de  las  casillas  y  se  señalarán  con  el  número  c;orrespondiente  á  éstas. 
Terminada  la  Imipieza  de  las  casillas,  el  depósito  de  las  basuras  será  colocado  en  la  galería  que 
dé  frente  á  aquéllas  y  junto  á  su  entrada  para  que  sean  recogidas  por  los  encargados  de  la 
limpieza. 

Art.  339.  Queda  prohibido  tener  descubiertos  los  caños  ó  canalizos  de  desagüe,  debiendo 
existir  además  en  cada  mercado,  en  las  poblaciones  donde  sea  factible,  una  instalación  sufi- 
ciente de  inodoros  y  urinarios  aprobada  por  la  junta  de  sanidad. 

Art.  340."  Dos  veces  al  día,  á  las  horas  señaladas  en  el  reglamento  administrativo  del 
mercado,  se  verificará  la  limpieza  general.  Los  encargados  de  hacer  la  limpieza  recogerán  la 
basura  de  cada  casilla,  lavando  el  depósito  y  volviéndolo  á  su  lugar.  Limpiarán  todas  las 
noches  cuidadosamente  los  inodoros  y  urinarios  y  las  bocas  de  las  alcantarillas,  desinfectán- 
dolas con  cal,  creolina,  etc. 

Aet.  34L  Queda  prohibido  colocar  tabiques  y  cualc(uiera  otra  clase  de  construcción  de 
madera  en  casillas  y  mesillas. 

Art.  342.  Habrá  en  cada  mercado  un  local  en  el  cual  se  depositarán  hasta  la  hora  de  la 
limpieza  los  efectos  decomisados  como  impropios  para  el  consumo,  con  el  fin  de  inutilizarlos 
y  arrojarlos  con  las  demás  basuras. 

Art.  343.  Las  inspecciones  de  los  mercados  se  efectuarán  diariamente  y  á  horas  distintas. 

Art.  344.  Se  prohibe  la  existencia  de  bodegas,  bodegones,  cafés,  cantinas  u  otros  estable- 
cimientos análogos  en  el  iiiterioi-  de  los  mercados. 

Art.  345.  Son  deberes  de  los  inspectores:  (a)  Examinar  cuidadosamente  todos  los  puestos 
destinados  á  la  venta;  (b)  informar  al  jefe  de  sanidad  acerca  de  lo  que  estime  conveniente 
para  la  limpieza  y  conservación  de  los  locales;  (c)  examinar  especialmente  Ifs  carnes,  pes- 
cados, aves,  y  demás  artículos  de  origen  anim.il :  (d)  hacer  letirar  de  la  venta  todos  los  efectos 
impropios  para  el  consumo,  dando  cuenta  inmediatamente  al  jefe  de  sanidad;  (e)  tomar  con 
las  debidas  formalidades  muestras  de  los  efectos  que  se  consideren  sospechosos,  en  mal 
estado,  ó  adulterados  para  su  análisis  eu  el  laboratorio,  dejando  en  poder  del  interesado 
comprobantes  por  medio  de  boletas  talonarias  de  la  clase  de  efecto  que  haya  tomado,  para 
evitar  dudas  ó  discusiones;  (f)  examinar  los  indoros,  urinarios  y  bocas  del  alcantarillado 
informando  al  jefe  de  las  infraccioues  que  obsei'vare. 

Capítulo  XIT. 
carnicerías  y  venta  de  carnes. 

Art.  346.  Para  la  apertura  de  una  carnicería  se  requerirá  informe  favorable  de  la  junta 
local  de  sanidad,  previa  inspección  referente  á  que  el  establecimiento  reúne  las  cocdicioces 
sanita  rias  correspondientes. 

Art.  347.  Los  establecimientes  destinados  á  la  venta  de  carnes,  además  de  estar  bien 
ventilados  y  de  conservarse  siempre  limpios  y  muy  aseados  el  piso,  las  paredes,  el  mostrador, 
los  ganchos  y  demás  utensilios,  deberán  reunir  las  condiciones  siguientes: 

(a)  Mostrador  de  mármol  blanco  pulimentado. 

(b)  Piso  de  mármol,  cemento  ó  de  losas  finas  cuyas  juntas  no  permitan  grietas.   , 


358  SEGU^iTDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

(c)  Cielo  raso,  siempre  que  el  techo  no  estuviese  en  condiciones  de  ser  pintado  al  óleo. 

(d)  En  las  paredes,  azulejos  rejuntados  con  cemento  ó  repellados  con  material  imperme- 
able desde  el  suelo  á  la  altura  de  2  metros,  por*lü  menos. 

(e)  Puntal  de  4  ó  5  metros,  excepto  aquellas  j'a  instaladas  que  tengan  suficiente  ventilación. 

(f)  Instalación  dfe  servicio  de  agua  ea  abundancia  para  la  limpieza. 

(g)  Refrigerador  ó  nevera  de  capacidad  suficiente  según  la  importancia  del  est^^bleci- 
miento,  para  contener  la  carne  sobrante  de  la  venta  diaria,  en  forma  que  no  esté  en  contacto 
con  el  agua  o  el  liielo,  y  que  se  ha  debido  retirar  de  los  gandíos  antes  de  las  10  de  la  mañana. 

(h)  Puertas  rejas  en  uno  ó  dos  huecos  que  den  á  la  calle,  para  mayor  circulación  del  aire. 

(i)  Colocación  de  la  carne  en  ganchos  de  acero.  Estos  ganchos  e.'^tarán  fuera  del  ídcance 
de  las  manos  de  los  compradores,  soste:iidos  por  una  barra  también  de  acero,  y  se  conserva- 
rán esmerilados. 

(j)  Instalación  sanitaria  del  local  ajustada  á  las  prescripciones  de  la  junta  de  sanidad  y 
prohibiéndose  la  existencia  de  retrete  en  el  mismo. 

(k)  Conservación  constante  del  local  en  el  mejor  estado  de  aseo,  baldeo  de  sus  pisos  una 
ó  más  veces  al  día  y  pintura  al  óleo  del  maderamen  y  de  las  paredes  renovada  cuantas  veces 
sea  necesaria. 

(1)  Abstención  de  ejercer  otra  industria  ó  comercio,  de  tener  víveres,  de  almacenar  huesos, 
piltrafas,  sebo,  basuras,  etc.,}'  separación  de  otros  establecimientos  por  tabiques  de  maApos- 
tería  completos,  sin  huecos  de  comunicación  con  aquellos. 

Art.  34S.  Los  carniceros  y  los  expendedores  de  pescados  estarán  obligados  á  guardar  las 
carnes  ó  pescado  sobrantes  de  la  venta  diaria,  en  refrigeradores  ó  cajas  bara  hielo,  forrados 
interiormente,  á  prueba  de  filtraciones,  con  planchas  de  plomo,  zinc  ú  otro  metal  duradero, 
y  dispuesto  el  forro  de  modo  que  el  agua  del  deshielo  se  derrame  constante  y  fácilmente  por 
medio  de  un  tubo  de  plomo,  cobre  ó  latón  conectado,  conforme  á  las  indicaciones  de  la  junta 
local  de  sanidad,  con  el  desagüe  más  próximo  dentro  del  edificio. 

Art.  349.  El  expendedor  usará  mandil  blanco,  siempre  limpio. 

Art.  350.  No  se  peiTuitirán  carnicerías  en  casas  de  madera,  excepción  hecha  de  aquéllas 
que,  por  circunstancias  especiales  de  localidad  y  bajo  detenninadas  condiciones  obtengan 
permiso  especial  por  escrito  de  la  junta  local  de  sanidad. 

Art.  351.  A  las  carnicerías  instaladas  en  la  actuahdad  y  que  no  reúnan  las' condiciones 
antes  expresadas,  se  les  concederá  un  plazo  de  seis  meses  para  ajustarse  á  ellas,  á  contar 
desde  la  promulgación  de  estas  ordenanzas,  procediéndcse  á  la  clausura  de  las  que  no  las 
hayan  cumplido. 

Art.  352.  Queda  prohibido  usar  como  residencia  ó  dormitorio  el  local  de  una  carnicería. 

Art.  353.  Para  su  mejor  aeración  las  carnes  se  conservarán  colgadas,  fuera  ó  dentro  del 
refrigerador,  desde  la  hora  de  su  llegada  al  establecimiento  hasta  las  10  de  la  mañana. 
Durante  el  resto  del  día  se  guardarán  en  el  refrigerador,  que  estará  provisto  durante  todo  el 
tiempo  del  servicio  de  cantidad  suficiente  de  hielo. 

Art.  354.  No  se  pennitirá  en  las  carnicerías  usar  picaderos  de  madera  ni  hachas,  debiendo 
cortarse  las  carnes  con  cuchillos  enterizos  de  acero,  lisos  en  las  hojas  y  en  los  mangos,  y  los 
huesos  con  sierras  de  análoga  construcción  á  la  de  los  cucliillos. 

Aet.  355.  No  se  permitirá  la  venta  de  carnes  procedentes  de  animales  que  no  se  hubiesen 
matado  expresamente  para  el  consumo,  en  los  mataderos  ó  lugares  autorizados  para  suplir 
la  falta  de  éstos. 

Art.  356.  El  dueño  de  una  carnicería  que  tenga  sospechas  de  que  la  carne  que  ha  recibido 
procede  de  un  animal  enfermo,  suspenderá  la  venta  de  la.  misma  y  dará  parte  inmediatamente 
del  hecho  al  jefe  de  sanidad. 

Art.  357.  Todos  los  utensilios  de  las  carnicerías  y  de  los  vendedores  de  carne,  embutidos, 
aves,  pescados,  etc.,  se  conservarán  siempre  en  el  mejor  estado  de  limpieza. 

Art.  358.  En  la  fabricación  de  salchichas,  longanizas  y  demás  embutidos  no  se  empleará 
otra  carne  que  la  de  cerdo  ó  de  res  vacuna  ni  otra  sal  que  la  común  (cloiiiro  de  sodio)  y  no 
podrán  usai'se  saladeros,  prensas  y  demás  utensilios  que  no  sean  de  madera,  hieiTO  ó  piedra, 
manteniéndose  todos  perfectamente  limpios. 

Art.  359.  No  se  permitirá  la  entrada  en  ningima  población  y  procedentes  de  otra,  de 
carnes,  en  trozos  ó  bandas,  que  no  vayan  marcadas  con  la  señal  del  matadero  correspon- 
diente y  acompañadas  del  oportuno  certificado  del  veterinario  inspector  del  mismo,  visado 
por  el  alcalde. 

Art.  350.  Se  declararán  clandestinas  y  serán  decomisadas  las  carnes  que  no  procedan  de 
matedero  autorizado  ó  que  no  hayan  sido  reconocidas  por  los  peritos  respectivos.  Estas 
carnes  se  remitirán  en  seguida  para  su  examen  sanitario  al  centro  correspondiente. 

Art.  361.  No  se  permitirá  curar  cueros  ni  preparar  sebo  ú  otra  grasa  en  las  carnicerías  ni 
en  ningún  otro  lugar  de  la  población,  para  el  que  no  se  haya  obtenido  permiso,  por  escrito, 
de  la  junta  local  de  sanidad. 

Art.  362.  La  venta  de  carne,  huesos,  menudos,  manteca,  etc.,  á  domiciho,  se  hará  en 
tableros  de  metal  esmaltado  ó  pulimentado  ó  de  madera  forrada  de  láminas  metálicas,  y  se 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  859 

conservarán  siempre  liinpio.s.     Los  tableros  estarán  además  protegidos  por  euVjiertau  para 
evitar  el  polvo,  los  insectos  y  el  manoseo. 

Art.  3f)3.  Se  pi'ohibe  el  uso  de  toda  substancia  proservativa,  que  no  sea  la  sal  común 
(cloruro  de  sodio),  para  la  conservación  de  las  caj-nes  destinadas  al  consumo. 

Capítulo  XIIL 
basukas  é  inmundicias. 

Art.  364.  En  las  habitaciones  en  que  no  se  haya  establecido  el  servicio  de  conducción  de 
basuras  6  inmundicias  al  mar,  éstas  se  arrojarán  en  vertederos  6  muladares  situados  á  no 
menos  dí?  un  kilómetro  del  perímetro  urbano  y  en  lugares  donde  no  puedan  causar  daño 
alguno  á  la  salud  pública,  señalados  por  la  junta  de  sanidad.  Cuando  haya  establecidos 
hoi'nos  crematorios  do  basuras  é  inmundicias,  éstas  serán  conducidas  á  ellos. 

Art.  305.  Cada  ayuntamiento,  si  el  servicio  no  se  efectúa  por  el  Estado,  deberá  establecer 
el  servicio  público  de  recogida  de  aguas  sucias,  basuras  é  inmundicias  de  calles,  plazas  y 
casas,  de  manera  regular  y  confonnc  á  las  prescripciones  que  scñlae  la  junta  de  sanidad. 

Art.  366.  Las  basuras  ú  inmundicias  de  las  casas  se  extraerán  en  envases  metálicos  6  de 
otro  material  impermeable,  sin  agujeros  ó  hendiduras  que  den  salida  á  parte  del  contenido, 
y  que  se  colocarán  en  la  calle,  junto  á  la  acera,  momentos  antes  de  pasar  el  carro  destinado 
á  recogerlas,  si  el  servicio  se  prestare  de  día,  en  cuyo  caso  se  hará  en  las  primeras  horas  de  la 
maña,na;  pero  si  fuere  de  noche,  se  extraerán  pasadas  las  10  de  la  misma. 

En  los  lugares  donde  no  haya  servicio  organizado  de  recogida  de  basuras,  éstas  se  que- 
marán cada  cuarenta  y  ocho  horas  en  los  patios  si  no  pudieran  ser  llevadas  á  las  afueras  de 
la  población,  á  menos  que  sea  necesario  hacerlo  antes  para  evitar  que  por  su  naturaleza, 
cantidad  ú  otra  circunstancia,  se  fermenten  ó  corrompan  dentro  de  las  casas  ó  en  los  patios. 

Art.  367.  El  ocupante  de  cualquier  casa  en  la  población  está  obligado  á  usar  número 
suficiente  de  cajas  ó  vasijas,  á  prueba  de  agua,  de  metal  ó  forrados  interiormente  de  metal, 
capaces  de  contener,  hasta  una  altura  de  10  centímetros  por  debajo  de  su  tapa,  todas  las 
basuras,  residuos,  cenizas,  etc.,  que  se  haj^an  acumulado  durante  el  día  en  su  domicilio. 
Usará  también  donde  no  existan  cloacas  ó  sumideros,  número  suficiente  de  vasijas  para 
contener  las  aguas  residuas  de  condiciones  iguales  á  las  de  basuras,  cuidando  de  recoger  de 
la  calle  los  envases  en  las  primeras  horas  de  la  mañana  si  el  servicio  se  presta  de  noche,  y  si 
de  día,  tan  pronto  como  los  encargados  de  la  limpieza  las  hayan  desocupado. 

Art.  368.  Queda  prohibido  á  los  transeúntes  agitar,  derramar,  remover  ó  extraer  el 
contendió  de  dichos  envases  ó  apoderarse  de  éstos. 

Art.  369.  En  los  lugares  donde  no  exista  el  servicio  público  de  limpieza,  los  residuos  y 
basuras  de  los  establecimientos  industriales  y  del  comercio,  se  conducirán  por  cuenta  de 
sus  dueños  á  los  vertederos  autorizados. 

Art.  370.  Queda  prohibido  arrojar  á  los  vertederos  ó  muladares,  á  que  se  refiere  el  artículo 
anterior,  materias  fecales  y  animales  muertos. 

Art.  371.  Los  ayuntamientos  dispondrán  que  las  basuras  arrojadas  en  los  muladares  6 
vertederos  se  quemen  ó  destruyan  por  los  contratistas  ó  por  los  empleados  cuando  el  ser- 
vicio se  haga  por  administración;  pero  en  ningún  caso  se  permitirá  extraer  de  las  basuras 
objetos  ó  materias. para  aplicaciones  industriales  ó  agrícolas,  sin  que  éstos  sean  ant-es  des- 
infectados y  mediante  permiso  especial  de  la  junta  de  sanidad. 

Art.  372.  Queda  prohibido  acumular  ó  depositar  en  ninguna  casa,  habitación,  sótano, 
patio,  etc.,  basuras,  residuos,  huesos  ó  cualquier  material  susceptible  de  descomposición  y 
que  pueda  causar  molestias  á  los  vecinos  ó  producir  malos  olores. 

Capítulo  XIV. 

TRANSPORTE   DE    BASURAS   T   ABONOS. 

Art.  373.  Queda  prohibido  conducir  estiércol  ó  residuos  de  los  establos  dentro  del 
perímetro  de  la  población,  á  no  ser  en  carros  especiales,  construidos  ad  hoc,  de  fondo  y 
paredes  impermeables,  sin  agujeros  ni  intersticios,  bien  tapados  y  conforme  al  modelo 
aprobado  por  la  junta  de  sanidad. 

Art.  374.  Los  carros  para  la  carga  de  estiércol  y  residuos  deberán  cargarse  dentro  de 
los  edificios  de  los  establos  ó  en  sus  patios  y  no  en  las  calles  ó  lugares  públicos :  r  el  contenido 
será  transportado  de  manera  que  no  despida  mal  olor.  Quedan  prohibidas  las  remociones 
parciales:  la  extracción  se  verificará  en  su  totalidad. 

Art.  375.  Todo  el  estiércol  ó  residuo  que  se  conduzca  deberá  ir  dispuesto  de  tal  modo 
que  ninguna  porción  del  mismo  caiga  del  carro  durante  el  transporte. 

Art.  376.  No  se  permitirá  la  descarga  de  basuras,  abonos  ó  residuos  á  distancia  menor 
de  100  metros  de  una  casa  habitada,  ni  la  permanencia  de  aquéllos  en  el  interior  de  los 
establos  por  más  de  veintí  cuatro  horas. 


360  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Akt.  377.  Queda  prohibida  la  construcción  6  el  uso  de  receptáculos  6  bóvedas  para 
almacenar  basuras,  estiércol  ó  residuos  en  ningún  lugar  de  la  población,  á  menos  que,  por 
razones  especiales  justificadas,  se  obtenga  un  permiso  por  escrito  de  la  junta  de  sanidad. 

Art.  378.  El  transporte  por  ferrocarril  de  las  basuras  ó  abonos  de  la  población,  se  ajus- 
tará á  los  requisitos  siguientes: 

(a)  Serán  conducidos  en  carros  cerrados  y  forrados  interiormente  con  planchas  metálicas 
ú  otro  material  que  los  haga  impermeable  y  fáciles  de  limpiar,  sin  intersticios  donde  pueda 
acumularse  la  materia  que  se  transporte. 

(b)  El  carro  permanecerá  cerrado  mientras  contenga  carga  y  una  vez  descargado,  será 
en  seguida  limpiado  mecánicamente  por  medio  de  chorro  de  agua  bajo  presión,  dejándole 
abierto  hasta  que  vuelva  á  ser  cargado. 

(c)  Si  no  ñiera  posible  limpiar  el  carro  en  seguida  de  su  descarga,  deberá  éste  continuar 
cerrado  hasta  donde  pueda  ser  limpiado  mecánicamente,  operación  que  no  deberá  omitirse 
por  ningún  motivo  antes  de  recibir  nueva  carga. 

(d)  Los  carros  destinados  á  la  conducción  de  basuras  no  serán  destinados  al  transporte 
de  ninguna  otra  clase  de  carga,  y  llevarán  estampada  á  cada  lado,  en  caracteres  visibles 
desde  lejos,  la  palabra  "basura." 

(e)  La  operación  de  cargar  y  descargar  las  basuras  se  hará  de  carro  á  carro  y  á  una  dis- 
tancia no  menor  de  100  metros  de  edificio  habitado  de  la  población  ó  de  camino  público. 
En  los  lugares  de  campo  las  carretas  ó  carretones  dedicados  á  este  servicio  tendrán  que  ir 
cubiertos  y  adaptados  de  modo  cjue  no  permitan  regueros  de  la  carga. 

(f)  Los  lugares  destinados  ex  profeso  para  la  carga  y  descarga  do  basura,  serán  de  piso 
impermeable  á  fin  de  que  sean  limpiados  convenientemente,  ó  en  su  defecto,  después  de 
recogidos  con  esmero  los  residuos,  se  cubrirá  con  una  capa  de  cloruro  de  calcio. 

(g)  No  se  permitirá  deposito  alguno  previo  para  cargar  ó  descargar,  y  para  ambas  opera- 
ciones se  preferirán  las  horas  de  la  noche  ó  sean  las  de  menos  tránsito. 

(h)  En  las  fincas  ó  en  cualquier  otra  parte  donde  se  desee  aprovechar  las  basuras  como 
abono,  se  tendrán  en  cuenta  las  disposiciones  dictadas  con  respecto  á  los  lugares  de  carga  y 
descarga. 

(i)  No  se  permitirá  que  los  lanchones,  botes,  etc.,  dedicados  al  transporte  de  basuras  ó  de 
materias  orgánicas  susceptibles  de  entrar  en  putrefacción,  permanezcan  con  la  carga 
ancladas  por  más  de  doce  horas  en  muelle  algimo  de  la  población.  Estos  lanchones  ó  botes 
serán  desinfectados  con  frecuencia. 

Capítulo  XV. 

LIMPIEZA   DE   LETRINAS   Y    SUMIDEROS. 

Art.  379.  Para  la  concesión  de  licencia  para  el  establecimiento  de  un  tren  de  limpieza 
de  letrinas  será  necesario  informe  favorable  de  la  junta  local  de  sanidad,  con  expresión  de 
los  requisitos  correspondientes. 

Art.  380.  Estos  establecimientos,  se  situarán  fuera  de  la  población,  y  será  obligación  de 
los  dueños  registrar  sus  nombres  y  direcciones  en  la  junta  local  de  sanidad. 

Art.  381.  Los  dueños  de  trenes  de  limpieza  de  letrinas  y  sumideros  están  obligados  á 
enviar  diariamente  al  jefe  de  sanidad  una  relación  firmada,  en  planillas  impresas  al  objeto, 
de  las  limpiezas  efectuadas  durante  la  ncclie  anterior,  con  expresión  de  calle  y  número  de 
la  casa,  propietario,  domicilio  de  éste,  número  de  carros  extraídos  y  capacidad  y  condición 
del  pozo  negro  ó  sumidero,  que  sea  objeto  de  la  limpieza. 

Art.  382.  Queda  prohibido  realizar  limpiezas  parciales  de  letrinas  3^  sumideros.  Si 
esta  operación  se  interrumpiere,  se  continuará  en  la  noche  siguiente.  Las  fosas  serán 
debidamente  desinfectadas  con  sulfato  ferroso  y  cal,  doce  horas  antes,  por  lo  menos,  de  la 
limpieza  y  después  de  terminada  la  operación,  dejándolas  completamente  vacías. 

A  la  inspección  de  este  servicio  se  le  prestará  preferente  atención  por  la  junta  de  sanidad. 

Art.  383.  Cuando  se  supriman  pozos  negros,  sumideros  ó  pozos  absorbentes,  alcantarilla, 
etc.,  deberán  cegarse,  y  antes  de  esta  operación  limpiarse  perfectamente  y  desinfectarse. 
El  material  que  se  emplee  para  el  relleno  estará  mezclado  con  cal. 

Art.  384.  La  limpieza  de  los  excusados  y  sumideros  se  efectuará  exclusivamente  desde 
las  once  de  la  noche  á  las  cinco  de  la  mañana,  colocándose  en  la  puerta  de  la  casa  donde 
aquélla  se  realice  un  farol  con  luz  verde  que  se  vea  desde  lejos. 

Art.  385.  El  encargado  de  la  limpieza  de  una  letrina  ó  sumidero  que  por  las  condiciones 
de  construcción  de  éste  ó  aquéUa  pudiera  dar  lugar  á  accidentes  consecutivos  al  despren- 
dimiento ó  inflamación  de  gases,  deberá  adoptar  las  precauciones  necesarias  para  evitar 
desgracias. 

Art.  386.  En  las  poblaciones  donde  el  servicio  no  se  realice  por  medio  de  aparatos 
modernos  de  aspiración,  las  materias  extraídas  se  colocarán,  previamente  desinfectadas, 
en  recipientes  bien  cerrados,  y  éstos  serán  conducidos  en  carros,  provistos  de  un  farol  de 
luz  verde,  á  los  lugares  autorizados,  fuera  de  las  poblaciones  donde  no  sea  posible  causar 
daño  alguno  á  la  salud  pública. 


SEGUNDA    CONFERENCIA    tíANI'l'AUlA    INTKKKA(;i(J-\ Al..  361 

Art.  387.  Fuera  do  las  lioras  designadas  para  la  limpieza,  los  carros  que  se  dediquen  á 
estos  usos,  no  deberán  transitar  por  las  calles,  aunque  vayan  vacios.  Los  carros  y  todos 
los  utensilios  empleados  en  las  operaciones  de  limpieza  se  desinfectarán  convenientemente 
y  se  tendrán  fuera  de  la  población. 

AiiT.  388.  Los  carros  destinados  á  esta  industria  serán  de  sólida  construcción  y  conducidos 
de  modo  que  no  derramen  la  carga  por  las  calles  do  su  tránsito.  Las  vasijas  estarán  tapadas 
para  evitar  los  derrames  y  malos  oloi'cs. 

AitT.  389.  Los  empleados  en  la  limpieza  de  una  de  l(;trina  ó  sumidero,  una  voz  terminada 
la  operación,  deberán  baldear,  fregar  y  limpiar  perfectamente  los  lugares  que  hayan  ensu- 
ciado en  la  casa. 

Ajrt.  390.  En  el  caso  de  que  un  carro  ó  depósito,  por  un  vuelco  ú  otra  avería  derramen 
toda  la  carga  ó  parto  de  ella,  sus  conductores  estarán  obligados  á  recogerla  en  seguida  y  á 
dejar  bien  limpios  los  lugares  ensuciados. 

Art.  391.  Los  carros  se  conservarán  limpios  y  de  modo  que  no  puedan  molestar  con 
malos  olores. 

Art.  392.  Se  prohibe  arrojar  á  las  letrinas  y  sumideros  basuras,  de.'=pchof:,  animales, 
vegetales,  cenizas  ó  cualquier  otro  residuo  extraño  al  oljjeto  para  que  fueron  construidos. 
■  Art.  393.  Será  obligación  de  los  propietarios  ó  inquilinos,  según  los  casos,  el  mantener 
cualquier  receptáculo  ó  depósito  de  inmundicias  ó  residuos  do  la  casa,  ya  sea  letrina,  inodoro, 
fregadero,  sumidero,  etc.,  en  el  major  estado  de  función  y  limpieza  para  que  no  constituya 
molestia  ni  peligro  para  la  vida  ó  la  salud. 

Art.  394.  Se  prohibe  arrojar  á  los  ríos,  puertos,  bahías,  arroyos,  lagunas,  cunetas,  etc., 
materias  fecales  ú  otras  inmundicias. 

Capítulo  XVI. 
ferrocarriles,  tranvías  y  ómnibus. 

Art.  39.5.  Todos  los  vehículos  destinados  al  transporte  de  pasajeros  han  de  estar  bien 
pintados,  lavados  y  aseados  con  el  mayor  esmero,  y  libres  de  todo  insecto. 

Art.  396.  Queda  prohibido  á  las  empresas  de  íFerrocavriles,  tranvías,  ú  ómnibus  arrojar 
dentro  del  perímetro  de  la  población,  basuras,  cenizas,  ú  otras  substancias  semejantes,  salvo 
la  arena  que  se  emplea  habitualmente  entre  los  raíles  y  las  ruedas  de  las  locomotoras. 

Art.  397.  Todos  los  carros  destinados  al  transporte  de  viajeros  deberán  tener  la  venti- 
lación suficiente. 

Art.  398.  No  se  permitirá  la  conducción  de  ropas  sucias  ú  otra  materia  análoga,  en 
atados,  cestos  ó  canastas,  en  el  lugar  destinado  á  los  viajeros,  sino  en  la  plataforma  delan- 
tera, y  en  los  ómnibus  además  en  el  techo. 

Art.  399.  Todos  los  coches  de  ferrocarril  tendrán  retretes  para  viajeros  de  ambos  sexos, 
y  estarán  construidos  con  material  impermeable  y  dispuestos  de  manera  que  se  consei-ven 
en  el  mejor  aseo  y  sin  que  despidan  mal  olor. 

Los  ómnibus,  tranvías  y  coches  de  ferrocarril  estarán  provistos  de  número  suficiente  de 
escupideras,  con  solución  desinfectante  y  que  se  lavarán  diariamente. 

Art.  400.  Las  estaciones  y  todas  sus  dependencias  se  conservarán  igualmente  en  la  mayor 
limpieza;  baldeándose  diariamente  los  pisos;  blanqueándose  ó  pintándose  las  paredes, 
puertas  j  ventanas  cada  vez  que  sea  necesario.  Estarán  provistas  de  escupideras  en  número 
apropiado,  con  solución  desinfectante,  sujetas  en  soportes  elevados,  las  que  se  limpiarán 
diariamente,  é  inodoros  ó  excusados  en  perfecto  estado  de  función  y  limpieza. 

Art.  401.  En  las  estaciones  y  en  los  vehículos  se  fijaran  carteles  en  que  se  advierta  la 
prohibición  de  escupir  en  el  piso. 

Art.  402.  Los  patios  de  las  estaciones  estarán  limpios,  sin  hierbas,  basuras  y  aguas 
estancadas  en  el  suelo,  y  con  las  zanjas  ó  desagües  en  buen  orden. 

Art.  403.  Las  empresas  de  ferrocarriles  quedan  obligadas  á  verificar  el  arrastre,  con 
sus  trenes  de  viajeros,  j  mediante  el  extipendio  que  acuerde  la  comisión  de  ferrocarriles, 
de  un  carro  especial  propiedad  de  la  Junta  Superior  de  Sanidad  para  transportar  pacientes 
atacados  de  enfermedades  transmisibles;  carro  que  se  desinfectará  inmediatamente  por 
cuenta  y  orden  de  la  junta  de  sanidad  cada  vez  que  se  use.  Este  carro  se  guardará  en 
alguna  de  las  estaciones  centrales. 

Capítulo  XVII. 

VÍAS   PÚBLICAS. 

Art.  404.  Se  prohibe  arrojar  á  las  calles,  plazas,  paseos,  solares,  etc.,  basuras,  inmundicias 
ó  cualquiera  otra  substancia  perjudicial  á  la  salud,  como  también  aguas  sucias,  corrompidas 
ó  pestilentes. 

Art.  405.  No  se  permitirá  dejar  salir  por  los  caños  y  bajantes  que  desemboquen  en  la 
vía  pública  materias  ó  líquidos,  de  ninguna  clase,  aunque  estén  limpios,  á  no  ser  las  aguas 
pluviales. 


362  SEGUXDA    CCNFEREXCIA    SAXITAKIA    INTERNACIONAL. 

Art.  403.  No  ss  p^rmitirii  einploar  en  el  r.>lleno  d"-  cavidad.^s  6  bach.'s,  ni  para  levantar 
parte  alguna  del  terreno,  do  las  calles,  plazas,  paseos,  etc.  ni  en  ningún  lugar  adyacente  á  las 
casas  de  la  población,  las  basuras  d:>  la  calle  ó  de  cualquiera  otra  procedencia,  residuos 
animal's,  6  vjg 'tales  ó  cualquier  otro  material  capaz  d?  entrar  en  d?scomposición  orgánica 
ó  de  producir  emanacionss  pútridas. 

Art.  40r.  Las  calbs,  plazas,  pas>03,  SDlavjs  yírmos,  etc  ,  s>  coasjrvarán  d3  manera  que 
las  aguas  no  sl>  encharqu  'n,  y  s  >  t?ndrán  libr-^s  di  hierbas  en  los  lugares  que  no  estén  desti- 
nados expresament'^  pava  sembrarlos  como  adorno. 

Art.  40$.  Los  caños  )•  las  aceras  S3  mantendrán  siempre  muy  limpios  por  los  residentes 
de  las  casas  respectivammt \ 

Akt.  409.  No  se  permitirá  hacer  ninguna  necesidad  corporal  en  las  calles,  plazas,  etc. 

Art.  410.  En  donde  no  exista  servicio  público  de  riego,  y  haya  agua  suficiente,  los  vecinos 
están  obligados  á  rrgar  con  agua  limpia  una  vez  al  día,  por  lo  menos,  la  parte  de  calle 
correspondiente  al  frente  de  sus  casas,  en  la  época  de  sequía,  haciéndolo  de  modo  que  no 
se  formen  bach(s  ni  sr  ocasionen  perjuicios  á  los  trans3unt::s. 

Art.  411.  Será  obligatorio  para  el  contratista  encargado  del  servicio  recoger  todos  los 
animales  niu'rtos  que  se  cncuentr"n  en  la  vía  pública  á  la  mayor  brevedad  posible. 

Art.  412.  Los  barrenderos  públicos  ó  privados  están  obligados  á  recoger  perfectamente 
toda  la  basura  de  las  vías  públicas,  raspando  la  que  se  encuentre  adherida  é  impidiendo  que 
vaya  á  la  cloaca  ó  á  otro  recipiente  conectado  con  ella. 

Art.  413.  Queda  prohibido  sacudir  en  la  vía  pública  alfombras,  paños,  etc.,  que  ocasionen 
la  dispersión  del  polvo. 

.'lrt.  414.  Se  prohibe  amarrar  ó  soltar  cerdos,  caballos,  cabras  ú  otros  animales  en  las 
callis  ó  lugares  públicos  de  la  población,  siendo  responsables  de  ello  sus  propietarios  ó 
encargados. 

Art.  415.  No  se  permitirá  la  descarga  de  ninguna  clase  de  ganado  en  lugar  público  de  la 
población,  á  no  ser  entre  las  10  de  la  noche  y  las  5  ds  la  mañana  siguiente.  En  ganado 
será  conducido  á  su  destino  por  las  calles  más  apartadas  j  de  modo  que  no  constituya  un 
peligro  para  la  salud  ó  la  vida  de  los  mismos  y  de  los  habitantes  de  la  población. 

Art.  416.  Se  prohibe  el  tránsito  de  vacas  lecheras,  con  sus  crías  ó  sin  ellas,  por  las  calles 
de  la  población,  sin  un  permiso  escrito  de  la  junta  de  sanidad. 

Art.  417.  Los  encargados  del  servicio  de  limpieza  púbHca  humedecerán  las  calles  inme- 
diatamente antes  de  practicar  el  barrido  de  éstas,  á  ím  de  evitar  la  dispersión  del  polvo. 

Capítulo  XVIII. 

HOSPITALES,  CASAS   DE    SALUD,  ENFERMERÍAS. 

Art.  418.  Los  hospitales,  casas  ó  quintas  de  salud,  enfermerías,  lazaretos,  etc.,  sean 
públicos  ó  privados,  Sj  instalarán  fuera  de  las  poblaciones.  Esta  disposición  no  comprende 
á  los  establecimientos  de  esta  clase  que  se  encuentran  ya  instalados. 

Art.  419.  No  se  podrá  establecer,  ensanchar  ó  trasladar  algún  hospital,  casa  ó  quinta  de 
salud,  enfermería,  lazareto,  etc.,  sin  consulta  y  resolución  favorable  de  la  junta  superior 
de  sanidad,  á  la  que  los  interesados  darán  los  datos,  planos,  etc.,  del  edificio  que  se  trate 
de  tstabbcjr  ó  modificar. 

Art.  420.  Los  hospitales,  lazaretos,  casas,  etc.,  que  ss  instalen  en  lo  sucesivo  para  el 
aislamiento  y  asistencia  de  pacientes  de  enfermedad  transmisible  estarán  separados  de  los 
edificios  adyacentes  por  una  distancia  no  menor  de  30  metros  y  rodeados  de  arbolados  ó 
jardines. 

Art.  421.  Todo  hospital  general,  quinta  de  salud  ó  enfermería  tendrá  uno  ó  más  locales, 
con  puertas  dobles  y  ventanas,  provistas  de  tela  metálica  á  prueba  de  mosquitos,  y  propia- 
mente arreglados  en  el  interior  para  el  aislamiento  oportuno  de  los  casos  que  ocurran  de 
las  siguientes  enfermedades:  Sarampión,  difteria  y  crup,  fiebre  amarilla,  escarlatina, 
vii-uela,  cólera  asiático,  tifus  exantemático,  ptste  bubónica,  tos  ferina,  lepra,  fiebre  puer- 
peral, filariasis  y  paludismo. 

Art.  422.  Los  hospitales  estarán  provistos  de  locales  y  de  aparatos  para  la  desinfección. 

Art.  423.  Cada  enfermo  que  se  presente  con  alguna  de  las  enfermedades  enumeradas  en 
el  artículo  421  será  separado  inmediatamente  de  los  demás  y  trasladado  al  local  de  aisla- 
miento, y  se  dará  por  el  director  el  parte  correspondiente  al  jefe  de  sanidad. 

Art.  424.  En  las  poblaciones  donde  existan  hospitabs  generales  dejarán  de  recibir  y  de 
asistir  atacados  de  enfermedad  transm.isible.  Los  enformos  de  esta  naturaleza  que  se 
declaren  en  ellos  serán  trasladados  á  las  de  aislamiento  con  las  precauciones  necesarias. 

Art.  425.  Los  hospitales,  casas  de  salud,  etc.,  estarán  obligados  á  desinfectar  con  fre- 
cuencia las  salas  destinadas  á  los  atacados  de  enfermedad  transmisible. 

Art.  426.  Los  convalecientes  de  enfermedades  transmisibles  y  los  enformeros  que  los 
hubieren  asistido  se  bañarán  y  desinfectarán  antes  de  sahr  del  hospital. 


tíJííiLTNJJA    tJONFEK  ENOJA    HAKilAillA    I  NTEKJS' ACIOís'AJj,  ijCy'ó 

Art.  427.  Los  hospitaltís,  casas  ó  quintas  do  salud.  Ja/.aritos,  «nform  «rías,  sanatorios, 
asilos,  etc.,  sian  piibiicos  6  privados,  ({u 'dan  sujttos  á  la  irwpocciiín  d-í  la  junta  d;  sanidad 
en  todo  lo  quo  so  roíioro  á  sus  oondif;ion:'s  sanitaiias  ó  higiónicas. 

Art.  428.  Las  casas  6  quintas  d.!  salud  s;;  (ístablocrán  y  rogirán  do  conforfnidad  con  las 
prescripcionos  d;5  los  artículos  qw.  siguon. 

Art.  429.  S:!  (mtondi  rá  i)o;'  casa  do  salud  todo  establecimiento  dodicado  á  la  asi.str^ncia 
de  enformos  en  sus  pi'opios  odiíicios  y  sostRuido  por  alguna  asociación  6  empresario,  miidiunte 
retribución  catijjulada  con  ol  intnivsado. 

AiiT.  430.  Los  (  dilicios  dostiriados  ¡1  casas  d.;  salud  dobon  reunir  buenas  condiciones  de 
oilevación,  aru'ación  suíicientíí,  capacidad  y  torrono  s'-co,  y  apartado  do  arroyos,  lagunas, 
pantanos  y  depiísitos  do,  substancias  orgánicas  en  descomposición. 

Art.,43L  Las  asociaciones  ó  empresarios  poseedores  de  esta  clase  de  establecimientos, 
<{uedaii' obligados  á  mautcnei-los  siempre  en  estado  de  completa  limpieza,  hermosearlos  en 
lo  posible  y  reuni/  en  ellos  cuai\to  es  indispensable  para  la  mejor  asistencia,  comodidad 
y  espaicimiento  do  luiimo  de  los  enfermos.  Deben  contar  estos  establecimientos  con  un 
inodoro,  un  lavamanos  y  un  baño,  por  lo  menos,  por  cada  veinte  eníermos,  así  como  jar- 
dines y  patios  suficientes. 

Art.  432.  No  se  concederá  licencia  para  establecer  casas  de  salud,  sin  que  preceda 
informe  favorable  de  la  junta  local  de  sanidad  que  acepte  y  apruebe  en  definitiva  la  junta 
superior  del  ramo.  Este  ini'orme  ver.sará,  además  de  los  particulares  que  considere  perti- 
nentes la  junta,  sobre  las  condiciones  higidnicas  del  edificio,  su  emplazamiento,  número  de 
enfennos  que  en  el  mismo  puedan  ser  asistidos.  El  arquitecto  del  ayuntamiento  ó  perito 
que  supla  á  este  funcionario  deberá  informar  respecto  de  las  condiciones  de  solidez  y 
capacidad  del  edificio  destinado  al  objeto. 

Art.  -!33.  A  la  instancia  que  se  presente  solicitando  la  apertura  de  una  casa  de  salud 
se  acompañará  un  plano  completo  de  los  edificios  del  establecimiento  determinado,  de 
manera  precisa,  el  número,  clase  y  condiciones  de  los  baños,  inodoros,  vertederos,  frega- 
deros, pozos  de  agua,  lavamanos,  etc.,  que  iiayan  de  instalarse,  a.?í  como  los  medios  de 
abastecimiento  de  agua  en  propprción  de  150  litros  diarios,  por  lo  menos,  por  cada  enfermo 
y  empleado  de  la  casa.  El  plano  irá  acompañado  de  una  memoria  descriptiva.  Además 
se  unirá  el  reglamento  para  el  régimen  interior  del  establecimiento,  en  el  que  se  expresará 
la  clase  de  servicios  profesionales  que  se  hayan  de  prestar,  así  como  la  ascendencia  de  las 
cuotas,  dietas,  etc.,  que  deban  abonar  los  eníermos  por  estos  servicios. 

Art.  434.  Una  vez  presentada  la  instancia  documentada,  el  alcalde  la  trasladará  á  la 
junta  local  de  sanidad,  para  que  informe  sobre  las  condiciones  higiénicas  del  edificio,  y  de 
su  emplazamiento,  con  expresión  del  número  de  eníermos  que  puedan  en  él  ser  asistidos. 
Evacuado  este  informe,  emitirá  el  suyo  el  arquitecto  municipal  6  el  perito  capacitado  que 
lo  supla,  sobre  las  condiciones  de  seguridad  de  dicho  edificio;  siendo  requisito  indispen- 
sable para  la  concesión  que  ambos  iníormes  sean  favorables,  así  como  el  de  la  junta  supe- 
rior de  sanidad. 

Art.  435.  El  reglamento  de  toda  casa  de  salud,  una  vez  aprobado,  deberá  imprimirse, 
y  el  administrador  de  la  casa  obligado  á  repartirlo  entre  los  subscriptores  ó  interesados  por 
cualquier  concepto. 

Art.  436.  Toda  casa  de  salud  contará,  por  lo  menos,  con  los  médicos  internos,  y  los 
enfermeros  y  asistentes  suficientes,  sin  que  aquél  ni  éstos  puedan  abandonar  sus  puestos 
hasta  que  hayan  sido  relevados  por  los  que  turnen  el  servicio.  El  servicio  de  enfermeros  ó 
enfermeras  estará  desempeñado  por  graduados  ó  incorporados  en  la  Universidad  de  la 
Habana, 

A  los  efectos  del  cimiplimiento  de  este  artículo  en  lo  que  se  refiere  á  los  errfermeros  y 
enfermeras  se  concede  un  plazo  de  tres  años,  á  contar  desde  la  promulgación  de  estas 
ordenanzas. 

Art.  437.  En  cada  caso  de  salud  habrá,  por  lo  menos,  un  médico  de  visita  por  cada 
cincuenta  (50)  enfennos,  y  tres  (3)  médicos  internos  por  cada  doscientos  (200)  enfermos, 
para  que  i-esulte  eficaz  el  servicio. 

,  Art.  438.  Las  farmacias  de  las  casas  de  salud  estarán  á  cargo  de  profesores  farmacéu- 
ticos. Estas  farmacias  se  sujetarán  al  reglamento  que  rija  para  el  ejercicio  de  la  profesión 
de  farmacia. 

Art.  439.  Los  directores  facultativos  darán  parte  diariamente  á  la  junta  local  de  sani- 
dad de  los  casos  de  eníermedades  transmisibles,  de  declaración  obligatoria,  que  ingresen 
en  la  casa  de  salud,  así  como  de  las  altas  por  curación  ó  muerte  de  los  mismos.  Paia  los 
efectos  del  artículo  423  se  llenará  un  registro  diario  en  el  que  consten  el  ingreso,  la  salida 
y  asistencia  de  los  eníermos  asistidos  en  el  establecimiento  y  el  diagnóstico  de  los  mismos, 
registro  que  será  inspeccionado  por  el  jefe  local  de  sanidad,  ó  un  delegado  del  mismo, 
siempre  riue  lo  estime  conveniente. 

Art.  440.  En  toda  casa  de  salud  deben  existir  dos  pabellones  completamente  indepen- 
dientes y  á  sotavento  de  los  demás  pabellones,  para  alojar  en  ellos  á  los  enfermos  de  afee- 


864  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

clones  contagiosas,  dedicándose  ei  uno  á  enfermedades  transmisibles  por  el  mosquito,  y  el 
otro  para  las  transmisibles  por  contagio. 

Akt.  441.  En  el  primero  de  dichos  pabellones  las  puertas  y  ventanas  estarán  pjotegidas 
por  tela  metálica  que  impida  la  entrada  ó  salida  de  los  mosquitos,  ó  sea  de  16  liilos  por  2^ 
centímetros  cuadrados.  Esta  tela  metálica  debe  ser  doble  en  la  puerta  de  entrada  del 
pabellón,  formando  á  modo  de  un  vestíbulo  para  mayor  seguridad  contra  los  mosquitos. 

Art.  442.  El  pabellón  para  casos  de  enfermedades  transmisibles  por  contagio,  á  que  se 
refiere  el  artículo  440,  se  dividirá  en  dos  ó  más  salas  para  el  caso  de  existir  enfermos  de 
distintas  afecciones,  á  fin  de  evitar  la  transmisión  al  paciente  de  otra  enfermedad  contagiosa 
distinta  de  la  que'sufre. 

Art.  443.  Las  salas  deben  estar  divididas  en  pequeñas  habitaciones  donde  sólo  existan, 
á  lo  más,  dos  camas  en  cada  una,  para  que  una  vez  que  se  ha  dado  un  enfermo  de  alta  por 
curación  ó  fallecimiento  puedan  ser  desinfectadas  con  facilidad. 

Habrá,  además,  un  pabellón  ó  sala  especial  de  tuberculosos,  á  distancia  conveniente  de 
los  demás  enfermos,  con  todas  las  precauciones  necesarias  á  evitai'  la  propagación  de  la 
tuberculosis. 

Art.  444.  Los  enfermeros  y  asistentes  de  las  salas  de  enfermos  infecto-contagiosos  no 
podi-án  bajo  ningún  concepto  estar  en  contacto  con  el  resto  del  personal  del  establecimiento. 

Art.  445.  Los  médicos,  enfermeros  y  asistentes  de  las  salas  mencionadas  usarán  batas 
que  han  de  ajustar  pe:iccta:uente  al  cuello  y  á  las  mufiecas,  y  de  las  que  se  desprenderán 
al  salir  de  las  salas  para  que  sean  desinfectadas. 

Art.  446.  Las  excretas  de  los  eniermos  serán  desinfectadas  debidamente.  También  se 
desinfectarán  las  vasijas,  ropas  de  cama  y  demás  objetos  que  hayan  estado  en  contacto 
con  el  paciente.  Todo  enfermo  de  cama  estará  obligado  al  entrar  en  la  casa  á  entregar  la 
ropa  que  viste  para  ser  desinfectada  en  el  acto,  y  á  vestir  mientras  guarde  cania  la  ropa 
que  se  le  señale. 

Art.  447.  En  todas  las  poblaciones  en  que  haya  alcantarillado  y  agua  suficiente,  los 
servicios  sanitai-ios  estarán  instalados  conforme  á  Ío  prescripto  por  estas  ordenanzas  sobre 
esta  materia. 

Art.  448.  En  las  poblaciones  que  carezcan  de  alcantarillado  las  casas  de  salud  tendrán 
número  suficiente  de  pozos  negros  con  fondo  y  paredes  mamposteados  y  cementados,  tubo 
ventilador  y  demás  especificaciones  de  la  junta  local  de  sanidad  y  que  se  harán  constar  en 
la  licencia  correspondiente. 

Art.  449.  Los  pozos  negi-os  se  construirán  á  la  mayor  distancia  posible  de  los  pabe- 
llones ocupados  por  los  enfermos  y  se  desinfectarán  diariamente  con  petióleo  crudo  y  una 
solución  de  sulfato  de  hierro. 

Art.  450.  Los  enfermos  que  por  su  estado  de  salud  no  puedan  ir  á  los  retretes  harán 
sus  deposiciones  en  vasijas  de  losa  ó  esmaltadas  y  con  tapas,  que  serán  sacadas  de  la  &ala 
tan  pronto  se  haya  hecho  uso  de  ellas,  no  pudiendo  ser  utilizadas  de  nuevo  mientras  no 
se  les  desinfecte. 

Art.  451.  En  toda  casa  de  salud  existirá  un  local  aislado,  en  el  que  se  depositarán  los 
cadáveres  hasta  que  se  proceda  á  su  inhmnación,  ó  se  entreguen  á  los  familiares.  Este 
local  será  desinfectado  cada  vez  que  haya  sido  ocupado  por  un  cadáver. 

Art.  452.  Las  casas  de  salud  serán  inspeccionadas  por  la  junta  local  de  sanidad,  así 
como  por  el  jefe  de  sanidad  por  sí  ó  por  delegado,  con  el  fin  de  cerciorarse  de  si  se  cometen 
ó  no  abusos  ó  deficiencias  en  el  servicio  de  los  enfermos  y  de  si  se  cumplen  las  leyes,  dis- 
posiciones ú  órdenes  sanitarias. 

Art.  453.  Toda  persona  que  sin  llenar  los  requisitos  expresados  abriese  una  casa  de 
salud,  se  le  clausurará  inmediatamente,  sin  perjuicio  de  la  aplicación  de  la  penalidad  que 
corresponda. 

Art.  454.  Todos  los  hospitales,  casas  de  salud,  etc.,  suministrarán  á  la  junta  local  de 
sanidad  los  datos  de  su  estadística  particular  y  demás  infoi-mes  que  se  les  pida  respecto  al 
estado  sanitario  del  establecimiento,  enfermos  que  asistan,  etc. 

Art.  4.55.  Los  requisitos  de  orden  sanitario  exigidos  para  las  casas  de  salud  se  aplicarán 
igualmente  á  los  hospitales,  enfermerías,  etc. 

Capítulo  XEX. 
animales  y  ganados. 

Art.  456.  Queda  prohibido  introducir  ó  conservar  en  la  población  animal  alguno 
atacado  de  enfermedad  transmisible  á  la  especie  humana  ó  que  haya  estado  en  contacto 
con  otros  animales  afectados  de  enfermedades  de  la  misma  naturaleza.  Los  dueños  ó 
encargados  de  dichos  animales  y  los  veterinarinos  que  ejerzan  su  profesión  están  obligados 
á  dar  parte  al  jefe  local  de  sanidad  de  cualquier  caso  de  los  indicados  que  se  les  presente. 

Art.  457.  Se  aislará  convenientemente,  en  lugar  designado  por  la  junta  de  sanidad, 
todo  animal  atacado  de  enfermedad  transmisible. 


SEGUNDA    CONFICRENCÍA    SANITARIA    INTEIlNAf 'TONAI..  'óOf) 

La  existencia  de  algún  caso  de  muermo  ó  tuberculosis  en  animales  en  la  Provincia  de  la 
Habana  será  participado  á  la  comisión  creada  por  la  orden  fifi  de  1901,  para  que  tome  las 
medidas  ((Uí!  en  la  minina  ho  ()staf)l()Cfsn.  En  las  demás  Provincias  se  seguirán  los  preceptos 
de  estas  ordenanzas  aplicables  á  la  materia. 

Art.  4/58.  Queda  prohibido  ulülizar  nuevamente  las  cuadras,  patios,  corrales,  etc.,  en 
que  hayan  estado  animales  (ínfermos,  sin  haberse  practicado  ant(!s  la  (lesinfección  corres- 
pondiente y  obtenido  perm¡.so  para  ello  do  la  junl-a  local  de  sanidad. 

AiiT.  459.  El  propiefcai'io,  encai'gado  6  vei-eiinario  (jU(!  adviei'l.a  en  algún  animal  .señales 
ó  signos  sospechosos  de  mucirmo  6  lamparones  avisará  con  urgencia  al  jefe  de  sanidad  tan 
pronto  como  (enga  nolicia  del  ca.so. 

Art.  460.  Todo  animal  enfermo  6  maltratado  que  se  encuentre  en  las  calles  ú  otros 
lugares  públicos  será  inmediatamente  recogido  por  la  policía,  y  conducido  al  lugar  designado 
al  efecto. 

Art.  461.  El  transporte  de  animales  afectados  do  enfermedad  transmisible,  6  del  cadáver 
de  los  mismos,  se  verificará  de  modo  que  .su  tránsito  no  constituya  peligro  por  el  riego  de 
deyecciones,  sangro  ú  otras  materias.  El  carro  .se  proferirá  que  sea  cerrado  y  en  seguida 
se  desinfectará  debidamente. 

Art.  462.  Se  prohibe  enterrar  en  la  población  cadáveres  de  animales.  ICstos  .serán 
conducidos  antes  de  que  se  inicie  la  putrefacción,  al  lugar  que  al  efecto  .se  halle  señalado 
para  su  enterramiento  ó  incineración  y  se  procederá  con  ellos,  en  la  forma  que  se  disponga, 
según  la  naturaleza  de  la  enfermedad  que  haya  causado  la  muerte. 

Art.  463.  No  se  permitirá  que  los  perros,  cualquiera  que  sea  su  clase  y  tamaño,  anden 
por  las  calles  sin  bozal,  á  menos  que  vayan  atados  y  conducidos  por  alguna  peisona.  El 
perro  que  se  encuentre  de  otra  manera  será  recogido  por  los  empleados  municipales 
encargados  de  llenar  este  servicio  y  llevado  al  depósito  correspondiente. 

a\rt.  464.  De  toda  persona  mordida  por  un  perro  ú  otro  animal  se  dará  aviso  en  seguida 
al  jefe  de  sanidad,  quien  dispondrá  que  sea  puesto  en  observación,  y  si  resultare  rabioso 
dicho  animal  dictará  las  medidas  que  estime  opoi'tunas. 

Art.  465.  Todo  animal  sospechoso  de  rabia  será  capturado  y  aislado,  y  se  dará  parte 
de  ello  al  jefe  de  sanidad. 

Art.  466.  Las  perreras,  cualquiera  que  sea  el  lugar  en  que  se  tengan,  han  de  mantenerse 
en  estado  de  completa  limpieza  y  ventilación,  bien  provistas  de  agua  para  beber  los  animales 
y  situadas  á  la  sombra. 

Art.  467.  Todos  los  animales  dosméisticos  han  de  tenerse  muy  limpios,  así  como  los 
lugares  donde  se  les  recoja. 

Art.  468.  Se  prohibe  la  cría  y  ceba  de  ganado  de  cualquier  clase,  en  basureros,  ester- 
coleros ú  otros  lugares  en  que  se  arrojen  restos  animales  ó  detritos  de  la  misma  naturaleza. 

Art.  469.  No  se  permitirá  la  traslación  de  un  distrito  á  otro  de  ningún  animal  atacado 
de  enfermedad  transmisible,  ni  dentro  de  un  mismo  distrito  á  lugares  donde  puedan 
contagiar  á  sus  semejantes  ó  á  las  personas. 

Art.  470.  Tan  pronto  como  el  jefe  local  de  sanidad,  ó  los  propietarios  respectivos, 
tengan  conocimiento  de  haberse  presentado  alguna  em'ermedad  epidémica  (epizoovia)  en 
los  ganados,  darán  aviso  por  la  vía  más  rápida  de  que  dispongan  al  jefe  superior  de  sanidad, 
tomando  desde  el  primar  instante  las  mididas  de  aislamiento  y  otras  señaladas  en  la  circular 
de  la  secretaría  de  gobernación,  sobre  epizootias,  fecha  17  de  febrero  de  1903,  publicada 
en  la  Gaceta  Oficial  el  día  19  del  propio  mes  y  año,  las  cuales  se  ratifican  por  las  presentes 
reglas. 

Art.  471 .  No  se  permitirá  aprovechar  para  ningún  uso  parte  alguna  de  animales  muertos 
de  enfermedades  transmisibles  á  la  especie  humana. 

Art.  472.  Todos  los  animales  muertos  de  enfermedades  transmisibles  serán  quemados 
hasta  su  completa  carbonización  y  los  de  otras  enfermedades  serán  enterrados,  si  no  se 
prefiere  quemarlos. 

Art.  473.  No  seiá  permitido  dentro  de  los  límites  de  la  población  ningún  hospital  ó 
establo  de  animales  atacados  de  enfermedades  transmisibles  á  la  e-specie  humana. 

,  Capítulo  XX. 

SANIDAD    Ó    HIGIENE   RURAL. 

Art.  474.  Las  viviendas  en  el  campo  se  construirán  lejos  de  los  pantanos  y  de  los  terrenos 
que  se  dediquen  á  cultivos  encharcados,  eligiéndose  en  cada  finca  los  pai'ajes  más  altos  y 
secos. 

Art.  475.  Los  dueños  de  fincas  rústicas  procurarán  la  desecación  de  los  pantanos  y  el 
desagüe  de  las  charcas  que  en  ellas  hubiere,  y  á  no  serle  posible  por  lo  costoso  verterán  en 
ellas  cantidad  de  petróleo  suficiente,  cada  dos  semanas,  á  fin  de  impedir  la  procreación  de 
los  mosquitos. 


366  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Art.  476.  Las  casas  en  el  campo  tendi'án  también  en  cuanto  sea  posible  análogas 
condiciones  higii^nicas  á  las  viviendas  en  general.  Se  evitará  que  de  las  cocinas  pase  el 
humo  á  las  habitaciones  haciendo  la  atmósfera  irrespirable. 

Art.  477.  Las  cosechas  no  se  depositarán  en  el  misino  local  de  las  viviendas,  ni  será 
permitido  en  ésas  la  permanencia  de  cerdos,  cabras  y  aves  de  corral. 

Art.  47S.  Las  caballerizas,  chiqueros,  gallineros,  palomares  y  otros  lugares  destinados 
á  los  animales  deberán  estar  apartados  de  las  viviendas  y  se  mantendi'án  en  buenas 
condiciones  de  limpieza. 

Art.  479.  Los  estercoleros  y  pozos  negros  estarán  situados  lo  más  lejos  posible  de  las 
viviendas  }'  de  los  pozos,  alljbes,  arroj'os  y  ríos. 

Capítulo  XXI. 

ENFERMEDADES   TRANSMISIBLES. 

Art.  480.  Es  obligatoria  para  el  médico  le  declaración  al  jefe  local  de  sanidad  de  todos  los 
casos  confirmados  que  se  presenten  de  las  enfermedades  que  se  enumeran  en  la  siguiente 
lista : 

Actiuomicosis,  anquilostomiasis  ó  uncinariasis,  beriberi,  carbunclo,  cólera  asiático , 
cólera  nostras,  difteria  y  crup,  disentería  epidémica,  enteritis  (de  cualquier  naturaleza), 
erisipela,  escarlatina,  fiebre  amarilla ,  fibre  de  ?naZto,  fiebre  miliar,  j^e¿>re  tifoidea,  filariasis, 
gripe,  lepra,  meningitis  cerebro-espinal  epidémica,  muermo  y  farcino,  neumonía,  oftalmía» 
{granulosa  y  purulenta) ,  paludismo  (en  todas  sus  formas),  paperas,  {parotiditis  epidémica)^ 
peste  bubónica,  rabia,  rubeola,  {sarampión  alemán  Rotheln),  sarampión,  septicemia  puer- 
peral y  otras  afecciones  puerperales,  tétanos  de  los  recién  nacidos,  tifus  exantemático,  tinas, 
tos  ferina,  tuberculosis  (en  todas  sus  iovvass),  varicela,  y  viruelas. 

La  obligación  de  la  denuncia  se  extiende  también  á  los  casos  sospechosos  de  las 
enfermedades  clasificadas  entre  las  cuarentenables. 

Para  los  efectos  de  estas  ordenanzas  se  e.itenderán  por  enfermedades  transmisibles  todas 
las  que  van  impresas  con  letra  itálica  en  la  lista  precedente,  y  por  enfermedades  curente- 
nables,  el  cólera  asiático,  la  peste  bubónica,  el  Tifus  exentimático,  la  viruela,  la  fiebre  amarilla 
y  la  lepra. 

La  obligación  de  declarar  la  existencia  de  estos  casos  recae  igualmente  sobre  los  médicos 
en  el  ejercicio  de  su  clientela  particular,  como  sobre  los  que  desempeñan  sei-vicios  nacionales 
ó  muaicipales:  y  se  refiere  á  los  casos  de  las  enfermedades  antes  enumeradas  donde  quiera 
que  se  encuentren,  dentro  de  la  jurisdición  terrestre  ó  marítima  de  la  República. 

Art.  481.  En  casos  de  dudas  del  diagnóstico  los  médicos  remitirán  al  jefe  local  de  sanidad 
las  muestras  de  esputos,  sangre,  secreciones,  etc.,  con  las  cuales  pudiera  comprobarse  el 
diagnóstico.  La  junta  local  de  sanidad  atenderá  en  el  acto  cualquier  consulta  y  el  resultado 
se  le  cornuDicará  en  seguida  al  médico  con  la  reserva  consiguiente. 

Art.  482.  Los  médicos  deberán  notificar  al  jefe  local  de  sanidad  si  hay  niños  en  la  casa 
donde  se  encuentre  el  enfermo  y  la  escuela  ó  colegio  á  que  asistan. 

Art.  483.  De  los  partes  de  casos  de  fiebre  amarilla,  viruelas,  peste  bubónica  y  cólera 
asiático  que  reciban  los  jefes  locales  darán  conocimiento  al  jefe  superior  de  sanidad  por 
la  vía  más  rápida  de  que  dispongan. 

Art.  484.  La  junta  superior  de  sanidad  podrá  adicionp.r  la  lista  del  artículo  480  con  otras 
enfermedades  que  juzgue  necesario  publicándolo  debidamente  para  gCDeral  conocimiento. 

Art.  485.  El  parte  se  dará  por  escrito  en  el  término  de  veinte  y  cuati'o  horas  de  la 
primera  visita  ó  consulta,  ó  inmediatamente  si  se  trata  de  un  caso,  confirmado  ó  sospechoso, 
de  cólera  asiático,  fiebre  amarilla,  escarlatina,  sarampión,  peste  bubónica,  difteria  ó  crup, 
muerma  y  tétanos  de  los  recién  nacidos,  ajustado  al  modelo  impreso  que  proporciona  la  junta 
de  sanidad. 

Art.  48.6.  El  médico  de  asistencia  ó  de  un  hospital,  enfermería,  quinta  de  salud,  asilo, 
etc.,  informará  además  al  jefe  de  .'¡anidad  del  resultado  final  de  la  enfermedad. 

AÍrt.  487.  Se  llama  especialmente  la  atención  de  los  médicos  acerca  de  la  obligación 
en  que  están  de  dar  parte  de  cada  enfermo  de  tuberculosis  que  se  les  presente,  aunque 
haya  estado  antes  asistido '  por  otro  médico.  Esta  obligación  %e  extiende  también  á  los 
directores  médicos  de  todas  las  instituciones  públicas  ó  privadas. 

Art.  488.  Es  deber  de  todo  individuo  afectado  de  tuberculosis,  de  sus  asistentes  y 
familiares  y  de  las  instituciones  públicas  ó  privadas,  observar  y  hacer  cumplir  todas  las 
reglas  y  medidas  dictadas  para  evitar  la  propagación  de  esta  enfermedad. 

Art.  489.  Si  el  enfenno  atacado  de  alguna  de  las  enfermedades  de  declaración 
obligatoria  ha  sido  visto  en  primera  ocasión  por  dos  ó  más  médicos  en  consulta,  corres- 
ponde dar  el  parte  al  que  se  haga  cargo  de  la  asistencia,  ó,  si  ninguno  se  hace  cai-go  de  ésta, 
al  primero  que  lo  hubiere  visto  ó  reconocido. 

Art.  490.  El  médico  dará  igualmente  parte  de  los  casos  de  declaración  obligatoria  que 
acudan  á  su  gabinete  de  consultas,  expresando  esta  circunstancia  en  el  parte,  con  el  nombre, 
domicilio,  etc.,  del  enfermo. 


SEGUNDA    GONFEKKNÍJIA    SAiNITAItlA    TNTERNACíONAL.  yf)7 

.Art.  491.  Los  propietarios  6  encargados  de  liolcles,  casas  de  hu(5spedei^,  posada.s,  fondas, 
casas  de  dormir,  colegios,  fábricas,  industrias,  centrales  6  colonias,  y,  en  general,  donde 
residen  6  pernocten  muchas  personas,  darán  tambitín  parte,  al  jefe  de  sanidad  de  todo  caso 
de  las  mencionadas  enfermedades  ((ue  ocurran,  dentro  d(í  las  primeras  veinticuatro  horas. 

Art.  492.  ICl  jefe  de  sanidad,  el  inspector  médico  de  sanidad,  6  la  coirfSsión  de  e;ií(!rme- 
dades  infecciosas  tendrán  derecho  á  visitar  cualquier  caso,  confirmado  ó  suspechoso,  de 
enfermedad  transmisible. 

AiiT.  493.  Los  directores  de  hospitales,  quintas  de  salud,  enfennerías,  etc.,  indicarán 
en  el  parte,  el  domicilio  del  enfermo  ó  el  lugar  donde  presuma  éste  haber  contraído  la 
enfermedad. 

Art.  494.  Cualquier  individuo  que  tenga  noticia  de  la  existencia  de  algún  caso  de- 
enfermedad  transmisible,  ó  de  fallecido  de  enfermedad  transmisible,  siíf  asistencia  médica^. 
está  obligado  á  dar  parte  al  jefe  de  sanidad. 

Art.  495.  El  módico  está  obligado  á  informar  al  jefe  de  familiü,  6  al  dueño  ()  encargado 
de  la  casa,  tan  pronto  como  reconozca  6  sospeche  (¡ue  el  caso  es  de  enfermedad  transmisible, 
de  las  medidas  inmediatas  que  deben  ponerse  en  práctica  para  evitar  entre  los  familiares  ó 
convecinos  el  contagio  y  la  propaganción  de  la  enfermedad. 

Art.  496.  Todo  caso  de  enfermedad  fácilmente  transmisible  será  ai.slado  por  orden  del 
jefe  de  sanidad,  bien  en  la  propia  residencia  del  enfermo,  si  existen  en  ella  medios  eficaces  de 
hacerlo  sin  peligro  para  la  salud  pública,  bien  en  un  hospital,  lazareto  6  casa  apáitada,  si  se 
carece  de  aquéllos. 

Art.  497.  Según  la  enfermedad  de  que  se  trate  el  aislamiento  podrá  .ser  de  todn  la  casa 
habitada  por  el  enfermo,  de  parte  de  ella  ó  de  una  habitación,  y  podrá  comprender  no  sólo 
al  enfermo  y  los  enfermeros  sino  también  por  cierto  tiempo,  mientras  se  adopten  las  medi- 
das necesarias,  á  todas  ó  parte  de  las  personas  que  se  encuentren  en  la  casa  ó  que  haj^an 
estado  en  contacto  con  el  enfermo,  conforme  lo  disponga  el  jefe  de  sanidad.  Estas  personas 
quedarán  obligadas  después  de  permitírseles  la  salida  de  la  casa,  á  someterse  á  los  requisitoí5 
de  observación  que  les  disponga  el  jefe  de  sanidad. 

Art.  498.  Las  casas  donde  existan  enfermos  de  cólera,  fiebre  amarilla,  peste  bubónica, 
tifus  exantemático,  vinielas,  escarlatina,  y  difteria  ó  crup  serán  marcadas  por  orden  del  jefe- 
de  sanidad,  con  banderas  y  carteles  visibles  desde  lejos.  Queda  prohibido  impedir  ó 
dificultar  la  colocación  de  estas  señales  y  mutilarlas  ó  rasgarlas  después  de  colocadas. 

Art.  499.  No  se  pemiitirá  en  los  colegios,  hoteles,  casas  de  huéspedes,  casas  de  vecindad, 
fábricas,  talleres,  cuarteles,  cárceles,  casas  de  comercio,  y  en  general  todo  recinto  donde 
vivan  colectivamente  ó  se  reúnan  muchas  personas,  la  asistencia  de  enfeniios  de  cólera,  peste, 
fiebre  amarilla,  tifus,  fiebre  tifoidea,  viruelas,  escarlatina,  sarampión  y  difteria,  á  no  ser 
que  se  cuente  con  un  local  a  propósito  para  hacer  el  aislaimento  á  satisfacción  del  jefe  de 
sanidad. 

Art.  500.  Cada  ajmntamiento  deberá  tener  un  hospital  esp  azareto,  ó  local  debi- 

damente preparado  para  el  aislamiento  de  los  enfermos  contagiosos  que  no  puedan  ser 
aislados  en  su  residencia. 

Art.  501.  Los  médicos,  enfermeros  y  demás  personas  que  presten  asistencia  á  un  enfermo 
de  enfermedad  transmisible,  no  podrán  ponerse  en  contacto  con  otras  personas  sin  desin- 
fectarse previamente,  con  arreglo  á  lo  dispuesto  para  estos  casos  por  la  junta  local  de  sanidad. 

Art.  502.  Cuando  el  caso  lo  requiera  se  colocarán  guardas  sanitarios  en  las  casas  que 
hayan  sido  aisladas,  pai-a  no  permitir  en^ ellas  la  entrada  y  salida  de  personas,  y  los  direc- 
tores, encargados,  jefes  de  familia,  dueños,  etc.  serán  responsables  de  las  infracciones  come- 
tidas por  el  personal  á  sus  órdenes. 

Art.  503.  Los  que  burlen  la  vigilancia  ó  quebranten  el  aislamiento  serán  castigados  con- 
forme á  la  penalidad  establecida  para  estos  casos  cuando  el  hecho  no  constituya  delito,  sin 
perjuicio  de  su  persecución  por  la  policía  y  de  ser  reintegrados  nuevamente  al  aislamiento 
dispuesto. 

Art.  504.  No  se  permitirá  trasladar  ningún  paciente  de  enfennedad  transmisible  del 
lugar  que  ocupa  á  otro  cualquiera,  sin  penniso  escrito  del  jefe  local  de  sanidad. 

Queda  prohibido  el  cambio  de  residencia,  y  el  tránsito  por  las  vías  públicas  de  todo  indi- 
viduo que  se  encuentre  padeciendo  de  enfermedad  transmisible,  igual  prohibición  será  apli- 
cable á  los  enfermeros,  asistentes  y  otras  personas  de  la  casa  que  hubieren  estado  en  contacto 
con  el  enfermo,  mientras  no  obtengan  peiTiiiso  del  jefe  local  de  sanidad,  el  que  sólo  podi'á 
concederlo  después  de  tomar  las  precauciones  necesarias  para  evitra-  la -propagación. 

Art.  505.  La  traslación  de  estos  enfermos  sólo  será  permitido  hacerla  en  ambulancias 
ad  hoc,  que  deberán  ser  desinfectadas  imnediatamente  después  de  usarse.  En  las  pobla- 
ciones donde  no  existan  esta  clase  de  vehículos  ó  no  sea  posible  utilizarlos  oportunamente, 
podrán  hacerse  las  traslaciones  en  carruajes  que  después  de  usarse  serán  desinfectados  en 
seguida  conforme  á  las  instrucciones  del  jefe  local  de  sanidad,  siendo  tesponsables  de  la 
infracción  de  estas  reglas,  sus  dueños  ó  conductores,  según  los  casos. 

Art.  506.  Se  prohibe  el  tránsito  de  pacientes  de  enfermedad  transmisible  en  los  tranvías 
y  ómnibus,  y  sólo  se  permitirá  en  los  ferrocaiTÜes  usando  compartimentos  ó  carros  separa- 


3*38  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

dos,  previo  permiso  del  jefe  local  de  sanidad,  con  sujeción  á  las  instmeciones  que  éste  dicte, 
y  de  acuerdo  con  el  Jefe  Superior  de  Sanidad. 

Los  coches  de  tranvías,  ómnibus,  ferrocarriles,  etc.  en  los  que  á  pesar  de  esta  prohibición 
se  hubiese  conducido  algún  enfermo  de  los  mencionados,  serán  separados  del  tráfico  y  no  se 
pondrán  en  uso  nuevamente  hasta  no  ser  debidamente  desinfectados,  sin  perjuicio  de  la 
penalidad  que  corresponda  á  los  infractores. 

Akt.  507.  Todo  enfermo  de  lepra  confirmada  bacteriológicamente  que  no  se  encuentre 
recluido  en  su  domicilio,  debidamente  aislado  y  asistido,  ó  que  carezca  de  recursos  para  ello, 
será  forzosamente  recluido  en  el  Hospital  "San  Lázaro"  de  la  Habana  ó  en  el  de  Santa  Clara 
conforme  á  las  disposiciones  que  rigen  en  la  materia. 

Art.  50S.  Tan  pronto  como  un  paciente  de  enfermedad  transmisible  sea  dado  de  alta 
por  el  medico,  éste  dará  aviso  al  jefe  local  de  sanidad,  mientras  no  se  obtenga  el  alta  sani- 
taria oficial  correspondiente,  por  la  que  se  acredite  que  no  constituye  peligro  para  la  salud 
pública,  no  se  perijiitirá  su  salida  á  la  calle. 

Art.  509.  Queda  prohibido  el  envío  á  las  escuelas,  colegios,  talleres,  etc.  de  los  niños 
afectados  de  enfermedad  transmisilik-  ó  procedentes  de  casas  donde  exista  algún  enfermo 
de  esta  naturaleza,  ó  ((ue  no  haya  obtenido  el  alta  sanitaria  correspondiente.  Igual  prohi- 
bición deberá  aplicarse  á  los  empleados  ú  obreros  á  las  mismas  y  á  los  talleres  ó  fábricas. 
Los  maestros  y  jefes  de  talleres  darán  parte  inmediatamente  al  jefe  de  sanidad,  de  cual- 
quier niño, «empleado  ú  obrero  que  no  observen  esas  condiciones.  Los  padres,  tutores, 
encargados,  maestros  y  jefes  de  talleres  serán  responsables  respectivamente  de  las  infrac- 
ciones de  esta  disposición. 

Art.  510.  En  las  casas  donde  existan  casos  de  enfermedad  transmisible,  el  jefe  de  familia, 
dueño,  encargado,  etc.,  queda  obligado  á  cumplir  estrictamente  las  órdenes  especiales 
del  jefe  de  sanidad  con  respecto  al  enfermo,  los  familiares,  habitación,  utensilios,  ropas, 
desinfecciones,  etc. 

Art.  511.  La  desinfección  general  ó  parcial  es  obligatoria  para  todas  las  casas  en  que 
haya  habido  enfermo  de  enfermedad  transmisible.  No  podrá  ser  nuevamente  ocupada 
ninguna  casa,  habitación,  etc.  donde  hayan  ocurrido  casos  de  estas  enfermedades,  sin  haber 
sido  previamente  desinfectada  por  la  sanidad. 

Art.  512.  Los  jefes  locales  darán  cuenta  al  Jefe  Superior  de  Sanidad  tan  pronto  como 
tengan  conocimiento  de  existir  en  sus  municipios  respectivos  algún  caso  de  enfermedad 
cuarentenable  aguda  (fiebre  amarilla,  cólera  asiático,  viruela,  peste  bubónica,  tifus  exan- 
temático) procediendo  inmediatamente  á  adoptar  las  medidas  que  estimen  necesarias  para 
evitar  su  propa-jación. 

Art.  513.  Independientemente  de  la  aplicación  de  las  reglas  establecidas  para  las  enfer- 
medades transmisibles  en  los  precedentes  artículos,  la  junta  local  de  sanidad  tan  pronto 
como  tenga  conocimiento  confirmado  de  la  existencia  en  la  localidad  respectiva  de  algún 
caso  de  enfermedad  cuarentenable  (fiebre  amarilla,  peste  bubónica,  viruela,  cólera  asiático, 
tifus  exantemático)  procurará  el  estricto  cumplimiento  de  las  medidas  profilácticas  dis- 
puestas por  la  Junta  Superior  de  Sanidad  según  la  enfermedad  de  que  se  trate,  tales  como 
el  aislamiento  del  caso  ó  casos  y,  á  ser  posible,  á  disponer  la  traslación  de  los  pacientes  á  un 
local  que  reúna  las  condiciones  necesarias  para  su  aislamiento  riguroso  y  asistencia.  Cuando 
sean  varios  los  focos  de  alguna  de  dichas  enfermedades  y  constituyan  una  epidemia,  pro- 
curará el  aislamiento  de  los  enfermos  en  barracas  situadas  en  lugares  apropiados  por  su 
alejamiento  de  la  población;  pedirá  á  las  autoridades  correspondientes  el  cierre  de  las  escue- 
las y  teatros  y,  en  general,  la  celebración  de  espectáculos  púbhcos  ó  reuniones  de  personas, 
e  igualmente  la  salida  de  la  población  infectada  á  todo  enfermo  ó  sospechoso  de  estarlo. 

La  junta  de  sanidad  dará  diariamente  cuenta  de  todas  sus  disposiciones  á  la  Superior  del 
ramo,  así  como  también  de  las  necesidades  que  observe  y  no  sean  prontamente  satisfechas. 

La  declaración  oficial  de  una  epidemia  en  cualquier  lugar  de  la  República,  sólo  correspon- 
derá hacerla  al  Ejecutivo,  oyendo  á  la  Junta  Superior  de  Sanidad. 

Art.  5L4.  Las  juntas  locales  de  sanidad  de  los  demás  ayuntamientos  emplearán  el  mayor 
celo  en  vigilar  las  comunicaciones  con  el  distrito  en  que  se  desarrolla  la  epidemia,  desinfec- 
tando todo  lo  que  de  allí  proceda  y  ejerciendo  severa  inspección  sobre  las  personas  también 
procedentes  del  lugar  infectado,  durante  un  plazo  igual  al  período  de  incubación  de  la 
enfermedad. 

Si  hubiere  necesidad  de  tomar  medidas  más  rigurosas  respecto  á  las  comunicaciones,  se 
someterá  el  punto  á.la  Junta  Superior  de  Sanidad. 

Art.  515.  En  época  de  epidemia,  la  junta  local  de  sanidad  dispondrá  la  desinfección  de 
todos  los  locales  en  que  haya  existido  algún  caso  de  la  enfermedad;  y  en  cualquier  otro 
tiempo,  dispondi'á  la  desinfección  respecto  de  las  enfermedades  transmisibles  más  impor- 
tantes, cuando  no  se  pueda  realizar  en  todas;  siendo  aplicable  esto  último,  en  tiempo  de 
epidemia,  á  las  demás  enfermedades  que  no  constituyan  el  pefigro  inmediato. 

Art.  516.  La  desinfección  ss  hará  exclusivamente  á  los  objetos  situados  en  las  habita- 
ciones de  los  enfermos  y  á  todo  cuanto  hubiere  estado  expuesto  al  contagio,  así  como  los 
Zibros  y  útiles  que  los  niños  han  de  llevar  después  á  la  escuela. 


SEGUNDA    (JONFKKKNOIA    SANI'I'AIJIA    INTERNACIÓN  A  [..  369 

Art.  517.  Queda  prohibido  conducir  á  los  trenes  de  lavado  ropas  do  vestir  ó  de  casa  de  los 
■enfermos  de  enfermedad  transmisible  qun  no  hayan  sido  desinfectadas  y  obtenido  licencia 
del  jefe  de  sanidad  para  su  extraeciítri  de  la  (;asa.  Ifj^ial  prohibición  se  establece  para  los 
muebles,  útil  s,  obj'tos,  (itc.,  de;  una  casa  infcct.ada. 

.  Art.  .518.  S-rá  obli<íatorio  para  el  propietario  df-  la  cosa  cuando  haya  ocurrido  alf^ún  caso 
de  enfermedad  transmisible,  ejecutar  (^n  el  pla/.o  que  se-  s  'ñalt!  por  la  junta  de  sanidad  laa 
■obras  ó  medidas  que  fueron  necesarias,  íi  juicio  de,  la  misma,  para  que  desaparezcan  las 
causas  de  insalubridad  que  pres mte  la  finca. 

Art.  519.  La  junta  de  sanidad  podt'á  disponei'  el  drssalojarniento  inmediato  de  una  casa 
que  sea  un  foco  de  epidemia  ó  de  ainenaza  o;rave  á  la  salud  pública,  la  qu".  no  n'ríi  habitada 
de  nuevo  hasta  que  no  haya  desaparecido  de  ella  todo  pr-lij^ro  de  infecciíjn. 

Art.  520.  Queda  prohibido  el  propalar,  sin  fundamento  ai<i;uno  de  veracidad,  noticias  ó 
l^lmores'con  respecto  á  la  existencia  de  enfermedad  epidíímica  ''n  una  ó  varias  localidades 
do  la  República. 

Art.  521.  Las  medidas  que  se  dicten  fundadas  en  los  preceptos  del  prcssnte  capítulo 
serán  desde  luej2;o  ejecutivas:  y  si  contra  las  mismas  se  inteipusies^n  por  los  interesados 
recursos  de  alzada,  se  cursarán  éstos  sin  suspender  la  ejecución  de  aquéllas. 

Capítulo  XXII. 

INHUMACIONES,  CEMENTERIOS,  AGENCIAS   FÚNEBRES   Y    EXHUMACIONES. 

Art.  522.  Las  inhumaciones  se  harán  sólo  previa  orden  escrita  del  juzgado  respectivo,  el 
cual  exigirá  la  presentación  de  la  certificación  facultativa  de  defunción. 

Art.  523.  Las  certificaciones  de  defunción  s:rán  extendidas  por  duplicado  y  ajustadas  á 
las  instruccionrs  contenidas  en  las  planillas  impresas,  conforme  á  un  modelo  uniforme, 
distribuidas  gratuitamente  por  la  Junta  Superior  de  Sanidad  entre  todos  los  médicos  en 
ejercicio.  Es  obligatorio  el  uso  de  la  Nomenclatura  internacional  de  Bertillon.  El  juzgado 
municipal  respectivo  conservará  una  de  las  certificaciones  y  remitirá  la  otra  al  Jefe  Superior 
de  Sanidad,  en  un  término  que  no  exceda  de  cinco  días. 

Art.  524.  Tan  pronto  como  un  cadáver  presente  signos  de  descomposición,  deberá  ser 
encerrado  en  su  ataúd. 

Art.  525.  Los  cadáveres  de  los  que  fallecieren  á  consecuencia  de  enfermedades  trans- 
misibles, se  mantendrán  envueltos  en  sábanas  humedicedas  en  los  líquidos  antisépticos 
indicados  por  la  junta  de  sanidad  y  encerrados  en  sus  ataúdes  en  el  más  breve  plazo  posible. 

Art.  526.  Queda  prohibido  la  reunión  de  personas  en  cualquier  casa  donde  hubiere 
algún  fallecido  á  consecuencia  de  enfermedad  transmisible,  y  una  vez  extraído  el  cadáver  de 
la  casa,  hasta  que  no  se  verifique  la  desinfección. 

Art.  527.  Los  cadáveres  sarán  conducidos  al  cementerio  ó  al  depósito  precisamente  en 
a,taúdcs  bien  ajustados  en  sus  uniones,  sin  grietas  ni  intersticios,  de  modo  qu3  no  permitan  el 
escape  de  gases  ó  líquidos,  y  transportados  por  personas  ó  en  carros  especiales,  y  no  S6 
permitirá  usar  para  el  objeto  ninguna  otra  clase  de  vehículos,  á  menos  que  lo  exija  la  necesi- 
dad y  lo  autorice  el  jefe  local  de  sanidad. 

Para  los  cadáveres  que  se  sepulten  en  la  tierra,  en  campo  común,  los  ataúdes  serán  de 
madera  ligera  y  paredes  delgadas  á  fin  de  facilitar  la  destiiicción  orgánica. 

Art.  528.  Los  cadáveres  de  fallecidos  de  enfermedades  transmisibks  no  serán  conducidos 
á  mano  ó  en  hombros  al  cemeterio,  á  menos  que  por  motivos  ineludibles  en  localidades  muy 
apartadas  no  s^a  posible  evitarlo.  No  s^rá  permitido  tampoco  llevarlos  á  las  iglesias  ú  otro 
lugar  púplico,  ni  que  figuren  niños  en  el  acompañamiento.  Si  el  caso  fuere  de  enfermedad 
cuarentenable  no  se  consentirán  otros  acompañantes  que  las  personas  indispensables  para  la 
conducción. 

Art.  529.  Queda  prohibido  transportar  cadáveres  en  ataúdes  abiertos,  aimque  sean 
conducidos  en  carros  con  cristales. 

Art.  530.  La  inhumación  se  verificará  entre  las  veinticuatro  y  treinta  horas  después  de 
ocurrido  el  fallecimiento  y  cuando  el  cadáver  presente  señales  de  putrefacción,  á  menos  que 
sea  éste  propiamente  embalsamado  y  se  obtenga  permiso  por  escrito  del  jefe  local  de  sanidad 
para  dilatar  el  sepelio  ó  la  translación  al  depósito  del  cementerio  sólo  por  varias  horas  más  y 
consignándose  este  término  en  el  permiso. 

Quedan  exceptuados  de  esta  disposición,  los  cadáveres  detenidos  en  el  necrocomio  ú  otro 
lugar  por  mandamiento  judicial,  observándose  siempre  las  debidas  precauciones  sanitarias 
que  no  entorpezcan  la  acción  .del  juzgado. 

Art.  531.  Los  cadáveres  de  los  fallecidos  por  viruelas,  difteria  ó  crup,  escarlatina,  tifus 
exantemático,  peste  bubónica,  cólera  asiático  y  lepra,  serán  conducidos  al  cemeterio  antes 
de  las  doce  horas  de  haber  ocurrido  el  fallecimien  to,  á  menos  que  el  cadáver  sea  propiamente 
embalsamado  y  se  obtenga  permiso  por  escrito  del  jefe  local  de  sanidad  para  dilatar  el  sepelio 

1112a— 06 24 


370        segujs'da  conferencia  sanitaria  internacional. 

ó  la  traslación  al  depósito  del  cementerio  por  varias  horas  más,  consignándoso.  este  término 
en  el  permiso. 

^\i{T.  532.  Queda  prohibido  sepultar  cadáver  alguno  dentro  de  las  poblaciones  y  fuera  de 
los  ceineterios  autorizados  por  la  ley.  D  j  la  infracción  de  esta  regla  serán  responsables  no 
sólo  todos  los  que  intervengan  en  el  enterramiento,  sino  los  que  lo  presencien  sin  dar  parte 
en  st^guida  á  las  autoridades. 

Akt.  533.  Los  cadáveres  de  los  que  fallezcan  eu  los  hospitales,  quintas  de  salud,  lazaretos, 
etc.  de  tifus  exantemático,  viruela,  escarlatina,  difteria,  cólera  asiático,  peste  y  lepra, 
serán  directamente  trasladados  al  cementerio. 

Art.  53-t.  Queda  prohibido  utilizar  un  mismo  ataúd  para  más  de  un  cadáver.  Se 
exceptúan  los  ataúdes  de  los  hospitales,  y  anfiteatros  anatómicos,  siempre  que  sean  cajas 
metálicas:  desinfectadas  esmeradamente  cada  vez  (jue  se  usen. 

Art.  535.  No  será  permitido  el  uso  de  ningún  refrigerador  de  cadáveres  cuyo  modelo  no 
sea  aprobado  por  la  junta  dfí  sanidad. 

Art.  536.  Queda  prohibido  el  uso  de  toda  clase  de  cortinas,  colgaduras  y  alfombras  en  las 
habitaciones  particuiai'f  s  ó  en  las  cámaras  en  que  se  expongan  los  cadáveres. 

Art.  537.  La  construcción  de  nuevos  cementerios  se  ajustará  á  las  siguientes  reglas: 

1°.  No  se  construirá  ningún  nuevo  cementerio  á  distancia  menor  de  1,000  metros  del 
perímetro  de  toda  población  de  importancia;  de  500  metros,  del  de  los  pueblos  menores; 
y  de  200  de  los  caseríos  aislados,  carreteras  ó  paseos,  debiendo  tenerse  además  en  cuenta 
el  ensanche  probable  de  la  población,  pueblo  ó  caserío  hacia  la  parte  en  que  esté  situado 
el  cementerio. 

2°.  No  se  permitirá  la  construcción  de  ningún  cementerio  á  distancia  menor  de  200  metros 
de  manantiales,  pozos,  aljibes,  fuentes  y  cañerías  que  contengan  ó  conduzcan  aguas  pota- 
bles. 

3°.  Para  establecer  un  nuevo  cementerio  deberá  escogerse  un  terreno  elevado,  de  ligero 
declive  y  situado  á  sotavento  de  la  población,  que  permita  cavar  fácilmente  fosas  de  2 
metros  de  profundidad,  y  que  sea  permeable  al  aire  y  al  agua,  para  los  fines  de  la  destrucción 
orgánica. 

^°.  La  extensión  superficial  del  terreno  ha  de  estar  en  proporción  con  el  número  de  habi- 
tantes de  la  localidad,  su  probable  crecimiento,  su  mortalidad  y  el  término  de  renovación 
de  las  sepulturas  dentro  de  cinco  años,  por  lo  menos,  calculando  3  metros  cuadrados  por 
cadáver,  y  teniéndose  en  cuenta,  asimismo,  el  espacio  necesario  para  vías,  construcciones, 
depósitos,  monumentos,  parques,  arbolado,  etc. 

5°.  Todo  el  terreno  del  cementerio  ha  de  estar  perfectamente  protegido  por  un  cerco  de 
reja  metálica,  de  mampostería  y  reja,  ó  de  mampostería  sola,  de  2  metros  de  altura  á  lo 
más,  á  fin  de  no  impedir  la  libre  circulación  del  ahe,  ni  la  acción  del  sol  en  parte  alguna. 

6°  No  se  permitirá  la  construcción  de  nichos:  el  suelo  de  las  bóvedas  ó  ¡lantanos  será  de 
tierra  y  enteramente  permeable. 

7°.  iÉn  todo  cementerio  ha  de  existh-  una  sala  especial  para  el  depósito  de  cadáveres,  y 
otra  para  la  práctica  de  autopsias,  propiemente  provista  de  agua,  mesas,  lavabos,  etc. 

8°.  Los  demás  requisitos  higiénicos  á  que  debe  ajustarse  el  régimen  interior  de  los  cemen- 
terios se  especificarán  en  sus  respectivos  reglamentos. 

La  ampliación  ó  reforma  de  los  cementerios  existentes  actualmente  se  ajustará,  en  lo 
que  les  sea  aplicable,  á  las  prescripciones  anteriores. 

Para  las  condiciones  de  los  cementerios  rurales,  cuyo  establecimiento  se  conceda  en  las 
fincas  ó  fábricas  muy  distantes  de  cementerio  público,  se  considtará  á  la  junta  local  de 
sanidad,  y  ésta  á  la  superior. 

Art.  538.  En  los  reglamentos  respectivos  de  los  cementerios  se  consignarán,  además,  las 
condiciones  siguientes: 

1°.  Dimensiones  y  separación  mínima  de  las  fosas,  que  serán  como  sigue :  Proftmdidad 
para  todas  las  f osas^  2  metros ;  longitud,  para  cadáveres  de  adultos,  2  metros ;  anchura,  85 
centímetros;  separación  en  todos  sentidos,  40  centímetros.  Para  los  cadáveres  de  niños, 
las  dimensiones  de  longitud  y  anchm-a  podrán  reducirse  proporcionalmente  á  la  edad  del 
sujeto. 

2°.  Espesor  de  1.50  metros,  por  lo  menos,  de  la  capa  de  tierra  bien  comprimida  que  cubre 
al  cadáver,  habiéndosele  antes  cubierto  al  colocarlo  en  la  fosa  de  otra  capa  de  cal  de  2  á  3 
centímetros. 

3°.  Prohibición  de  los  enterramientos  en  zanjas,  destinándose  al  efecto  ima  fosa  para 
cada  cadáver. 

4°.  Condición  previa  de  consultar  á  la  junta  local  de  sanidad  para  la  apertura  y  remoción 
de  sepulturas,  nichos  y  panteones,  el  acumulo  de  restos  en  osario,  mondas  ó  limpias  parciales 
ó  totales  de  cementerios  clausurados  y  traslación  de  los  restos  existentes  en  los  mismos  á 
otros  cementerios. 

5°.  Aprobación  del  reglamento  por  la  Junta  Superior  de  Sanidad,  previo  informe  de  la 
junta  local  del  municipio  respectivo. 


SEGUNDA    CONFERENCIA    .SANITAKIA    INTERNACIONAL.  371 

Art.  539.  Todo  cementerio  tendrá  en  sitio  apartado  un  local  apropósito  para  quemar 
los  féretros,  mortajas,  ropas  y  otros  objetos  que  se  recojan  de  las  exhumaciones. 

Art.  540.  No  se  pormitii'á  vender  ni  conservar  en  lugar  alguno  de  los  cementerios,  bebidas, 
dulces,  confituras  ú  otros  comestibles. 

Art.  541.  Los  empresarios  do  pompas  i'iincl)re8  desinfectarán  en  el  mismo  cementerio, 
cada  voz  que  sean  usados,  por  el  pi'0(;ed¡miento  que  les  señalo  la  junta  de  sanidad,  los 
carros  mortuorios  que  hayan  conducido  cadáveres  de  enfermos  de  tifus  exantemático,  fiebre 
tifoidea,  viruelas,  sarampión,  escarlatina,  difteria  y  crup,  cólera  asiático,  peste,  lepra, 
erisipela,  fiebi'c  puerperal,  tuberculosis  y  muermo. 

AuT.  542.  Igualmente  serán  desinfectados  por  sus  dueños,  en  el  cementerio,  los  carruajes 
particulares  que  por  algún  motivo  inexcusable  se  utilicen  para  conducir  cadáveres  de 
fallecid9s  por  cualquier  a  causa. 

Art.  543.  Todo  dueño  de  agencia  funeraria,  enterrador  ó  encargado  de  pompas  fúnebres, 
está  obligado  á  consignar  su  firma,  nombres  y  residencia  suya  y  de  su  establecimiento,  en 
un  registio  que  llevará  la  junta  de  sanidad. 

Art.  544.  Todo  el  que  en  lo  sucesivo  quiera  establecer  una  agencia  funeraria,  ó  ejercer 
las  funcinones  de  enterrador,  tendrá  que  proveerse  de  una  licencia,  la  ¡unta  de  sanidad 
expedirá  diclia  licencia  si  el  candidato  demuestra  competencia  práctica  de  la  desinfección 
en  general  y  de  la  manipulación  de  cadáveres  de  enfermedades  transmisibles  en  particular. 

Art.  545.  Todo  dueño  de  agencia  funeraria,  enterrador  ó  encargado  de  funerales,  enviará 
cada  lunes  á  la  oficina  de  sanidad  un  estado  semanal  detallado  de  los  entierros  que  haya 
efectuado. 

Art.  546.  No  será  permitido  verificar  ninguna  exhumación  hasta  dos  años  después  del 
enterramiento,  á  menos  que  sea  dispuesta  por  orden  judicial  ó  hava  sido  embalsamado  al 
cadáver. 

Art.  547.  No  se  permitirá  ninguna  exhumación  sin  informe  de  la  junta  local  de  sanidad, 
en  que  se  consigne  que  no  existe  peligro  para  la  salud  pública. 

Ajbt.  548.  Toda  exhumación  será  presenciada  por  un  médico  delegado  de  la  junta  local 
de  sanidad,  el  que  tomará  las  mayores  precauciones  para  evitar  que  la  operación  residte 
perjudicial  á  la  salud,  disponiendo  los  elementos  necesarios  para  desinfectar  la  fosa,  el 
ataúd  j  el  cadáver  ó  los  restos. 

Art.  549.  No  será  permitida  la  exhumación  de  cadáveres  de  fallecidos  de  peste  bubónica, 
cólera  asiático,  tifus  exantemático,  difteria,  viruelas,  escarlatina,  lepra  y  muermo  sin  que 
hayan  transcmTido  cinco  años,  por  lo  menos,  de  la  inhumación  y  obtenido  autorización  pre- 
via de  la  junta  local  de  sanidad. 

Capítulo  XXIII. 
autopsias,  embalsamamientos,  etc. 

Art.  550.  No  se  permite  ejecutar  fuera  de  los  hospitales,  necrocomios,  cementerios, 
escuelas  de  medicinas  y  cinigía,  autopsia  alguna  ó  apertura  de  cadáveres,  hasta  después  de 
haber  transcurrido  doce  horas  desde  que  ocurrió  la  defunción.  Tampoco,  es  lícito,  hasta 
cumplirse  el  mismo  plazo,  hacer  operación  alguna  de  embalsamamiento,  momificación, 
petrificación  ú  otra  cualquiera  que  tenga  por  objeto  dar  una  larga  conservación  á  los  cadá- 
veres, si  para  ello  se  requiere  atacar  la  integridad  de  los  tejidos  orgánicos  ó  de  los  humores. 
Queda  prohibido  asimismo,  durante  el  propio  tiempo,  y  sin  la  previa  autorización  del  jefe 
de  sanidad,  modelar  el  rostro,  cuello  ó  torso  de  los  cadáveres  por  medio  de  yeso  ú  otra 
materia,  lo  cual  no  se  permitirá  nunca  en  los  fallecidos  de  viruelas,  sarampión,  escarlatina, 
peste  y  lepra. 

Art.  551.  Para  proceder  á  cualquiera  de  estas  operaciones  se  requiere:  (f')  Que  no  haya 
oposición  por  parte  de  la  familia  del  difunto;  (^)  el  certificado  de  defunción  ajustado  al 
modelo  corriente;  («)  la  asistencia  al  acto, del  jefe  de  sanidad  ó  de  un  médico  delegado  del 
mismo,  quien  comprobará  la  defunción  y  autorizará  el  embalsamamiento;  (f')  para  las 
autopsias  no  se  requiere  la  presencia  de  este  funcionario. 

Art.  552.  La  junta  de  sanidad  tiene  el  derecho  de  disponer  la  práctica  de  alguna  de  estas 
operaciones  cuando  lo  exija  el  interés  de  la  salud  pública. 

Art.  553.  Tanto  las  auptosias  como  todas  las  operaciones  dirigidas  á  conservar  los 
cadáveres,  se  ejecutarán  exclusivamente  por  profesores  de  medicina  y  cirugía. 

Art.  554.  Se  levantará  un  acta  subscripta  por  el  jefe  de  sanidad  ó  delegado  médico  de 
éste,  ó  por  el  profesor  ó  profesores  que  hayan  ejecutado  el  embalsamamiento  ú  operación 
destinada  á  conservar  al  cadáver  y  por  dos  testigos,  en  la  cual  habrá  de  consignarse  sobre 
lo  mencionado  en  el  certificado  de  defunción,  la  hora  en  que  se  ha  operado,  el  procedimiento 
seguido  para  el  embalsamamiento,  momificación,  etc.,  y  la  composición  de  los  líquidos 
inyectados  en  el  cadáver  ó  empleados  de  cualquier  otro  modo  para  conservarlo. 

Art.  555.  El  certificado  de  defunción  y  el  acta  á  que  se  refiere  el  artícido  anterior  serán 
remitidos  por  el  jefe  local  de  sanidad  á  la  Junta  Superior  de  Sanidad,  donde  se  archivará. 


372  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Art.  556.  El  tiempo  de  depósito  6  permanencia  de  los  cadáveres  embalsamados,  ya  sean 
en  las  casas  mortuorias,  ya  en  las  iglesias,  no  podrá  e.xceder  de  veinticuatro  horas  des- 
pués de  lembalsamamiento  sin  permiso  especial  del  jefe  de  sanidad,  durante  las  cuales,  y 
por  si  el  es'ado  del  cadáver  exigiera  acortar  el  plazo,  quedará  bajo  la  vigilancia  del  médico 
delegado  que  asistió  á  la  operación. 

Art.  557.  Las  disposiciones  anteriores  podrán  suspenderse  ó  modificarse  en  todo  ó  en 
parte  por  las  autoridades  sanitarias  en  los  casos  de  epidemia. 

Capítulo  XXIV. 

TRANSPORTE   DE   CAD.\ VERES.  , 

Art.  558.  Queda  prohibido  el  transporte  de  cadáveres  de  fallecidos  de  viruela  y  de  peste 
bubónica,  de  uno  á  otro  pueblo,  municipio  ó  provincia  de  la  República. 

Art.  5.59.  Sólo  se  permitirá  el  transporte  de  cadáveres  de  fallecidos  de  fiebre  tifoidea, 
tuberculosis,  cólera  asiático,  fiebre  amarilla,  tifus  exantemático,  difteria  y  crup,  escarla- 
tina, sai'ainpión,  erisipela,  fiebre  puerperal,  muermo,  ántrax  y  lepra,  cuando  hayan  sido 
acondicionados  para  el  embarque  y  debidamente  desinfectados  de  la  manera  siguiente:  (") 
Invección  forzada  arterial  y  cavitaria  con  un  líquido  antiséptico  de  reconocida  eficacia;  C*) 
desinfección  y  taponamiento  de  todos  los  orificios  con  algodón  absorbente;  y  (f)  lavado  de 
todo  el  exterior  del  cuerpo  con  el  líquido  antiséptico.  Estas  operaciones  serán  practicadas 
por  un  médico  y  con  autorización  del  jefe  local  de  sanidad. 

Art.  560.  Desinfectado  el  cadáver  en  la  forma  descripta,  se  le  envolverá  primero  con  una 
capa  de  algodón  de  3  centímetros,  por  lo  m.enos,  de  espesor,  y  después  con  una  sábana 
perfectamente  ajustada,  y  se  le  colocará  en  ataúd  de  zinc,  estaño,  cobre  ó  hierro,  ó  revestido 
interiormente  de  plomo,  bien  soldadas  las  uniones,  cerrado  herméticamente  y  colocado  todo 
á  su  vez  en  una  caja  de  madera  sólida  y  bien  tapada. 

Art.  561.  Los  cadáveres  de  fallecidos  por  otras  enfermedades  distintas  de  las  men- 
cionadas en  los  artículos  anteriores  podrán  ser  transportados  á  localidades  donde  puedan 
llegar  dentro  de  treinta  horas  después  de  la  muerte,  colocados  en  ataúdes  metálicos  ó  reves- 
tidos interiormente  de  metal,  herméticamente  cerrados,  y  estos  á  su  vez  envasados  en  otras 
cajas  sólidas  de  madera  bien  tapadas.  Si  el  lugar  de  su  destino  estuviere  á  mayor  distancia, 
se  exigirán  los  requisitos  señalados  en  las  reglas  anteriores. 

Art.  562.  No  se  permitirá  que  acompañen  en  el  transporte  de  los  cadáveres  de  fallecidos 
de  las  enfermedades  citadas  en  el  artículo  559  personas  ú  objetos  que  hayan  estado  expues- 
tos al  contagio,  sino  mediante  certificado  del  jefe  de  sanidad  que  acredite  haber  sido  debida- 
mente desinfectados. 

Los  jefes  de  estación  de  las  empresas  ferrocanileras,  líneas  de  vapores,  etc.,  examinarán 
cuidadosamente  el  permiso  de  traslación  del  cadáver  en  que  conste  el  nombre  del  encargado 
de  diclia  tra.slación  }•  demás  acompañanles  autorizados  por  la  sanidad,  y  cuidarán  de  la 
observancia  de  esta  regla  al  liacer  el  despacho  del  cadáver  y  de  las  boletas  para  las  personas 
y  objetos  que  vayan  con  el  mismo. 

Art.  563.  El  jefe  local  de  sanidad  dará  aviso  oportunamente  por  telégiafo  al  jefe  de  sani- 
dad del  lugar  á  que  va  destinado  el  cadáver,  expresando  la  enfermedad,  día,  hora,  tren  6 
vapor  en  que  sale  y  estación  ó  muelle  á  que  llegará. 

Art.  .564.  Todo  cadáver  que  se  transporte  irá  á  cai'go  de  una  persona  provista  de  un  per- 
miso del  jefe  local  de  sanidad  y  de  un  certificado  de  éste  en  que  se  consignen  los  datos  de 
la  certificación  facultativa  de  defunción  expedida  por  el  médico  de  asistencia,  á  saber: 
Nombre  de]  fallecido,  fecha  y  hora  de  la  muerte,  edad,  lugar  donde  falleció,  causa  de  la 
muerte  y  demás  detalles  exigidos  en  el  modelo  de  certificación  de  la  Junta  Superior  de  Sani- 
dad. En  el  peimiso  concedido  por  el  jefe  local  de  sanidad  se  expresará  también  si  la  enfer- 
medad es  ó  no  transmisible,  la  localidad  á  donde  se  destina  el  cadáver  y  los  nombres  de  los 
acompañantes  autorizados  para  el  acompañamiento  si  la  causa  de  la  muerte  ha  sido  alguna 
de  las  referidas  en  el  artículo. 

Art.  565.  También  se  exigirá  el  certificado  del  médico  embalsamador  acerca  de  la  forma 
en  que  ha  sido  acondicionado  el  cadáver  para  su  transporte.  Un  duplicado  6  copia  de  este 
certificado  se  fijará  en  la  parte  exterior  de  la  caja. 

Art.  .566.  El  permiso  de  remisión  se  expedirá  por  duplicado,  firmados  ambos  por  el  mé- 
dico de  asistencia,  el  jefe  local  de  sanidad  y  el  médico  embalsamador,  entregándose  uno  al 
encargado  del  cadáver  y  el  otro  se  remitirá  al  Jefe  Superior  de  Sanidad. 

Art.  567.  La  caja  exterior  tendrá  cuatro  agarraderas,  por  lo  menos. 

Art.  568.  Para  el  transporte  de  cadáveres  por  expreso,  se  exigirán  los  mismos  requisitos 
expresados  en  los  artículos  559,  560,  561,  563,  564,  566,  y  567  y  el  expreso  remitirá  á  su 
agente  en  el  lugar  á  que  va  destinado  el  cadáver  los  documentos  de  referencia,  y  el  dupli- 
cado de  los  mismos  á  la  Junta  Superior  de  Sanidad. 

Art.  569.  Todo  cadáver  exhumado,  cualquiera  que  haya  sido  la  enfennedad  causante 
de  la  muerte,  se  considerará  como  infectante  y  peligroso  á  la  salud  pública.     Para  conceder 


SEGUNDA   CONFERENCIA    SANITARIA    INTERNACIONAL.  37.S 

su  traslación  se  rcfiuorirá:  Autorización  (1(!  la  Junta  Superior  do  Sanidad  (\  informes  f a vora- 
blofl  do  la  junta  local  de  sanidad  d*;!  propio  niuiii(;ipio  y  de  aquél  á  donde  será  trasladado 
el  cadáver. 

Kistos  cadáveres,  sus  restos  6  las  cajas  (|uo  los  contonf^an,  sei'án  envueltos  con  una  frazaíla 
de  lana  saturada  en  una  solución  d(!  bicioiuro  do  liidrai'girio  al  1  poi-  1  ,(XX)  y  encerrado  todo 
en  una  caja  metálica  herinóticainojito  soldada. 

Art.  570.  Los  cadáveres  embalsamados  y  acondicionados  como  se  lia  indicado  ya,  y 
depositados  provisionalmente  en  bóvedas,  \w  so  considerarán  como  exhumados  si  el  trans- 
porte so  efectúa  dentro  del  término  de  treinta  días  después  de  la  muerte,  y  no  será  necesario 
obtener  permiso  previo  dol  jefe  do  sanidad  del  lugar  á  que  se  remiten. 

Pasados  treinta  días  de  ocurrida  la  muerte,  el  féretro  será  colocado  en  otra  caja  soldada 
herméticamente. 

Capítulo  XXV. 

BARBERÍAS   Y   PELi/qUERÍAS. 

Art.  571.  Los  instrumentos  metálicos  de  barbería  y  peluquería  que  se  utilicen  en  el  ser- 
vicio público,  como  navajas,  peines,  tijeras  y  maquinillas,  así  como  las  brochas,  con  excep- 
ción de  los  de  uso  particular,  después  de  haberse  usado  en  cada  cliente,  .se  sumergirán  por 
espacio  de  cinco  minutos  en  un  recipiente  metálico  que  contenga  agua  caliente  renovada 
en  cada  caso,  á  la  que  se  agregará  antes  un  trozo  de  jabón  ó  bien  carbonato  de  soda  en  la 
proporción  de  50  gramos  por  litro  de  agua.  Esta  solución  no  perjudica  al  temple  ni  al  filo 
de  los  instrmnentos.  Dichos  útiles  podrían  también  ser  desinfectados  sometiéndolos  á  la 
acción  de  los  vapores  de  formol  durante  quince  minutos  en  un  aparato  adecuado. 

Art.  572.  Sólo  se  emplearán  peines  metálicos  y  navajas  de  mango  de  metal,  á  fin  de 
que  puedan  ser  debidamente  desinfectados. 

Art.  573.  Se  prohibe  pasar  por  los  asentadores  las  navajas  que  no  hayan  sido  previa- 
mente desinfectadas,  así  como  el  limpiar  éstas  cuando  se  preste  servicio  al  cliente,  con  otro 
papel  que  no  sea  uno  especial  destinado  al  objeto,  ó  en  un  utensilio  de  goma  que  se  desin- 
fectará como  los  demás  instrumentos. 

Art.  574.  Se  prohibe  el  uso  de  esponjas,  los  cepillos  de  cara,  y  las  motas,  pudiéndose 
substituirlos  coa  un  poco  de  algodón  renovado  para  cada  servicio  ó  con  un  insuílador  las 
motas.  El  almnbre  ú  otro  astringente  que  se  emplee  para  la  cara,  sólo  se  permitirá  en 
forma  pulverulenta  ó  en  disolución. 

Art.  575.  En  las  partes  del  sillón  en  que  se  apoya  la  cabeza,  se  colocará  una  toalla  ó  un 
papel  apropiado  que  se  cambiará  en  cada  servicio. 

Art.  576.  Los  laarberos  y  peluqueros  se  lavarán  las  manos  con  cepillo  y  jabón  inmedia- 
tamente antes  de  atender  á  cada  cliente;  y  los  peinadores,  toallas,  paños,  etc.,  se  emple- 
arán limpios  y  renovados  para  cada  persona. 

Art.  577.  Queda  prohibido  el  desempeño  de  su  oficio  á  los  barberos  y  peluqueros  afecta- 
dos de  alguna  enfermedad  transmisible,  así  como  prestar  servicio  en  el  establecimiento  á 
clientes  enfermos  de  las  mismas  que  no  lleven  sus  propios  utensihos,  pudiendo  en  algunos 
casos  negarse  á  admitirlos,  sobre  todo  á  los  que  presenten  manifestaciones  cutáneas. 

Art.  578.  Se  lavará  diariamente  el  piso  del  establecimiento,  se  barrerá  el  pelo  esparcido 
por  el  suelo  con  un  lienzo  húmedo,  y  se  mantendrán  el  salón,  los  lavatorios,  muebles,  escu- 
pideras, etc.,  en  completo  estado  de  limpieza. 

Art.  579.  Es  obligatorio  para  las  barberías  y  peluquerías  tener  colocado  en  sitio  visible 
del  establecimiento  un  ejemplar  de  los  artículos  de  estas  ordenanzas  en  lo  que  les  atañe  y 
que  proporcionará  la  junta  local  de  sanidad. 

CAPÍruLO  XXVI.  ^ 

í 

BAÑOS  PÚBLICOS. 

Art.  580.  Para  abrir  un  establecimiento  de  baños  al  servicio  público,  sea  de  agua  dulce 
d  de  mar,  se  requerirá  informe  previo  favorable  de  la  jimta  local  de  sanidad,  con  vista  del 
plano  y  memoria  descriptiva  del  proyecto,  aplicación  que  ha  de  dai-se  al  establecimiento 
duración  de  la  temporada,  procedencia  del  agua  que  se  utilice,  desagües  y  cuantos  más 
datos  sean  necesarios  al  efecto. 

Los  baños  minero-medicinales  se  regirán  por  un  reglamanto  especial. 

Art.  581.  Todo  establecimiento  de  baños  deberá  estar  provisto  de  inodoros  y  urinarios 
con  relación  á  su  importancia. 

Los  servicios  sanitarios  de  los  establecimientos  destinados  á  baños  de  mar  estarán 
acometidos  á  fosas  cementadas  é  impermeables,  á  no  ser  que  la  alcantarUla  á  que  pudieran 
acometerles,  desaguase  en  el  mar  á  más  de  200  metros  del  sitio  destinado,  á  los  baños. 

Art.  582.  Las  bañeras  serán  de  mármol,  ó  porcelana,  ó  hierro  esmaltado,  y  acometidas 
directamente  á  la  tubería  ó  atarjea  de  desagüe. 


374  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

Art.  583.  Los  pisos  se  mantendrán  en  el  mejor  estado  y  se  secarán  antes  de  dar  entrada 
en  el  cuarto  del  baño  á  otra  persona. 

Art.  584.  Los  cuartos  de  baños  estarán  provistos  de  ventanas  altas  que  faciliten  directa- 
mente la  luz  y  la  ventilación  necesarias,  así  como  de  timbres  de  llamada  y  de  puertas  que 
puedan  ser  abiertas  fácilmente  por  los  bañeros  en  casos  de  accidentes. 

Art.  585.  En  las  piscinas  ó  baños  de  natación,  se  colocarán  cuerdas,  cables,  etc.,  para  la 
debida  segui'idad  de  los  bañistas,  estarán  dotadas  del  agua  necesaria  renovada  constante- 
mente, y  no  se  permitirá  bañarse  en  ellos  á  niños  menores  de  10  años  que  no  estén  acompa- 
ñados de  persona  que  cuide  de  ellos. 

El  agua  ya  servida  de  las  piscinas,  pocetas,  bañeras,  etc..  no  podrá  ser  utilizada  para 
baños  de  ninguna  otra  persona. 

Art.  586.  Las  ropas,  toallas,  paños,  etc.,  que  se  empleen  para  el  servicio  de  los  bañistas 
estarán  bien  limpias,  y  renovadas  para  cada  persona,  y  serán  desinfectadas  cuando  lo 
disponga  el  jefe  local  de  sanidad. 

Art.  587.  Los  establecimientos  de  baños  de  uso  terapéutico  tendrán  á  su  frente  un 
médico  director. 

Art.  588.  No  serán  admitidos  en  los  establecimientos  de  baños  personas  atacadas  de 
enfermedad  transmisible,  y  en  caso  de  infracción  de  este  artículo  se  practicará  la  desinfección 
de  la  casa  sin  perjuicio  de  la  penalidad  consiguiente. 

Art.  589.  En  los  establecimientos  de  baños,  no  será  permitida  la  residencia  de  familias 
ni  el  inquilinato  de  habitaciones,  sin  autorización  especial  para  ello  y  por  escrito  de  la  junta 
local  de  sanidad. 

Art.  590.  Un  ejemplar  de  este  capítulo,  impreso  por  la  junta  local  de  sanidad,  se  colocará 
en  parte  visible  del  establecimiento  para  conocimiento  general. 

Capítulo  XXVII. 

ASUNTOS   VARIOS. 

Art.  591.  Los  dueños  de  terrenos  y  solares  yermos  que  estén  urbanizados  tendrán  la 
obligación  de  conservarlos  limpios  y  libres  de  excavaciones,  evitando  que  se  depositen  en 
ellos  basuras  ni  ningún  otro  material  nocivo  á  la  salud  ó  que  constituya  peligro  para  los 
transeúntes. 

Se  prohibe  depositar  ó  esparcir  en  los  patios  de  las  casas  y  solares  yermos  de  las  pobla- 
ciones basuras  ó  materias  orgánicas  para  el  abono  de  las  siembras*que  se  afectúen  en  ellos. 

La  roturación  de  tierras  y  las  siembras  en  los  patios  de  las  casas  y  solares  yermos  de  los 
poblados  podrán  permitirse,  á  los  efectos  de  la  sanidad,  siempre  que  como  abono  no  se 
empleen  basuras  é  inmundicias. 

Art.  592.  Se  prohibe  escupir  6  expectorar  en  las  aceras,  ó  en  los  pisos  de  los  parques, 
plazas,  edificios  públicos,  ferrocarriles,  tranvías,  ómnibus,  vapores,  carruajes  de  alquiler,  etc. 

Se  prohibe  igualmente  escupir  ó  expectorar  en  el  suelo  ó  en  las  paredes  de  cualquier 
lugar  donde  sea  obligatorio  tener  escupideras. 

Art.  593.  Todos  los  establecimientos  mercantiles,  fábricas,  hospitales,  asilos,  iglesias, 
escuelas,  prisiones,  oficinas  públicas  y  privadas,  cafés,  casas  públicas,  etc.,  estarán  propia- 
mente dotados  de  escupideras,  según  el  sistema  y  número  dispuesto  por  la  junta  local  de 
sanidad. 

Art.  594.  En  todos  los  lugares  citados  en  los  dos  artículos  precedentes  se  tendrán  avisos 
en  sitios  visibles  prohibiendo  escupir  en  el  suelo. 

Art.  595.  La  policía  y  los  dueños,  encargados  ó  empleados  respectivos,  llamarán  en  el 
acto  la  atención  de  los  infractores  de  la  prohibición  de  escupir  en  el  suelo,  y  si  no  obedecieren 
darán  el  parte  correspondiente  al  jefe  local  de  sanidad,  con  el  nombre  y  dirección  del 
infractor. 

Art.  596.  Todas  las  escupideras  se  limpiarán  diariamente  y  se  tendrán  con  alguna  cantidad 
de  agua  ó  mejor  aun  de  solución  antiséptica.  En  los  lugares  públicos  que  indique  la  junta 
local  de  sanidad  las  escupideras  se  tendrán  en  alto,  en  aros  fijos  en  la  pared. 

Art.  597.  Los  cafés  y  demás  establecimientos  análogos  harán  uso  para  fregar,  solamente 
de  aguas  limpias,  mantendrán  secos  los  pisos  y  estarán  siempre  en  condiciones  de  completa 
limpieza. 

Art.  598.  Queda  prohibido  en  los  días  que  no  sean  de  lluvia  tener  cubiertos  de  serrín, 
total  ó  parcialmente,  los  pisos  de  los  cafés,  cantinas,  fondas,  restaurants  y  otros  estableci- 
mientos públicos. 

Art.  599.  Los  pisos  de  los  establecimientos  públicos  serán  baldeados  y  fregados  diaria- 
mente. 

Art.  600.  En  los  días  de  lluvia  y  mientras  haya  lodo  en  las  calles  están  obligados  los 
establecimientos  públicos  á  tener  colocadas  en  las  puertas  de  entrada  esteras  de  esparto, 
goma  ó  alambre,  para  el  uso  de  los  concmTentes  y  evitar  la  suciedad  del  piso. 


SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL.  í-^75 

Art.  601.  Los  puestos  do  frutas  estarán  dotados  de  recipientes  impermeables,  con  sus 
tapas  coiToapondicntcs,  para  cascaras  y  residuos;  no  se  expenderán  en  ellos  frutas  podridas 

y  se  consorvarán  en  completo  aseo. 

Art.  602.  lios  vehículos  do  todas  clases  estarán  perfectamente  limpios  y  serán  desinfecta- 
dos cada  vez  que  so  lo  disponga  por  el  jefe  local  do  .sanidad. 

Art.  &}'i.  Queda  prohibida  la  venta  do  ropa  do  vestir,  6  de  cama,  y  de  muebles,  alfom- 
bras, cortinajes,  tapicerías  y  otros  objetos  usados,  procedentes  de  casas  donde  existan  ó 
haya  existido  alojún  sujeto  atacado  do  enfermedad  transmisible,  sin  que  dichos  objetos  sean 
desinfectados  por  la  sanidad  antes  do  extraerse  do  la  casa.  Tanto  el  vendedor  como  el 
comprador,  según  los  casos,  serán  responsables  de  la  infracción  de  este  artículo.  La  desin- 
fección so  llevará  á  cabo  con  los  menores  perjuicios,  siempre  que  sea  posible,  al  comercio  y  á 
los  particulares. 

Los  dueños  de  casas  de  empeño,  rastros,  etc.,  darán  aviso  al  jefe  local  de  sanidad  al  ir  á 
efectuar  alguna  compra  en  una  casa  donde  haya  existido  recientemente  un  enfermo. 

Art.  604.  La  ropa  usada  puesta  á  la  venta  en  tiempo  que  no  exista  epidemia  alguna  en 
la  población,  será  convenientemente  desinfectada.  FJn  tiempo  de  epidemia,  quedan 
prohibidas  estas  ventas. 

Art.  605.  No  se  permitirá  el  comercio  de  trapos  que  no  hayan  sido  desinfcctadso. 

Los  depósitos  de  trapos  y  otras  materias  que  puedan  dar  lugar  á  la  formación  de  focos 
infecciosos  estarán  situados  íncra  de  la  población  y  requerirán  permiso  previo  de  la  junta 
de  sanidad. 

ÁRT.  606.  Los  sueros  y  vacunas  curativos  y  preventivos,  nacionales  ó  extranjeros,  tanto 

Í)ara  enfermedades  del  hombre  como  de  los  animales,  sólo  podrán  expenderse  si  proceden  de 
aboratorios  aceptados  por  la  secretaría  de  gobernación,  previo  informe  de  la  Junta  Supe- 
rior de  Sanidad,  y  bajo  la  responsabilidad,  con  respecto  á  la  procedencia,  identidad  ó  pureza, 
de  dichos  sueros  ó  vacunas,  del  dueño  ó  encargado  del  laboratorio,  que  será  precisamente 
un  médico,  un  farmacéutico  ó  un  veterinario. 

Art.  607.  Los  sueros  y  vacunas  se  expenderán  en  sus  envases  de  origen  con  rótulo  en  que 
se  consigne  el  laboratorio,  dirección  de  éste,  fecha  de  la  preparación,  y  una  iastrucción 
para  su  empleo,  en  que  se  exprese  su  valor  medido  por  una  escala  generahnente  admitida. 

Art.  608.  Se  prohibe  en  los  laboratorios,  á  no  ser  mediante  una  autorización  especial  y 
por  escrito  de  la  Junta  Superior  de  Sanidad,  el  cultivo  de  géiTnenes  de  enfermedades  cuaren- 
tenables  agudas,  mientras  dichas  enfermedades  no  se  presenten  en  el  país. 

Art.  609.  Todos  los  laboratorios  públicos  y  sus  productos  quedan  sujetos  á  la  inspec- 
ción de  la  junta  local  de  sanidad. 

Art.  610.  Todo  el  que  ejerza  la  medicina,  la  cirugía,  la  farmacia,  la  veterinaria,  la  obste- 
tricia ó  el  arte  del  dentista,  en  todas  ó  algunas  de  sus  ramas,  quedan  obligado  á  registrar  su 
nombre,  firma  y  dirección;  en  la  oficina  de  la  junta  local  de  sanidad. 

Art.  611.  Todo  el  que  ejerza  la  medicina  y  cii^ugía  en  cualquiera  de  las  ramas  menciona- 
das en  el  artículo  anterior  está  en  el  deber  de  acudir  al  llamamiento  del  jefe  local  de  sanidad 
para  cualquier  asunto  del  servicio  relacionado  con  la  salud  pública. 

Art.  612.  Los  plomeros  ó  instaladores  que  se  establezcan  en  lo  sucesivo,  habrán  de 
obtener  licencia  de  la  junta  local  de  sanidad,  ajustarse  á  un  reglamento  especial  que  se 
publicará  oficialmente,  é  inscribirse  en  el  registro  que  se  llevará  al  efecto  en  la  junta  local 
de  sanidad. 

Art.  613.  Todo  el  que  preste  en  un  parto  asistencia  médica,  ó  practique  la  cura  del 
cordón  umbilical  del  recién  nacido,  sin  las  debidas  precauciones  de  asepsia,  incurrirá  en 
responsabilidad. 

Art.  614.  Será  obligatorio  para  los  ayuntamientos  tener  en  depósito  en  las  farmacias  ú 
oti'os  lugares  que  designen,  paquetes  asépticos  para  la  cura  del  ombligo  de  los  recién  nacidos 
j  proporcionarlos  gratuitamente  á  los  que  los  soliciten,  acreditando  su  destino. 

Art.  615.  El  profesional  que  haga  alteraciones  deliberadas  en  el  diagnóstico  ó  en  el  cer- 
tificado de  defunción,  ó  proporcione  de  intento  datos  falsos  á  la  junta  local  de  sanidad,  para 
la  ocultación  de  alguna  enfermedad  en  un  caso  presente,  curado  ya  ó  faUecido,¿ncurrirá  en 
la  responsabilidad  consiguiente. 

Incurrirán  en  responsabilidad  los  que  deliberadamente  oculten  hechos,  ó  proporcionen 
datos  falsos,  á  la  junta  local  de  sanidad,  que  se  relacionen  con  la  salud  pública. 

Art.  616.  Se  prohibe  tener  en  las  casas  y  otros  lugares  de  la  población  pozos,  aljibes,  etc., 
que  no  estén  debidamente  tapados  á  prueba  de  mosquito  y  constituyan  un  peligro. 

Art.  617.  Se  prohibe  tener  en  la  población  aves  ú  otros  animates  perjudiciales  á  la  salud 
<$  que  con  sus  ruidos  ó  malos  olores  perturben  la  tranquilidad  y  reposo  de  los  vecinos. 

Art.  618.  En  las  iglesias  y  capillas  públicas,  además  de  las  prescripciones  sanitarias 
generales,  se  obsei-varán  las  especiales  siguientes:  1°,  Se  colocai'án  escupideras  con  solución 
antiséptica,  del  modelo  y  en  el  número  que  señale  la  junta  local  de  sanidad  según  la  impor- 
tancia del  templo,  y  que  se  lavarán  diariamente;  2°,  á  los  confesionarios  se  les  pondrá 
rejillas  laterales  de  metal,  que  se  lavarán  con  frecuencia;  3",  los  pisos  se  mantendrán  en 


376  SEGUNDA   CONFERENCIA    SANITARIA   INTERNACIONAL. 

perfecto  estado  de  aseo  baldeándolos  á  menudo,  y  además  después  de  la  celebración  de  cada 
fiesta;  4°,  se  cambiará  diariamente  el  agua  bendita  de  las  pilas  y  se  desinfectarán  éstas  con 
agua  hirviendo  ú  otro  desinfectante,  y  5°,  en  la  parte  exterior  de  las  mamparas  se  fijarán 
carteles  ó  avisos  de  la  junta  local  de  sanidad  prohibiendo  escupir  en  el  suelo. 

Art.  G19.  En  las  huertas  ó  sembrados  queda  prohibido  conservar  pozos  ó  excavaciones 
con  materias  excrementicias  6  en  putrefacción,  así  como  regar  hortalizas  ó  siembras  con 
estas  materias. 

Art.  620.  Antes  de  la  aprobación  por  los  ayuntamientos  de  todas  las  obras  públicas  que 
se  relacionen  con- la  sanidad  é  higiene,  como  la  provisión  de  aguas  potables,  construcción  de 
mataderos,  mercados,  basureros,  cementerios,  alcantarillados,  etc.,  deberán  ser  oídas  las 
juntas  locales  de  sanidad  respectivas,  y  sometidas  por  éstas  su  informe  á  la  aprobación  de 
la  superior  del  ramo. 

Akt.  621.  Las  juntas  locales  de  sanidad  dictarán  las  órdenes  encaminadas  á  la  desecación 
de  pantanos,  lagunatos,  charcas,  etc.,  y,  á  no  ser  posible  aquéUa,  hacer  que  periódicamente 
se  vierta  en  ellos  la  cantidad  de  petróleo  crudo  que  se  estime  conveniente  para  la  extir- 
pación de  las  larvas  de  mosquito. 

Pondján  los  medios  para  hacer  desaparecer  también  las  demás  causas  que  contribuyan  á 
la  propagación  del  paludismo. 

Art.  622.  Cada  ayuntamiento  quedaiá  obligado  á  expedir  las  licencias  para  las  obras  de 
órdenes  sanitarias  que  lo  requieran  en  un  término  no  mayor  de  treinta  días,  salvo  que,  por 
razones  determinadas,  se  le  comuniquen  éstas  á  la  junta  de  sanidad  antes  de  que  expire  dicho 
plazo,  y  á  participar  á  la  misma  la  concesión  de  cada  licencia  tan  pronto  como  haya  sido 
expedida. 

En  los  casos  desfavorables  á  la  concesión  de  la  licencia,  el  ayuntamiento  presentará 
sus  reparos  á  la  junta  de  sanidad,  dentro  del  término  de  diez  días. 

Si  la  obra  fuere  de  reconocida  m'gencia,  el  ayuntamiento  haiá  la  concesión  de  la  licencia 
en  el  plazo  que  le  proponga  la  junta  de  sanidad. 

Art.  623.  Se  prohibe  el  oponerse,  ó  presentar  dificultades  ú  obstrucciones  á  las  visitas  de 
inspección,  durante  las  horas  hábiles  del  día,  del  jefe  de  sanidad  ó  de  los  inspectores  de  la 
junta  de  sanidad,  debidamente  acreditados. 

Los  agentes  de  la  pohcía  auxiliaián  á  los  inspectores  cuando  soliciten  su  auxilio  en  casos 
de  necesidad. 

PARTE  TERCERA. 
INFRACCIONES  Y  PENALIDADES. 

Art.  624.  Las  infracciones  de  las  reglas  establecidas  por  las  ordenanzas  sanitarias  que  el 
código  penal  no  defina  como  delitos,  constituyen  faltas  contra  la  salud  pública  y  de  unos  y 
otros  se  daiá  cuenta  al  juzgado  competente  para  su  persecución  y  castigo. 

Art.  625.  Todo  el  que  cometa  una  falta  por  infacción  de  dichas  ordenanzas  ó  no  dé 
cumplimiento  á  las  órdenes  del  jefe  de  sanidad  sci  apenado  conforme  á  lo  estatuido  en  el 
segimdo  extremo  del  apartado  (e)  de  la  sección  3  de  la  orden  civil  N.  159,  serie  de  1902,, 
con  una  multa  de  $10  á  $100,  moneda  oficial,  y  arresto  de  diezma  treinta  días,  ó  solamente 
con  multa  ó  con  arresto,  á  juicio  del  juez  competente  para  conocer  de  la  falta,  con  vista 
de  las  diligencias  remitidas  por  el  jeíe  de  sanidad,  de  las  pruebas  que  se  aduzcan  y  de  la 
acusación  sostenida  en  el  juicio,  la  cual  señalaiá  determinadamente  el  artículo  ó  artículos 
de  las  ordenanzas  que  hayan  sido  infringidos,  exponiendo  además  las  otras  circunstancias 
que  ilustren  debidamente  el  caso. 

Art.  626.  El  jefe  de  sanidad  ó  un  funcionario  de  sanidad  en  delegación  de  aquél  será  el 
encargado  de  sostener  la  acusación  en  el  juicio  correspondiente.  ; 

Los  infoimes  escritos  de  los  inspectores  de  sanidad  formaián  parte  de  la  prueba  y  serán 
apreciados  por  el  juez  conforme  á  las  reglas  de  la  sana  crítica. 

Art.  627.  El  pago  de  la  multa  y  la  extinción  del  arresto,  no  exirahán  al  infractor  de  la 
ejecución  de  la  obra  ó  medida  sanitaria,  ó  del  cumplimiento  de  la  orden  dictada  por  el  jefe 
de  sanidad.  La  reincidencia  después  del  cumplimiento  de  la  pena  se  considerará  circuns- 
tancia agravante. 

Art.  628.  Cuando  alguna  corporación  oficial,  autoridad,  funcionario  público,  junta  ó 
jefe  local  de  sanidad,  se  negare  á  dar  cirmplimiento  á  lo  preceptuado  en  la  orden  Ño.  159, 
serie  de  1902,  en  este  reglamento,  en  las  ordenanzas  sanitarias  ó  en  otras  disposiciones 
sanitarias  aprobadas  por  el  Ejecutivo,  así  como  á  las  de  urgencia  en  casos  excepcionales  3^ 
de  epidemias  que  dicte  la  Junta  Superior  de  Sanidad,  y  cuya  observancia  competa,  por 
razónde  su  cargo,  á  alguna  de  las  corporaciones  ó  autoridades  referidas,  el  Jefe  Superior  de 
Sanidad  acudiiá  al  secretai'io  de  gobernación  en  demanda  de  que  sea  cmnplido  lo  dis- 
puesto y  se  imponga  la  sanción  establecida  en  las  leyes. 

Art.  629.  Las  faltas  en  que  incurran  los  inspectores  do  sanidad  por  infracción  de  los 
preceptos  contenidos  en  este  reglamento  y  en  los  artículos  de  estas  ordenanzas,  cuya  obser- 
vancia les  concierne  directamente  por  razón  de  su  cargo,  serán  penados  por  el  jefe  de  sanidad 


SEGUNDA   CONFEEENCIA    .SANITARIA    INTERNACIONAL.  377 

con  amonestación,  suspensión  de  empleo  y  siieldíj  de  un  á  treinta  días,  ó  destitueión  con  la 
consulta  do  la  Junta  Superior  riel  ramo.  Si  la  inlracción  fuere  oonHtitutiva  de  delito,  se 
pasaiá  el  tanto  de  culpa  ti  los  tribunales  de  justicia. 

Art.  630.  Seián  circunstancias  afíiavaiites  i)aia  la  sanción  penal  la  premeditación  y  la 
ocultación  do  la  lalta  y  la  reincidencia. 

AiiT.  031.  Las  faltas  so  clasiílcaián  en  leves  y  graves,  conforme  á  un  importancia  con 
respecto  á  la  salud  pública. 

Art.  632.  Serán  consideradas  siempre  como  faltas  graves:  (a)  Las  infracciones  come- 
tí das  por  los  funcionarios  ó  delegados  de  sanidad  por  negligencia  ó  mala  fe  en  ejercicio  de 
su  cargo,  si  el  hecho  no  constituye  delito;  (b)  la  ocultación  de  los  casos  de  enfennedadcs  de 
declaración  obligatoria  por  lo  que  están  en  el  deber  do  declararlas;  (c)  la  demora  injustificada 
en  no  haber  hecho  esta  declaración;  (d)  la  omisión  de  las  medidas  de  desinfec(;ión  en  los 
casos  que  correspondan;  (o)  el  ingreso  en  algún  establecimiento  de  ensííñanza  ó  de  benefi- 
cencia do  sujetos  que  estén  enfermos  ó  convalecientes  de  alguna  enfermedad  transmisible; 
(f)  la  negativa,  falseamiento  ó  inexactitud  notoi-iamente  intcmcional  de  noticias  ó  datos 
podidos  por  el  jefe  do  sanidad  h  los  directores  ó  jefes  de  los  establecimientos  de  en.señanza 
y  beneficencia  relativos  ti,  la  higiene  de  éstos  ó  la  salud  do  los  alumnos,  asilados,  empleados, 
dependientes,  etc. 

Art.  633.  Cometerá  una  falta  grave,  y  quedará  sujeto  á  la  penalidad  consiguiente,  todo 
el  que  infrinja  los  capítulos  que  se  señalaián  en  este  artículo. 

Art.  634.  Cualquiera  otra  infracción  de  las  ordenanzas,  que  no  constituya  delito  y  no  se 
encuentre  señalada  en  el  artículo  anterior  se:  á  considerada  como  falta  leve. 

Art.  635.  Quedan  derogados  todos  los  decretos,  ordenanzas,  reglamentos,  disposiciones, 
etc.,  anteriores  que  se  opongan  al  cumplimiento  de  estas  ordenanzas. 


INFORME  DE  LOS  DELEGADOS  DEL   ECUADOR,   SEÑORES 
ALCIVAR  Y  WHITHER. 

Señor  Presidente:  De  conformidad  con  el  programa  de  la  Convención  tenemos  el  honor 
de  informar  á  Vd. — 

Primero.  A  partir  del  1°  de  enero  de  1904  al  31  de  diciembre  del  mismo  año  tuvimos  en 
Guayaquil  190  casos  de  fiebre  amarilla.  Durante  el  presente  año  puede  decü'se  que,  gracias 
á  las  enérgicas  medidas  que  la  junta  superior  de  sanidad  puso  en  práctica  desde  la  aparición 
de  la  fiebre  amarilla  en  Guayaquil,  que  data  del  año  1903,  y  que  fué  importada  de  Panamá, 
la  fiebre  ha  desaparecido  casi  completamente,  pues,  si  en  algunas  semanas  se  señala  uno  que 
otro  caso,  podemos  afirmar  que  ellos  proceden  de  lugares  distantes  de  la  ciudad,  de  la  zona 
comprendida  entre  Chimbo,  Bucay  y  Yaguachi,  pues  las  orillas  del  río  Yaguachi  en  casi 
toda  su  extensión  y  las  tembladeras  y  pantanos  que  abundan  en  esta  sección  y  que  no  se 
secan  ni  aún  en  el  verano  son  un  magnífico  cultivo  para  las  larvas  de  los  mosquitos  que 
favorecen  la  propagación  de  la  especie  de  la  epidemia.  La  junta  superior  de  sanidad,  á  fin 
de  exterminar  esos  focos  y  protejer  á  los  enfermos  para  evitar  por  uno  y  otro  medio  el  con- 
tagio, ya  que  el  saneamiento  de  Guayaquil  sería  casi  imposible,  si  se  mantiene  esa  ameneza 
constante  á  sus  puertas,  va  á  emprender  en  la  campaña  de  sanear  en  los  focos  de  infección  y 
en  la  construcción  de  un  pequeño  lazareto  forrado  con  red  de  alambre  y  dotado  del  personal 
y  útiles  que  un  establecimiento  de  esta  clase  requiere,  de  acuerdo  con  los  adelantos  modernos. 
La  junta  superior  de  sanidad  espera,  pues,  en  breve  tiempo  haber  estü-pado  por  completo 
los  gérmenes  de  la  fiebre  amarilla. 

Segundo.  Desde  que  en  la  cosfcasur  del  Pacífico  aparecieron  los  primeros  casos  de  bubónica, 
la  junta  superior  de  sanidad  de  Guayaquil  cerró  completamente  los  puertos  del  Ecuador  á 
las  procedencias  de  puertos  infectados  y  dictó  medidas  enérgicas  de  higiene  y  saneamiento 
de  las  poblaciones  de  la  costa.  A  la  sazón  el  Dr.  Miguel  H.  Alcivar,  que  había  presenciado 
en  Europa  experiencias  notables  de  la  aplicación  del  gas  Clayton,  recomendó  á  la  junta  de 
sanidad  la  inmediata  y  urgente  convenienciu  de  dotar  el  puerto  de  Guayaquil  de  una  planta 
de  desinfección,  sistema  Clayton,  y  por  cable  se  ordenó  al  consul  de  Nueva  York  la  compra 
de  una  lancha  á  vapor  con  un  aparato  Clayton,  tipo  "A"  y  otro  tipo  "B,"  para  instalarlo 
en  un  vagón  especial.  El  primer  puerto  de  la  costa  sur  del  Pacífico  que  tuvo  una  planta  de 
desinfección,  sistema  Clayton,  fué,  pues,  Guayaquil,  y  desde  entonces  se  le  dio  entrada  al 
puerto  á  las  procedencias  de  puertos  infectados  con  la  bubónica,  haciendo  nidas  las  cuarente- 
nas, desde  que  con  la  desinfección  del  gas  sulforoso  Clayton  se  destruyeron  por  completo 
todos  los  génnenes.  Es  de  notar  el  hecho  constante  de  que  la  bubónica  invadió  puertos 
inmediatos  al  golfo  de  Guayaquil,  como  Paita  en  el  Perú  y  en  el  norte  del  Ecuador:  en 
Panamá,  también,  se  registró  oficialmente  un  caso,  y  aún  cuando  las  procedencias  del  norte  y 
sur  de  puertos  infectados  fueron  aceptadas  en  Guayaquil,  el  puerto  se  ha  conservado  inmune 
debido  á  la  prolija  desinfección  que  hace  la  junta  superior  de  sanidad  á  todos  los  buques 
que  entran  en  el  puerto,  empleando,  como  dejamos  dicho,  el  sistema  Clayton.  Circun- 
stancia que  conviene  observar  es  la  que,  el  único  buque  procedente  de  puertos  infectados. 


378  SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL. 

que  no  fué  recibido  en  Guayaquil  ni  tampoco  desinfectado,  llevó  el  contagio  á  Panamá.  De 
las  experiencias  anotadas  puede'  deducirse  que  el  día  que  las  naves  que  hacen  el  tráfico  de 
pasajeros  y  carsa  gean  dotados  de  aparatos  de  desinfección  Clayton,  y  la  desinfección  se 
verifique  bajo  la  vigilancia  de  los  empleados  de  sanidad  de  los  puertos,  se  alcanzará  la 
inmunidad  para  el  contagio  de  flagelos  como  la  bubónica. 

Durante  el  segundo  semestre  de  1901  pueron  fumigados  94  buques  en  el  Puerto  de 
Gua3'aquil  por  medio  del  sistema  Clayton.  Acompañamos  los  reglamentos  de  desinfec- 
ción de  buques  y  de  la  estación  de  cuarentena. 

La  junta  sup;n-Íor  de  sanidad  de  Guayaquil,  para  ma3'or  facilidad  del  tráfico,  ha  estable- 
cido en  el  golfo  de  Guaj'aquil,  en  Puna,  una  estación  sanitaria  notante,  para  observación, 
<K)n  capacidad  para  treinta  personas,  con  todas  las  comodidades  y  comfort  modernos, 
aparatos  de  desinfección,  sn'vicio  médico,  etc. 

Esta  instalación  S3  considera  insuficiente,  y  con  tal  motivo  la  junta  de  sanidad  ha  empren- 
dido en  la  construcción  de  otra  estación  del  mismo  género  con  capacidad  para  mantener 
hasta  s:senta  pasajeros  en  observación,  cómodamente. 

Las  medidas  que  la  junta  superior  de  sanidad  tiene  en  práctica  para  impedir  tanto  la 
importación  como  la  propagación  de  los  casos  de  fiebre  amarilla  son:  1°  Atendiendo  á  que 
las  cuarentenas  son  inestimablemente  inútiles  para  evitar  la  penetración  de  la  fiebre  ama- 
rilla, cada  vez  que  se  presenta  en  un  buque  un  caso  sospechoso  ó  comprobado,  el  enfermo  es 
transportado  en  ima  camilla  con  red  de  alambre  al  Lazareto  Urbano,  también  forrado 
completamente  con  red  de  alambre.  Los  demás  pasajeros  quedan  bajo  la  vigilancia  del 
médico  de  sanidad  dutante  el  período  de  incubación;  2°  para  los  casos  que  se  produzcan 
en  la  localidad  se  procede  de  ima  manere  semejante,  aislando  imuediatamente  á  los  que 

{)arecÍ8ran  sospechosos  yá  los  que  francamente  fueran  atacados  del  mal,  se  les  conduce,  con 
as  mismas  precauciones  anotadas,  al  lazareto.  Las  habitaciones  dond:»  se  ha  presentado  un 
caso  sospechoso  ó  franco  son  imuediatamente  sometidas  á  una  fumigación  rigurosa  con  el 
aparato  urbano  Clayton.  Además  del  lazareto,  la  junta  de  beneficieucia  municipal  ha 
puesto  á  la  disposición  de  la  junta  de  sanidad  uno  de  los  pabellones  de  su  magnífico  hospital, 
completamente  aislado  y  rodeado  ds  red  de  alambre  para  los  enfermos  sospechosos  que 
ingresen  en  el  hospital,  mientras  están  en  observación  y  son  conductidos  al  lazareto.  La 
estadística  del  primer  semestre  de  este  año  ha  demostrado  que  todas  las  precauciones 
tomadas  por  la  junta  de  senidad  han  dado  por  resultado  le  reducción  y  casi  la  extirpación 
del  mal  en  la  ciudad,  pues  uno  que  otro  que  se  registra  es  siempre  proveniente  de  Yaguachi 
y  sus  inmediaciones. 

Terminaremos  haciendo  presenté  á  la  Convención  que  la  necesidad  de  un  reglamento 
internacional  de  cuarentenas  es  de  vital  importancia  para  los  intereses  del  comercio  en 
general  y  cualquier  esfuerzo  para  alcanzar  un  acuerdo  á  este  respecto,  sería  el  mejor  y  más 
práctico  de  los  triunfos  de  la  Convención  Sanitaria  de  1905. 


Anexo  1. 
REGLAMENTO  PARA  LA  DESINFECCIÓN  DE  BUQUES  Y  EQUIPAJES. 

Aetículo  1 .  Los  buques  procedentes  de  puertos  infectados  serán  sometidos  al  siguiente 
procedimiento  de  desinfección: 

(1)  Las  bodegas,  inclusive  la  mercadería,  serán  fumigadas  y  desinfectadas  por  medio  del 
gas  Cla3'ton,  exceptuando  las  harinas,  granos  3"  demás  sustancias  alimenticias  que  puedan 
sufrir  alguna  alteración  bajo  la  acción  de  dicho  gas. 

(2)  Los  entrepuentes  y  demás  cubiertas  del  buque  después  de  un  lavado  hecho  con 
abundan t.e  cantidad  de  agua,  y  que  tiene  por  objeto  remojar  y  desprender  las  materias 
orgánicas  adheridas  al  suelo  y  paredes,  se  regarán  con  una  solución  de  hipoclorito  de  cal  al 
10  por  ciento.  Esta  solución  debe  actuar  durante  una  hora  por  lo  menos,  después  de  cuyo 
tiempo  se  hará  un  lavado  con  abundante  cantidad  de  agua  común.  Estos  lavados  los  harán 
los  buques. 

(3)  Prohíbese  traer  sobre  cubierta  mercaderías  en  general.  Las  frutas,  legumbres  y 
verduras  no  deben  recibirse  absolutamente  si  proceden  de  puertos  infectados. 

(4)  Las  paredes,  suelo,  puertas  3'  ventanas  de  los  camarotes  y  salones  se  lavarán  escropu- 
losamente  con  paños  empapados  en  solución  boricada  al  6  por  ciento  después  del  lavado 
disciplinario  del  buque. 

(5)  Terminada  que  sea  la  desinfección  del  buque  se  recogerán  los  cadáveras  de  las  ratas  y 
demás  animales,  así  como  las  basuras  y  demás  desperdicios,  los  que,  previa  indicación  del 
médico  de  sanidad,  se  arrojarán  á  la  hornilla  para  su  completa  incineración,  y  de  ninguna 
manera  al  agua. 


SEGUNDA    CONFERENÍJIA    SANITARIA    INTERNACIONAL.  379 

(ü)  Los  equipajes  abiertos  serán  rif^u rosamente!  desinfectados  por  Jos  vapores  del  forraol 
<5  cualquier  otro  procedimiento,  á  juicio  del  mf^dico  do  sanidarl. 

(7)  Se  some  terán  á  saneamiento  y  d(  sinfííccidn  las  ropa.s  limpias  de  uso  de  los  viajeros,  los 
equipajes  en  buen  estado  de  eonscrvaeiíjn,  los  ol)j(et(Js  de  metal  pulimentado,  el  algodíín, 
mobiliario  y  las  maderas  secas,  labradas  6  sin  labrar,  también  á  juicio  d'l  médico  de  sanidad. 

(S)  Se  prohib:!  la  entrada  de  ropas  y  harapos,  vi'jos  y  sucios,  colchones,  almohadas  y 
mantas  sucias,  alfombras  y  esteras  deterioradas,  lanas,  plumas  y  pielt  s  de  animalr'S,  fn  seas  ó 
sin  curtir,  y,  en  general,  todo  género  de  objetos  qui'  se  hiciere  sospechoso  por  su  estado  dea 
suciedad,  así  como  las  sustancias  animales  ó  vegitalis  en  estado  do  descomposición;  y  de 
encontrarse  dichas  especies  se  incinerarán  en  la  hornilla  del  buque. 

(9)  Serán  admitidos  sin  precaución  sanitaria  alguna  los  objetos  nuevos  de  metal  puli- 
mentados, materiales  de  hierro  ú  otro  metal  para  constiaicción  de  maquinarias. 

PASAJEROS. 

Akt.  2.  Los  pasajeros  serán  recibidos,  cualquiera  que  sea  su  procedencia,  observando  las 
reglas  siguientes: 

(1)  El  médico  de  sanidad  practicará  con  el  mayor  detenimiento  el  examen  facultativo  de 
los  viajeros,  no  permitiendo  la  entrada  al  puerto  á  aquellas  personas  que  pnsenten  el  más 
leve  síntoma  sospechoso,  las  cuales  deberán  pasar  al  lazareto  do  observación  en  donde 
guardarán  la  cuai'entena  necesaria  hasta  su  restablecimiento. 

(2)  Los  viajeros  que  procedan  de  puertos  infectados  serán  recibidos  en  la  estación  sani- 
taria para  su  observación  y  aislamiento,  si  fuere  nc  c;  sario  hasta  completar  diez  días  contados 
desde  aquél  en  que  abandonaron  el  pueito  infectado. 

(3)  Si  los  viajeros  tienen  otra  procedencia,  pero  viniesen  en  buques  que  hubieren  hecho 
escala  en  algún  puerto  infectado,  se  les  permitirá  libre  entrada,  previa  desinfrcción  indi- 
vidual, otorgándoles  el  médico  de  sanidad  una  patente  en  la  que  conste  su  procedencia  y 
destino,  según  propia  declaración  de  los  pasajeros. 

Estas  patentes  serán  unipersonales,  y  habrán  de  presentarlas  los  viajeros  al  presidente  de 
la  junta  de  sanidad,  quien  ordenará  al  médico  visite  en  sus  domicilios  durante  diez  días  á 
dichos  viajeros  é  informará  del  estado  de  salud  de  ellos. 

(4)  El  médico  de  sanidad  ordenará  el  aislamiento  en  el  lazareto  al  pasajero  que  durante 
los  días  de  vigilancia  presente  el  más  leve  síntoma  sospechoso  de  enfermedad;  así  como 
también  una  escrupulosa  desinfección  de  las  ropas,  efectos  de  uso,  ropas  de  cama,  equipajes 
y  todo  cuanto  hubiere  estado  en  contacto  con  dicho  pasajero  y  de  la  habitación  que  hubiere 
ocupado. 

(5)  La  desinfección  individual  de  los  pasajeros  se  practicará  de  la  manera  siguiente: 
Baño  general  con  agua  boricada  al  2  por  ciento;  desinfección  especial  de  las  manos  por  medio 
del  cepillo,  con  agua  v  jabón  primero,  y  luego  con  una  solución  de  sublimado  al  1  por  ciento; 
desinfección  de  la  boca  y  garganta  con  agua  boricada;  cambio  completo  de  la  ropa  de  viaje 
por  otra  que  haya  sido  previamente  desinfectada  ya  por  los  vapores  del  formol  ó  por 
cualquier  otro  procedimiento  á  juicio  del  médico  de  sanidad. 

Las  ropas  de  viaje  serán  entregadas  á  un  empleado  de  la  sanidad  para  su  desinfección. 

GANADOS,  AVES   T   ANIMALES   DOMÉSTICOS. 

AnT.  3.  Los  ganados  lanar,  vacuno,  cabrío  ó  de  cerda  no  serán  sometidos  á  otro  procedi- 
miento que  el  descanso  y  observación  durante  diez  días,  en  corrales  limpios,  espaciosos  y 
ventilados,  bajo  la  inspección  diaria  del  veterinario  municipal. 

Art.  4.  Los  ganados  caballar,  mular,  asnal  y  demás  animales  de  pelo  se  someterán 
también  á  la  inspección  en  corrales  adecuados,  por  el  mismo  tiempo. 

Ae,t.  5.  Las  aves  de  corral  y  de  más  animales  de  pluma  se  someterán  igualmente  á 
ventilación  y  descanso  por  el  mismo  espacio  de  tiempo. 

Akt.  6.  Se  desinfectarán  cuidadosamente,  ó  se  quemarán,  si  fuese  necesario,  todos  los 
objetos  procedentes  de  los  animales  que  pueden  servir  de  vehículo  á  los  gérmenes  patógenos. 

Aet.  7.  Todos  los  útiles  empleados  para  el  desembarque  y  traslado  de  los  animales  serán 
cuidadosamente  desinfectados  bajo  la  vigilancia  de  un  empleado  de  la  sanidad. 

DISPOSICIONES   TRANSITORIAS. 

Art.  8.  Mientras  la  junta  superior  de  sanidad  no  posea  estación  sanitaria  ó  lazaretos 
para  llevar  á  debido  efecto  los  incisos  1,  2  y  3  de  este  reglamento,  los  buques  procedentes 
de  puertos  infectados  no  se  recibirán  en  libre  plática,  y  se  mantendrán  incomunicados  todo 
el  tiempo  que  necesiten  para  sus  operaciones  de  carga  y  descarga;  los  pasajeros  de  estos 
buques  no  serán  admitidos  sino  después  de  quince  días  después  de  haber  salido  ó  pasado  por 
puerto  infectado,  ó  de  haber  desembarcado  de  ima  nave  infectada. 


380  SEGUNDA   CONFERENCIA    SANITARIA    INTERNACIONAL. 

Anexo  2. 

REGLAMENTO  DE  LA  ESTACIÓN  SANITARL^. 

« 

Artículo  1.  Establécese  una  estación  sanitaria  marítima  provisional  con  el  objeto  de 
aisler  y  bacer  guardar  cuarentena  de  observación  á  los  pasajeros  que  vengan  de  puertos 
inf c  ctados  ó  sosp  ?  ch  osos . 

Art.  2.  La  estación  sanitaria  se  establecerá  en  el  lugar  que  de  antemano  designe  la  junta 
superior  de  sanidad. 

Art.  3.  La  estación  se  compondrá  del  número  de  embarcaciones  necesarias  para  el 
objeto,  y  so  la  dotará  de  todos  los  muebles  enseres  de  cocina  y  refectorio,  farmacia  y  demás 
elementos  indispensables  para  el  buen  servicio  y  cuidado  de  los  pasajeros. 

PERSONAL   DE    SERVICIO. 

Art.  4.  Formará  el  personal  de  servicio:  Un  médico  director,  1  inspector,  1  practicante, 
2  sirvientes  de  cámara,  1  sirviente  para  señoras,  1  cocinero,  1  ayudante  de  cocina,  2 
enfermeros,  2  marineros,  y  empleados  que  hacen  el  servicio  de  desinfección  de  buques. 

EL   MÉDICO. 

Art.  5.  El   médico  de  la  estación  de  Puna  será  el  médico  de  la  estación  sanitaria  ■ 
marítima.     Sus  atribuciones  son: 

(1)  Practicar  la  visita  de  sanidad  á  los  buques  procedentes  del  exterior,  conferme  á  lo  que 
dispone  el  reglamento  de  la  junta  de  sanidad  y  postei-iores  acuerdos  de  la  misma. 

(2)  Hacer  la  desinfección  de  buques  que  procedan  de  puertos  infectados  ó  sospechosos,  de 
acuerdo  con  lo  dispuesto  por  la  junta  superior  ds  sanidad. 

(3)  Visitar  dos  veces,  ó  más  si  fuere  necesario,  á  los  pasajeros  sujetos  á  cuarentena  do 
observación,  y  comimicar  á  la  junta  de  sanidad  cualquiera  novedad  que  ocurriera. 

(4)  Al  enfermar  algunos  de  los  pasajeros  sometidos  á  observación  se  constituirá  á  su  lado 
el  médico  de  sanidad,  aislando  antes  á  dicho  enfermo,  si  se  trata  de  enfermedad  contagiosa. 

(5)  En  el  caso  que  procede,  el  médico  de  sanidad  lo  comunicará  á  la  junta  á  fin  de  que  esta 
envíe  inmediatamente  á  un  médico  que  se  haga  cargo  del  servicio  del  puerto. 

(6)  Cuidar  que  las  desinfecciones  se  hagan  rigurosamente  y  que  los  empleados  encargados 
de  hacerla  cumplan  absolutamente  con  sus  deberes. 

(7)  Vigilar  que  los  pasajeros  sean  atendidos  y  cuidados  de  la  mejor  manera,  satisfaciendo 
sus  deseos  en  todo  aquello  que  no  esté  en  oposición  á  lo  dispuesto  en  este  reglamento. 

(8)  Vigilar  que  los  empleados  cumplan  estrictamente  los  deberes  de  su  cargo,  é  informar 
semanalmente  á  la  junta  de  sanidad  de  todo  lo  ocurrido  en  el  servicio. 

INSPECTOR   Y    EMPLEADOS    SUBALTERNOS. 

Art.  6.  Son  deberes  del  inspector: 

(1)  Practicar  la  desinfección  de  los  buques  bajo  la  inspección  del  médico,  cuidando  que 
aquella  se  cumpla  de  conformidad  con  lo  dispuesto  por  la  junta. 

(2)  Cuidar  del  orden  y  buen  servicio  en  las  embarcaciones  destinadas  á  los  pasajeros, 
prestándoles  á  éstos  todas  las  facilidades  compatibles  con  la  condición  y  aislamiento  que 
deben  guardar. 

(3)  Disponar  y  hacer  cmnplir  todo  lo  concerniente  al  servicio  de  mesa,  cocina,  aseo  y 
limpieza  de  las  embarcaciones,  velando  por  la  disciplina  y  buen  comportamiento  de  sus 
subalternos,  especialmente  en  lo  que  toca  al  buen  trato  que  se  debe  dar  á  los  pasajeros. 

(4)  Acompañar  al  médico  en  los  momentos  de  visita  y  siempre  que  éste  lo  solicite, 
recibiendo  de  él  diariamente  las  órdenes  concernientes  al  servicio. 

(5)  Vigilar  el  completo  aislamiento  de  incomunicación  de  las  embarcaciones  destinadas  al 
servicio,  é  impedir  que  los  pasajeros  se  pongan  en  comunicación  con  otras  personas. 

Art.  7.  Los  sirvientes  de  cámara,  cocina  y  demás  empleados  subalternos  están  bajo  las 
órdenes  del  inspector  y  cumplirán  estrictamente  las  disposiciones  que  éste  les  imparta. 

PRACTICANTE. 

Art.  8.  El  practicante  prestará  sus  servicios  bajo  las  órdenes  inmediates  del  médico, 
cuidadando  especialmente  de  la  asistencia  de  los  enfermos.  Acompañará  al  médico  en  sus 
visitas,  llevará  una  anotación  clínica  de  los  enfermos  y  un  recetario  en  debida  forma; 
cuidará  que  se  cumplan  las  prescripciones  del  médico,  y  que  se  administre  á  los  enfermos 
los  medicamentos  recetados;  vigilará  la  dieta  de  los  enfermos  y  hará  que  los  enfermeros 
y  sirvientes  atiendan  á  ac^uellos  con  proligidad  y  esmero  en  todas  sus  necesidades. 


HKGUJNDA    t;ONFKKKN('IA    SANITAItlA    ÍNTERNACIONAL.  üHi 

I'AKA.IIÍROS. 

Art.  9.  Los  pasajeros  que,  proctsdan  do  puertos  infcictados  ó  sospechosos  guardarán 
cuarentena  de  obs  irvación  en  las  (unbarcacioms  d  ;st¡nadas  al  efecto. 
r  Esta  cuanüitena  s:írá  do  diez  días  contados  desde  el  día  que  abandonen  el  último  puerto 
infectado  6  sospechoso. 

Los  pasajeros  que  prefiriran  hac.ír  su  cuarentena  en  otro  buque  arrendado  por  su  propia 
«uonta,  pouL'án  hacerlo,  som  itiéridos ;  en  todo  íí  lo  pr:;scrito  en  este  regla'n  ¡nto. 

Art.  10.  Bajo  nlní^ún  pr.itesto  podrán  los  pasaj  iros  ponersrj  en  conunicacii'in  in'nediata 
■con  otras  p;írsonas,  ni  monos  abandonar  el  buque  en  qu  ;  d  "ba  cumplir  su  cuar  ¡nt  ;na. 

Si  al^ún  pasajero  enfermase  durante  los  días  de  su  cuarentena  será  aislado  ó  no  á  juicio 
del  módico  en  el  lugar  que  é^te  diwigno. 

Art.  ÍL  Los  enfermos  que  pueson  aislados  no  podrán  comunicarse  sino  con  el  médico, 
el  practicante  y  los  enfermeros  del  servicio.  El  aislamiento  terminará  cuando,  á  jucio 
del  médico,  el  enfermo  entre  en  un  período  de  franca  convalecencia. 

Art.  12.  El  pasajero  que  al  llegar  á  Puna,  se  encontrase  afectado  de  enfermedad 
contagiosa  como  peste,  fiebre  amarilla,  tifus,  fiebres  eruptivas  ú  otras  análogas,  no  podrá 
ser  receibido  eii  la  estación  sanitaria. 

Art.  13.  Todos  los  pasajeros  están  sujetos  á  la  visita  diaria  del  facultativo  y  á  seguir 
las  indicaciones  que  éste  creyere  conveniente  hacer. 

Art.  14.  Los  pasajeros  abonarán  $5  diarios  por  pensión,  aparte  de  los  gastos  extraodinarioa 
<jue  hiciesen. 

Este  reglamento  se  pondrá  en  conocimiento  de  los  pasajeros  para  su  exacto  cumplimiento. 

presupuesto. 

Un  médico,  1  inspector,  1  practicante,  2  sirvientes  de  cámara,  1  sirviente  para  señoras, 
1  cocinero,  1  ayudante,  2  marineros,  y  2  enfermeros. 
Art.  15.  La  junta  podrá  reformar  este  reglamento  cuando  lo  crea  conveniente. 
Dado  en  la  sala  de  sesiones  de  la  junta  superior  de  sanidad  á  veintidós  de  septiembre 
de  mil  novecientos  cuatro. 

Antonio  Gil,  El  Presidente. 
J.  Cueva  García,  El  Secretario. 


INFORME  DE  DR.  JOAQUÍN  YELA,  DELEGADO  DE  GUATEMALA. 

Señor  Presidente,  Señores:  Al  ser  invitado  el  Gobierno  de  la  República  de  Guate- 
mala para  tomar  parte  en  la  Primera  Convención  Sanitaria  Internacional  de  las  Repúblicas 
Americanas,  que  debía  reunirse  en  Washington,  D.  C,  á  principios  del  mes  de  diciembre 
del  año  de  1£02,  cúpome  la  honra  de  ser  designado  oficialmente  por  mi  país  para  formar 
parte  de  tan  importante  é  ilustrado  Congreso.  Ausente  yo  de  los  Estados  Unidos  de  Amé- 
rica en  esa  época  al  recibir  el  nombramiento,  emprendí  mi  regreso  á  esta  nación,  pero,  por 
desgracia,  debido  á  un  accidente  imprevisto  y  casual  llegué  á  esta  metrópoli  recien  temíi- 
nadas  las  sesiones. 

En  estos  últimos  días  me  veo  favorecido  una  vez  más  con  el  nombramiento  por  cable, 
de  delegado  oficial  por  Guatemala  á  la  Segunda  Convención  Sanitaria  Internacional. 
Anúnciaseme  al  mismo  tiempo,  también  por  cable,  la  remisión  de  las  últimas  disposiciones 
gubernativas  sobre  higiene  pública,  y  de  importantes  observaciones  clínicas  sobre  la  actual 
epidemia  de  fiebre  amarilla  en  las  poblaciones  de  Zacapa  y  Gualan  por  los  médicos  que 
asisten  á  los  pacientes.  Por  desgracia,  hasta  la  fecha  no  han  llegado  á  mi  poder  para  dar 
cuenta  de  ellos. 

A  estos  motivos  se  debe  que  el  informe  que  ahora  presento  no  sea  tan  concreto  como  era 
de  desearse. 

El  paludismo  y  sus  múltiples  manifestaciones  ha  sido  la  enfermedad  más  común  en  todo 
el  litoral  de  las  costas  de  la  República  y  en  algunas  otras  de  sus  poblaciones.  Las  fiebres 
perniciosas,  que  al  segundo  ó  tercer  acceso  causaban  la  muerte  del  paciente,  hoy  casi  son 
desconocidas,  por  las  medidas  higiéncias  puestas  en  estricta  práctica  por  las  autoridades  y 
el  Cuerpo  de  Salubridad. 

Únicamente  dos  invasiones  se  cuentan  del  terrible  flagelo,  el  cólera  morbus,  que  diezmaron 
la  República  y  todo  Centro  América.  La  última  fué  el  año  de  1857  importada  de  Nicaragua, 
al  regiese  de  las  tropas  que  fueron  á  coadyuvar  á  la  expulsión  de  las  huestes  que  amena- 
zaban nuestra  independencia.  Posteriormente,  algunos  años,  no  todos,  suele  aparecer  de 
un  modo  esporádico,  al  principio  de  la  estación  de  las  lluvias,  uno  que  otro  caso  de  cólera 
nostras,  que  siempre  cede  á  un  tratamiento  apropiado. 

Una  parte  muy  considerable  de  la  población  de  Guatemala,  la  forma  la  raza  indígena. 
El  indio  es  vigoroso  y  de  costumbres  sencillas  y  puras,  sin  más  vicio  que  el  de  las  bebidas 
alcohóhcas,  principalmente  el  de  la  llamada  "Chicha." 


382  SEGUNDA   CONFERENCIA   SANITARIA    INTERNACIONAL. 

Jamás  padece  de  sífilis;  se  casa  apenas  entra  en  la  pubertad  formando  familia  numerosa. 
Las  epidemias  son  las  que  únicamente  ponen  fin  á  su  existencia,  en  especial  la  viruela, 
porque  huye  de  la  vacuna  á  la  que  tiene  un  horror  pánico.  Como  los  de  esta  raza  siempre 
viven  hacinados  en  pequeñas  habitaciones  llamadas  ranchos,  al  enfermarse  uno  sigue  todo 
la  familia,  y  luego  la  población  entera.  Afortunadamente  ahora,  con  el  empeño  constante 
del  Gobierno  y  del  Consejo  Superior  de  Higiene,  que  con  penas  fuertes  los  obliga  á  la  vacuna- 
ción y  revacunación,  ya  no  se  ven  las  frecuentes  y  devastadoras  epidemias  de  antes,  sino 
de  vez  en  puando  casos  aislados  de  forma  benigna.  En  las  poblaciones  principales  hay 
médicos  remunerados,  y  allí  las  autoridades  respectivas  conducen  á  los  indios  á  ser  vacu- 
nados, teniendo  especial  cuidado  de  inspeccionar  si  ha  tenido  ó  nó  buen  resultado  la  inocu- 
lación, repitiéndose  hasta  obtener  el  efecto  deseado. 

De  la  elef ant  iasis  de  los  Griegos,  que  en  época  de  atrás  se  veían  por  todas  partes  muchos 

Bacientes,  no  se  ha  vuelto  á  ver  un  sólo  caso  nuevo,  desde  que  por  acuerdo  gubernativo, 
evado  á  estricta  práctica,  fueron  recogidos  3'  secuestrados  todos  los  que  la  padecían,  y 
colocados  en  el  asilo  llamado  "La  Piedad"  en  donde  están  bien  asistidos  y  nada  les  falta, 
pero  sí  se  les  evita  toda  comunicación  con  el  resto  de  la  sociedad. 

La  peste  bubónica  que  en  estos  últimos  años  ha  hecho  víctimas  en  algunas  poblaciones 
de  la  América,  en  donde  era  absolutamente  desconocida,  nunca  ha  visitado  mi  país,  y  es  de 
esperarse  que  con  las  medias  higiénicas  que  se  toman  á  cualquier  amenaza  de  tan  terrible 
azote  nunca  aportai'á  á  nuestras  playas. 

Hace  treinta  y  cinco  años  que  una  epidemia  de  escarlatina  hizo  grandes  estragos  en  todo 
la  nación.  Después  de  esa  época  aciaga  no  ha  vuelto  á  observarse  ningún  caso.  Desde 
entonces  sí  han  aparecido  periódicamente  casos  de  difteria  que  han  hecho  muchas  víctimas 
en  los  niños,  hasta  que  se  descubrió  el  suero  apropiado  para  dominar  esta  terrible  y  penosa 
dolencia. 

La  tos  ferina  y  el  sarampión,  suelen  aparecer  de  tiempo  en  tiempo,  bajo  forma  epidémica 
de  carácter  más  ó  menos  grave. 

La  influenza  es  la  que  ha  hecho  más  apariciones. 

La  fiebre  tifoidea  es  muy  rara  entre  nosostros,  lo  mismo  que  la  tuberculosis.  Las  condi- 
ciones del  país  se  prestan  más  para  curar  la  dolencia  que  para  producirla;  y  es  tanto  así, 
que  personas  de  lejanos  países  afectadas  de  tuberculosis  ó  predispuestas  á  ella,  vienen  á 
Guatemala,  como  á  una  pierna,  y  la  mayor  parte  consiguen  su  restablecimiento. 

Actualmente  lamentamos  en  nuestro  suelo,  en  dos  importantes  poblaciones,  llamada  la 
una  Zacapa  y  la  otra  Gualan,  la  invasión  de  la  fiebre  amarilla.  Gran  número  de  profesores 
médicos,  en  aras  de  la  filantropía,  espontáneamente  han  ido  á  ofrendar  sus  vidas  en  bene- 
ficio de  sus  hermanos,  habiendo  muerto  ya  varios  de  ellos,  al  estar  prestando  sus  servicios 
profesionales  á  los  atacados  de  la  fiebre.  Entre  ellos  está  el  nombre  del  distinguido 
Dr.  José  Arrióla  víctima  del  deber  profesional,  que  deja  sin  terminar,  según  informes,  un 
importante  trabajo  clínico  que  demuestra  con  hechos  observados  por  él  que  el  mosquito 
Stegomyia  fasciata  es  el  único  agente  de  trasmisión  de  la  fiebre  amarilla. 

Va  cediendo  notablemente  esta  epidemia,  gracias  ó  los  activos  medios  que  el  Gobierno  y 
el  Consejo  Superior  de  Higiene  han  hecho  se  pongan  en  práctica,  ya  para  tratar  los  casos 
existentes  como  para  precaver  su  propagación,  encontrando  eficaz  ayuda  en  todo  el  cueipo 
médico,  con  lo  cual  se  ha  obtenido  circunscribir  su  acción  invasora  á  una  limitada  zona. 
Nunca  esta  dolencia  ha  sido  endémica  en  Guatemala. 

Un  Consejo  Superior  de  Higiene  Pública  reside  en  la  capital  de  Guatemala  dependiente 
de  la  Secretaría  del  Interior,  y  juntas  especiales  de  salubridad  en  cada  departamento,  que 
dependen  y  reciben  las  intrucciones  del  Consejo.  Una  ley  especial  ha  creado  separada- 
mente el  cuerpo  de  higiene  militar,  cuyo  objeto  es  velar  por  el  mejoramiento  de  la  salud  del 
soldado. 

El  Consejo  de  Higiene  tan  sólo  tiene  facultades  consultivas,  pues  la  Secretaría  del  Interior 
es  la  que  promulga  los  acuerdos,  y  hace  que  se  pongan  en  práctica  las  leyes  sanitarias. 

Entre  las  muchas  é  interesantes  leyes  sobre  higiene  pública,  acordadas  por  el  Gobierno  á 
iniciativa  del  Consejo  Superior,  está  la  de  vacunación  y  revacunación  obligatoria,  las  que 
reglamentan  la  prostitución,  j  la  que  exige  la  declaración  de  las  enfeimedades  siguientes: 
Fiebre  tifoidea,  tifus  exantQmático,  viruela,  peste  bubónica,  cólera  morbus,  elefantiasis 
de  los  Griegos,  escarlatina  y  sarampión.  El  médico  que  asista  á  un  paciente  que  adolezca 
de  alguna  de  estas  enfermedades,  ó  el  jefe  de  la  familia,  está  obligado,  bajo  severas  penas 
á  dar  aviso  inmediato  á  la  autoridad  competente. 

La  vigilancia  médica  en  los  puertos  de  la  República  está  confiada  á  los  facultativos  compe- 
tentes que  dependen  imnediatamente  de  la  autoridad  local,  y  reciben  instrucciones  del 
Consejo  Superior  de  Higiene.     En  cada  puerto  hay  aparatos  apropiados  para  la  de.'^infección. 

Tan  luege  el  Gobierno  ha  tenido  noticia  fidedigna  de  que  en  algunos  de  los  países  con  los 
cuales  cultiva  relaciones  comerciales  existe  una  epidemia  que  puede  ser  trasportada,  ha 
tomado  las  disposiciones  y  medidas  higiénicas  del  caso  á  fin  de  evitar  su  importación  en  la 
República. 

Entre  los  últimos  acuerdos  relativos  á  este  objeto  aparece  el  de  26  de  julio  próximo  pasado 
que  ordena  que  para  los  efectos  consiguientes  se  tengan  como  sospechosas  de  viruela  las 


SEÜU-NDA    CONFERENCIA    HANITAUIA    INTERNACIONAL.  ii>i{i 

procerloucias  do  Valparaíso  en  Chile;   y  en  esa  virtud  las  autoridades  de  los  puertos  de 
Guatemala,  sobre  el  Pacífico,  deberán  cumplir  estrictamente  toda«  las  leyes  y  reglamentos 
dictados  por  el  Gobierno  con  anterioridad. 
En  G  (le  septiembre  próximo  pasado  el  Presidente  de  la  República  acordó  cerrar  los 

?uertos  de  San  José,  Cnampeiico  y  Ocas  en  la  Costa  del  Pacífico  á  las  procedeucias  de 
'anamá  por  sospechosas  de  liebre  amarilla  y  peste  bubónica. 

Si  so  continúa  con  el  empeño  y  la  actividad,  ((uc  al  presente  en  la  magna  obra  de  llevar 
á  la  práctica  las  muclias  y  sabias  disposiciones  higiénicas,  acordadas  por  leyes  anteriores, 
casi  casi  se  jjodría  asegurar  sin  jactancia  que  en  la  capital  de  Guatemala  no  se  vería  ya 
otra  o?ii'emiedad  ftiora  de  las  traumáticas,  que  la  senectud,  y  que  todos  sus  moradores 
morirían  únicamente  de  viejos. 

La  capital  de  Guatemala  posee  un  magnífico  hospital  general  al  e^te  de  la  población. 
Tiene  quinientas  camas  en  espaciosos  y  bien  ventilados  salones;  sin  pago  ninguno  se 
encuentran  módicos,  enfermeros,  medicinas,  alimentos,  alojamiento  confortable  y  todo  lo 
que  puede  necesitarse  para  recupei-ar  la  salud  perdida.  En  este  edificio,  que  tiene  una 
vasta  extensión,  hay  un  cuerpo  competente  de  médicos  y  cirujanos  de  los  más  distinguidos, 
y  practicantes  y  enfermeros  hábiles.  Se  encuentra  en  un  todo  arreglado  á  los  preceptos  y 
adelantos  modernos  de  la  ciencia.  Anexa  está  la  Casa  de  Salud  para  los  que  pueden  pagar 
una  corta  pensión,  dotada  como  el  Hospital  General  de  un  arsenal  quirúrgico  completo,  y 
medicinas  que  se  importan  frecuentemente  de  los  Estados  Unidos  de  América  y  de  Europa. 

En  un  pintoresco  lugar  llamado  el  Parque  de  la  Reforma,  á  tres  millas  de  la  ciudad,  está 
el  Hospital  Militar,  institución  moderna,  donde  encuentra  el  soldado  el  alivio  de  sus  males. 

Hay  un  bien  organizado  manicomio  que  no  sólo  sii-ve  para  asilar  á  los  desgraciados  que 
han  perdido  el  uso  de  la  razón,  sino  también  para  curar  muchas  de  las  formíis  de  locura  de 
los  que  ingresan  en  él. 

A  doce  millas  al  norte  de  la  capital  está  el  Asilo  La  Piedad,  á  donde  se  conduce  á  todos 
los  que  padecen  el  terrible  mal  de  la  elefantiasis  de  los  Griegos.  Allí  tienen  todo  lo  necesario 
para  hacerles  menos  molesta  su  existencia.  Próximo  se  encuentra  el  cementerio  destinado 
á  sepultar  sus  cadáveres. 

El  Hospital  Modelo,  así  llamado,  el  que  aloja  á  las  mujeres  que  padecen  de  sífilis,  se 
halla  situado  al  este  de  la  ciudad  en  los  suburbios,  y  la  mayor  parte  de  las  que  ingresan 
aUí  son  mujeres  de  la  vida  pública.  La  creación  de  este  hospital  y  el  haberse  reglamentado 
de  un  modo  conveniente  la  prostitución  ha  contribuido  grandemente,  si  no  á  exterminar 
esta  terrible  plaga,  sí  á  que  sea  poco  frecuente  y  que  los  casos  que  se  presentan  revistan 
menor  gravedad. 

Para  los  casos  de  enfermedades  epidémicas  y  contagiosas,  que  por  esta  razón  no  pueden 
ser  admitidos  en  los  otros  hospitales  de  la  ciudad,  existe  uno  muy  amplio  en  las  afueras  de 
la  población,  con  competente  número  de  empleados,  de  medicinas  y  de  todo  lo  necesario 

{)ara  atender  á  los  pacientes.  Con  lo  cual,  no  sólo  se  curan  estos,  sino  que  se  evita  también 
a  propagación  del  mal. 

No  puedo  pasar  en  silencio  la  creación  de  un  asilo  altamente  filantrópico,  para  los  hombres 
y  mujeres  que  padecen  de  esa  horrible  enfermedad,  que  hasta  ahora  no  ha  podido  curarse 
á  pesar  de  los  prodigios  actuales  de  la  ciencia,  y  que  se  llama  vejez.  Aquí,  distraídos  en  las 
ocupaciones  que  les  permite  su  estado,  y  sin  que  nada  les  haga  falta,  esperan  tranquilos  la 
terminación  de  sus  días.  También  existen  sanatorios  particulares  de  distinguidos  pro- 
fesores, entre  los  cuales  me  es  grato  nombrar  el  más  notable  y  completo,  el  de  los  compe- 
tentes hermanos  Doctores  Ortega,  que  reúne  al  buen  servicio  facultativo  los  últimos 
adelantos  de  la  ciencia,  en  aparatos  é  instmmentos  y  todo  lo  necesario  para  la  asistencia 
clínica. 

No  sólo  en  la  capital  de  la  Rebúplica  se  encuentran  las  casas  de  beneficencia,  si  que 
también  las  hay  y  completamente  dotadas  de  todo  lo  necesario  en  las  cabeceras  de  los 
departamentos.  Las  principales  son  los  hospitales  de  la  ciudad  de  Quezaltenango,  de  la 
antigua  Guatemala,  Amatitlán  y  Escuintla. 

Falta  hacía  en  medio  de  tanto  establecimiento  de  beneficencia  pública,  uno  para  aquellos 
infelices,  que  sin  ser  considerados  como  enfermos,  convalecen  de  graves  dolencias.  Por  eso 
el  Sr.  Estrada  Cabrera,  actual  Presidente  de  la  República  vá  á  Uenar  tan  gran  vacío  con  el 
magnífico  y  extenso  establecimiento  que  está  constmyendo  al  sur  de  la  ciudad,  en  el  local 
ocupado  anteriormente  por  la  Exposición  Centro-Americana,  destinado  principalmente  al 
alojamiento  y  cuidado  de  los  convalecientes.  Pronto  estará  terminado,  porque  se  trabaja 
con  asiduo  empeño,  siendo  el  mismo  filántropo  mandatario  el  que  inspecciona  á  diario  los 
trabajos. 

Para  terminar,  señores,  hago  únicamente  mención  de  la  honra  que  cupo  á  Guatemala  de 
ser  designada  para  que  en  su  capital  se  celebre  el  Cuarto  Congreso  Médico  Pan  Americano. 
Al  efecto,  tanto  el  Gobierno  como  la  facultad  de  medicina  y  fannacia,  por  medio  de  sus 
comisiones  ti'abaja  con  asiduo  empeño  á  fin  de  que  á  los  ilustres  huéspedes  de  la  ciencia  se 
les  haga  agradable  su  permanencia  entre  nosotras. 


SSi  SEGUNDA    CÜIÍFERENCIA    SAKITAKIA    INTERNACIONAL. 

INFORME  DEL  DELEGADO  DE  MÉXICO,  DR.   EDUARDO  LICÉAGA. 

Señores:  El  presente  informe  lo  rindo  siguiendo  el  programa  científico  aceptado  por  el 
Comité  Internacional  de  las  Repúblicas  Americanas. 

(a)  Datos  sobre  las  enfermedades  dominantes,  especialmente  la  plaga,  la  fiebre  amarilla  y  la 
malaria,  á  partir  del  1°  de  enero  de  1904,  Que  fué  aproximadamente  la  fecha  en  la  que  débig 
reunirse  la  Convención  en  Santiago  de  Chile. 

I.  PESTE  BUBÓNICA. 

En  una  colección  del  Boletín  extraordinario  del  Consejo  Superior  de  Salubridad,  publi- 
cado con  motivo  de  la  aparición  de  la  peste  bubónica  en  el  puerto  de  Mazatlán,  Estado  de 
Sinaloa,  enviado  al  Comité  Internacional  de  las  Repúblicas  Americanas,  se  dio  noticia 
detallada  de  la  aparición  de  esta  enfermsdad  en  diciembre  de  1902;  del  curso  que  siguió 
la  epidemia  y  de  la  serie  de  medidas  que  se  tomaron,  hasta  extinguir  definitivamente  la 
enfermedad  en  mayo  de  1933.  Debo  decir  de  paso,  que  desde  que  se  adoptó  en  la  Conven- 
ción Sanitaria  anterior,  la  resolución  de  que  cada  una  de  las  Repúblicas  aquí  representadas, 
quedaba  obligada  á  declarar  la  existencia  de  enfermedades  transmisibles  en  su  territorio, 
al  Com'.té  Internacional  de  las  Repúblicas  Amsricanas,  la  de  México  no  ha  dejado  de  cumplir 
con  esa  obligación,  dando  una  noticia  semanaria  por  el  correo  ó  por  el  cable,  siempre  que  ha 
sido  necesario. 

Como  aaexo  número  1  acompaño  una  colección  de  esos  boletines,  y  voy  á  dar  lectura  á 
la  memoria  que  resume  la  historia  de  esa  epidemia,  porque  pienso  que  puede  ser  instructivo 
el  conocimiento  de  las  medidas  que  se  adoptaron  para  combatirla,  y  que  no  solamente  la 
sofocaron  en  su  cuna,  sino  que  permitieron  librar  de  ella  al  resto  de  la  República  Mexicana 
y  á  toda  la  América  Septentrional. 

I.  oeigen7peobable''de  la  epidemia. 

Mazatlán  es  un  puerto  situado  en  las  costas  del  Pacífico,  á  los  23°  11'  2"  latitud  norte, 
y  á  los  "7°  17'  34"  longitud  oeste  de  México.  Está  situado  en  la  zona  tórrida,  siendo  su 
clima  tropical.     Su  población  llega  á  25,000  habitantes. 

Este  puerto  está  en  frecuente  comunicación  con  el  de  San  Francisco,  Cal.,  de  los  Estados 
Unidos,  donde  tres  años  antes  ha  existido  la  peste  bubónica,  en  un  barrio  central  de  aquella 
ciudad,  que  se  llama  "Chinatown." 

Probablemente  por  temor  á  las  restricciones  cuarentenarias  que  pudieron  haber  sido 
impuestas  al  comercio  en  puertos  extranjeros,  las  autoridades  de  San  Francisco,  Cal.,  habían 
ocultado  cuidadosamente  la  existencia  de  la  enfermedad,  y  expedían  patentes  limpias  de 
sanidad  á  los  buques  que  salían  de  dicho  puerto. 

El  13  de  octubre  de  1902,  el  vapor  Cura';ao  llegó  á  Mazatlán  con  un  cargamento  de  efectos 
de  China,  que  desembarcó  en  dicho  puerto.  Siete  días  después  fué  observado  el  primer 
caso  de  la  enfermedad,  pero  ningún  diagnóstico  pudo  hacerse,  porque  como  la  afección  no 
se  había  visto  nunca  en  la  República  Mexicana,  sus  síntomas  eran  desconocidos  para  los 
médicos,  por  cuya  razón  se  supuso  que  los  enfermos  se  encontraban  atacados  de  una  rara  y 
maligna  forma  de  malaria. 

No  ha  sido  posible  todavía  descubrir  si  esos  efectos  venían  directamente  de  "Chinatown" 
en  San  Francisco,  Cal.,  ó  si  habían  sido  transbordados  al  Curacao  de  algún  buque  proce- 
dente directamente  del  Asia;  lo  incuestionable  fué  que  el  buque  había  salido  de  San  Fran- 
cisco y  que  el  cargamento  contenía  efectos  de  origen  chino. 

n.    PRIMERAS   NOTICIAS   DE   LA    APARICIÓN   DE   LA    EPIDEMIA. 

El  13  de  diciembre  de  1902,  el  delegado  del  Consejo  Superior  de  Salubridad  en  Mazatlán, 
comunicó  por  telégrafo  que  una  rara  enfermedad  había  aparecido  en  la  localidad:  De  19 
casos  ol)servados,  8  habían  terminado  fatalmente;  todos  ellos  durante  el  tiempo  transcu- 
rrido del  20  de  octubre  al  13  de  diciembre,  y  que  la  enfermedad  se  caracterizaba  principal- 
mente por  una  fiebre  violenta  y  por  la  aparición  de  bubones  en  las  ingles,  en  las  axilas  y  en 
el  cuello. 

El  Consejo  Superior  de  Salubridad  que  por  ley  tiene  á  su  cargo  la  policía  sanitaria  inter- 
nacional en  los  puertos  no  tuvo  conocimiento  durante  los  primeros  días  del  mes  de  diciem- 
bre del  hecho  antes  mencionado,  de  que  el  vapor  Curasao  hubiera  llevado  procedencias  de 
origen  chino;  pero  fundándose  en  que  se  sabía  de  una  manera  extraoficial  la  existencia  de 
la  peste  en  un  barrio  de  San  Francisco,  Cal.;  y  en  que  la  única  enfermedad  transmisible 
que  se  acompaña  de  fiebre  intensa  y  de  bubones,  es  la  peste,  ordenó  á  su  aelegado  que 
anotara  las  patentes  de  sanidad,  diciendo  que  existía  en  el  puerto  una  enfermedad  sospe- 


SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL.  385 

«hosa  do  sor  la  peste  bubónica.  Al  mismo  tiempo  se  dirigió  á  las  autoridades  locales  de 
Mazatlán  y  ai  Gobernador  dol  Estado  de  Sinaloa  (al  cual  corresponde  esa  ciudad),  excitán- 
dolos íi  <)Uü  tomaran  las  mcsdidas  ordenadas  por  el  código  sanitario,  pai'a  la  extinción  de 
cualquiera  enfermedad  opidómica. 
•  Para  proceder  con  ordeh  en  la  enumei-ación  de  estas  medidas,  (istndiarí;:  Primero,  las  que 
se  dictai'on  contra  la  enl'ermedad  para  extinguiíla  caí  el  lugar  donde  apare(;ió;  segundo, 
las  destinadas  á  inif)cdir  su  propagación  por  la  vía  marítima,  y  pov  último,  las  que  debían 
«vitar  la  transmisión  por  la  vía  terrestre. 

III.    MEDIDAS    ADOPTADAS     PARA     EXTINGUJB     LA     ENFERMEDAD    DONDE    HABÍA     APARECIDO. 

Se  ordenó  á  la  autoridad  política  de  Mazatlán  que  hiciera  recordar  por  bando  la  obliga- 
ción que  tienen,  conforme  al  código  sanitario,  los  módicos,  los  padres  de  familia,  los  jefes 
de  talleres,  los  de  fábticas  y  los  directoics  de  escuelas  y  colegios,  de  hacer  la  declaración  de 
los  casos  de  peste  de  que  tuvieran  conocimiento. 

Las  autoridades  locales  ordenaron  desde  luego  la  visita  domiciliaria  para  descubrir  á  los 
enfermos  á  quienes  hubieran  ocultado  sus  deudos;  para  hacer  practicable  esta  medida  se 
dividió  la  ciudad  en  cuarteles  y  se  encargó  á  los  médicos  auxiliados  por  12.5  hombres  de 
policía  sanitaria,  que  hicieran  dicha  investigación.  A  la  vez,  y  en  cumplimiento  de  lo 
dispuesto  por  el  código  sanitario  federal,  se  hizo  obligatorio  el  aislamiento  de  los  enfermos 
en  un  lazareto. 

Para  hacer  más  efectivo  este  aislamiento,  se  arregló  el  lazareto  de  la  Isla  de  Belvedere, 
donde  se  estableció  un  departamento  para  recibir  á  los  enfermos  de  peste  confirmada,  otro 
aislado  del  anterior  para  los  sospechosos  de  tener  la  peste  bubónica  y  otro  para  los  conva- 
lecientes, destinándose  en  el  mismo  local  un  servicio  de  baños,  una  botica  y  una  habitación 
especial  para  los  practicantes,  así  como  para  el  personal  que  atendía  á  dicho  edificio. 

La  situación  del  lazareto  en  una  isla  hacía  fácil  y  seguro  el  aislamiento.  Mas  como  las 
personas  que  habían  estado  asistiendo  á  los  enfermos,  antes  de  llevarlos  al  lazareto,  podían 
tener  en  incubación  la  enfermedad,  se  estableció  un  campo  de  observación  en  las  lomas  del 
Velódromo,  situado  junto  á  la  playa  y  fuera  de  la  población. 

Este  campo  de  observación  consistía  de  una  serie  de  barracas  destinadas  á  alojar  á  las 
familias  de  los  pacientes,  atendiendo  á  su  subsistencia,  dejándolas  en  observación  durante 
diez  días  y  no  permitiéndoles  la  salida  de  dicho  campo,  sino  cuando  se  encontraban  en 
buena  salud,  después  de  la  terminación  de  dicho  plazo.  A  las  gentes  pobres,  á  su  salida,  se 
les  proporcionaba  ropa  nueva  y  cierta  cantidad  de  dinero. 

Como  en  los  barrios  pobres  del  puerto  de  Mazatlán  hay  grande  aglomeración  en  muchas 
casas,  se  ordenó  la  desocupación  del  excedente  de  habitantes  de  cada  una  de  ellas,  alojándo- 
los en  tiendas  de  campaña. 

í'  En  cumplimiento,  también,  del  código  sanitario  se  ordenó  la  desinfección  de  las  casas  que 
habían  ocupado  los  enfermos,  así  como  la  de  las  ropas  de  que  habían  hecho  uso,  y  cuando 
^stas  eran  de  poco  valor  se  quemaban. 

Para  el  servicio  de  desinfección  de  los  diferentes  cuarteles  de  la  ciudad,  se  nomljraron 
ocho  médicos  con  el  personal  necesario,  y  se  usaba  la  solución  de  bicloruro  de  mercurio  al 
uno  por  mil,  pulverizada  por  medio  de  bombas  impelentes,  sobre  los  techos,  las  paredes  y 
los  pisos  de  las  liabitaciones.  Cuando  estas  habitaciones  eran  de  poco  valor  y  especial- 
mente cuando  no  podían  desinfectarse  se  destruían  por  medio  del  fuego.  Más  de  375  casas 
han  desaparecido  de  esa  manera. 

Como  la  epidemia  había  sido  precedida  de  una  gran  mortandad  de  ratas  y  ratones,  se 
declaró  la  guerra  á  estos  animales  por  todos  los  medios  que  se  usan  ordinariamente,  entre 
los  cuales  se  empleaba  un  virus  destinado  á  producir  en  ellos  una  epizootia  que  no  podía 
transmitirse  á  los  hombres. 

Al  mismo  tiempo  las  autoridades  locales  ordenaban  la  limpieza  de  las  casas  y  hacían 
efectivo  el  barrido  de  las  calles,  el  completo  aseo  en  los  rastros  y  mercados,  procediendo  á 
la  extracción  y  después  á  la  incineración  de  las  basuras. 

La  circunstancia  de  que  jamás  se  había  presentado  la  peste  en  la  República  Mexicana, 
había  hecho  innecesario  que  se  tuvieran  preparados  los  sueros  curativo  y  preservativo  de 
a-quella  enfermedad;  pero  éstos  se  pidieron  inmediatamente  al  Instituto  Pasteur  en 
número  de  1,000  frascos  de  suero  de  Yersin  y  500  del  de  Hafkine,  aunque  otras  cantidades 
mucho  maj'ores  fueron  subsecuentemente  consumidas. 

IV.   MEDIDAS  PARA   EVITAR   LA  PROPAGACIÓN   DE   LA   EPIDEMIA  POR   LA   VÍA  MARÍTIMA. 

Como  se  acaba  de  decir,  la  peste  no  había  visitado  jamás  la  República  Mexicana.  Cuando 
en  los  últimos  años  invadió  de  nuevo  la  Europa  y  algunos  pueblos  de  la  América  del  Sur, 
se  hizo  necesario  adicionar  el  Reglamento  de  Sanidad  Marítima  con  un  capítulo  especial, 
destinado  á  proteger  nuestros  puertos  contra  la  invasión  de  la  peste,  pues  anteriormente  no 

1112a— 06 25 


386  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL, 

mencionaba  el  código  sanitario  esta  enfermedad,  por  creerlo  innece-sario.  Las  adiciones  al 
Capítulo  II  del  Reglamento  de  Sanidad  Marítima  destinadas  á  protegernos  contra  la  peste, 
se  promulgaron  en  30  de  mayo  de  1900.  Desde  entonces  so  tuvieron  en  vigor  y  nos  hubieran 
delendido  de  la  enfermedad,  si  las  autoridades  sanitarias  de  San  Francisco  no  hubieran 
ocultado  la  existencia  de  ella,  dando  patente  limpia  á  todas  las  embarcaciones  que  salían  de 
aquel  puerto.     Así  fué  como  la  peste  pudo  halier  llegado  á  Mazatlán. 

La  primera  medida  que  se  ordenó  al  delegado  del  consejo  de  .salubridad  en  el  puerto  de 
Mazatlán,.i'ué  la  de  que  anotara  las  patentes  de  sanidad,  diciendo  que  se  había  presentado 
allí  una  enfermedad  epidi^mica  que  se  sospechaba  ser  la  peste  bubónica.  Esta  declaración 
se  hizo  no  sólo  para  proteger  á  nuestros  puertos,  sino  también  á,  los  extranjeros  contra  las 
procedencias  de  Mazatlán. 

Las  medidas  destinadas  á  impedir  la  propagación  por  la  vía  marítima  pueden  dividirse  en 
dos  grupos:  (a)  las  que  se  habían  tomado  en  el  puerto  de  partida,  y  (o)  las  que  deberían, 
tomaise  en  los  puertos  de  llegada. 

(a)  Se  nonibió  una  comisión  de  médicos  que  expidieran  pasaportes  de  sanidad  á  las  per- 
sonas que  llegaran  al  puerto  con  objeto  de  cmbarcaise,  evitando  así  que  pudiera  ir  á  bordo 
algún  individuo  enfermo  ó  sospechoso  de  llevar  la  peste.  Esta  comisión  estuvo  también 
encargada  de  desinfectar  los  equipajes  de  los  pasajeros  y  las  mercancías  c{ue  se  embarcaran: 
y  al  delegado  sanitario  en  el  puerto  se  le  ordenó  que  hiciera  la  destiucción  de  las  ratas  y 
ratones  en  los  buques  que  zarpaian;  con  estas  precauciones  se  tenía  ya  gran  seguridad;  mas 
para  confomiaise  á  las  piesoripciones  de  nuestro  reglamento  de  sanidad  maiítima  y  de  sus 
adiciones,  se  recordaion  á  todos  los  delegados  en  los  puertos  del  Pacífico  las  reglas  á  que  me 
voy  á  referir. 

(b)  Los  puertos  del  litoral  del  Pacífico  son  muy  numerosos  y  como  algunos  de  ellos  ncv 
tienen  médico  delegado — que  es  la  autoridad  sanitaria  encargada  de  practicar  la  visita 
médica  de  los  buques  y  la  que  ha  de  dirigir  las  operaciones  de  desinfección — estos  puertos, 
que  son  de  escasa  importancia  comercial,  se  cerraron  para  todo  tiáfico  directo  con  Mazatlán; 
señalándose  paia  él  los  puertos  de  Guaymas,  San  Blas,  Manzanillo  y  Acapulco,  pero  sujetán- 
dose á  las  prescripciones  legales  antes  mencionadas  y  que  se  pueden  resimiir  como  sigue: 

Los  buques  deberían  detenerse  en  la  bahía,  en  un  fondeadero  especial  destinado  á  las 
embarcaciones  sospechosas;  á  su  costado  se  acercaiían  los  delegados  de  sanidad,  para, 
ordenar  una  detención  de  diez  dí£s  contados  desde  la  salida  del  buque  del  pueito  infec- 
tado. Esta  detención  tenía  por  objeto  cerciorarse  de  que  en  ningún  pasajero  ó  tripulante  se 
había  desarrollado  la  enfermedad.  Mientras  duraba  esta  observación,  se  hacía  la 
desinfección  de  las  ropas  de  uso  y  de  los  equipajes  de  los  pasajeros,  y  en  las  bodegas  la 
desinfección  de  la  carga  y  la  destrucción  de  las  ratas  y  ratones  por  medio  del  ácido  sulfuroso, 
quemándose  el  azufre  en  la  proporción  de  40  gi-amos  por  cada  metro  cúbico  de  capacidad  de 
la  bodega,  dejándose  ésta  cerrada  herméticamente  por  el  espacio  de  veinticuatro  horas. 
Entre  tanto,  se  hacía  la  desinfección  de  los  pisos  del  buque  por  medio  de  una  solución  de 
bicloruro  de  meicurio  al  uno  por  mil  ó  de  ácido  fénico  al  5  por  ciento.  Sólo  los  objetos 
que  debían  ser  desinfectados  en  su  superficie  se  trataban  por  kiS  vapores  de  la  formaldchida. 
Terminadas  estas  operaciones,  para  comenzar  la  descarga,  el  delegado  registraba  bulto  por 
bulto  de  las  mercancías,  hasta  cercioiarse  de  que  los  envases  no  llevaban  ratas  ó  ratones  y 
de  que  no  estaban  agujereados.  Si  alguno  de  ellos  se  encontraba  en  estas  condiciones,  era 
de  temerse  que  estos  roedores  estuvieran  en  el  interior  del  bulto,  y  entonces  se  le  abría  para 
convencerse  de  la  verdad,  y  se  disponían  los  bultos  de  manera  que  al  saltar  los  ratones 
cayeran  en  el  agiia  hirviendo,  de  la  que  no  deberían  ser  extraídos  sino  por  medio  de  pinzas. 
Tomados  con  ellas  se  les  untaría  de  petróleo  para  quemarlos. 

Si  los  buques  hubieren  Uegado  con  enfermos  ó  si  la  peste  se  hubiere  desarrollado  á  bordo 
durante  los  diez  días  de  observación,  deberían  haber  pasado  al  puerto  de  Acapulco,  donde 
existe  un  lazareto  con  las  condiciones  apropiadas  para  recibir  á  los  enfermos  de  peste,  de 
cólera  ó  de  fiebre  amarilla. 

Si  el  destino  final  del  buque  no  era  alguno  de  los  cuatro  puertos  mencionados,  después  de 
terminados  los  diez  días  de  observación,  y  de  practicadas  las  operaciones  de  desinfección,  el 
delegado  les  expedía  un  certificado  en  que  constaban  los  hechos  anteriores,  y  con  este  docu- 
mento podían  arribar  á  cualesquiera  de  los  puertos  del  litoral  del  Pacífico. 

Para  facilitar  la  llegada  de  víveres  á  Mazatlán,  de  sustancias  para  la  desinfección  ó  de  otros 
objetos  de  que  se  necesitara,  se  expidieron  pennisos  especiales  por  el  Consejo  Superior  de 
Salubridad  á  determinados  buques,  á  fin  de  que  llevaran  dichos  efectos  á  Mazatlán,  pero  sin 
entrar  al  puerto.  En  esos  casos  el  buque  se  detenía  en  alta  mar,  llegaba  hasta  él  la  embar- 
cación que  conducía  al  delegado  sanitario  y  recibía  los  objetos  de  á  bordo,  no  permitiendo 
que  las  gentes  de  tierra  comunicaran  con  las  del  buque;  y  expedía  un  certificado  en  que  se 
declaraban  todos  estos  hechos,  y  el  buque  podía  volver  al  lugar  de  su  partida  ó  á  cualquiera 
otro  puerto,  sin  quedar  sometido  á  ninguna  prescripción  cuarentenaria. 

Estas  medidas  fueron  tan  eficaces,  que  ni  un  sólo  caso  de  la  peste  se  desarrolló  en  las 
embarcaciones,  ni  fué  llevada  á  ningún  otro  puerto,  en  el  espacio  de  seis  meses  que  duró  la 
epidemia. 


SEGUNDA    CONFERENCIA    SANITAItlA    JNTKRNACfONAL.  W7 

V.    MEDIDAK    DESTINADAS    A    UVITAH    I,A    IMlOrAOACIÓX    DE    LA    PKSTr',    I'OH   TJKRKA. 

El  inoxlio  más  eficaz  do  (Jct(!ncr  una  opidciiua,  es  disminuir  el  número  de  liabitanles  de  la 
población  en  donde  existe,  pues  se  comprende  que  se  disií)inuye  el  elemento  cjue  da  pábulo  á 
la  propagación  de  la  onrermedad.  La  administración  pública  no  puede  ordenado  sino  en 
poblaciones  muy  reducidas;  peco  en  el  caso  actual,  el  vecindario  fl(!  Mazatlán  salió  de  allí,  y 
se  hace  subir  á  más  de  8,001)  el  número  de  personas  que  emigraron;  mas  es  indispensablr;  que 
al  haceívso  la  evacuación  de  una  ciudad,  los  emigrantes  no  lleven  el  contagio  en  sus  peisonas 
ni  en  sus  equipajes.     Para  evitai'  (ísLe  peligro  se  arloptaron  las  niculidas  siguientes: 

Se  nombi'ó  una  comisión  do  médicos  ()ue  examinaban  á  las  pcirsonas  (jue  d(íscaban  ó  inten- 
taban salir  de  Mazatlán;  si  las  encontraban  sanas  les  exi)edían  un  pasaporte  en  fjue  consta- 
ban su  nombre  y  su  apellido,  el  estado  de  su  salud  y  lugar  de  su  destino.  Esta  comisión 
daba  una  noticia  semejante  á  las  autoridades  del  lugar  á  donde  se  dirigían  los  pasajeros  y 
consignaban  en  un  registro  estos  datos. 

En  los  caminos  (jue  parten  de  Mazatlán  (no  hay  aún  ferrof;arriles)  para  otros  puntos  del 
Estado  de  Sinaloa  y  de  los  estados  y  territorios  que  i'odean  á  éste  y  en  los  lugares  más 
transitados,  se  establecieron  estaciones  sanitarias  que  constaban  de  un  departamento  para 
los  que  llegaban  con  la  enfermedad  confirmada;  de  otro  destinado  á  los  eniermos  en  quienes 
solamente  se  sospechaba  que  estuvieran  ata(;ados  de  la  peste;  de  un  tercero  en  doncíc  se 
alojarían  los  convalecientes;  do  un  departamento  de  baños;  de  otro  para  Ja  estufa  de  desin- 
fección; de  una  cámara  destinada  á  la  i'mnigación  de  las  mercancías  por  el  ácido  sulfuroso,  y 
por  último  de  las  habitaciones  para  el  personal. 

Estas  estaciones  estaban  dirigidas  por  un  médico  higienista. 

Además  de  esto,  se  estableció  una  segunda  zona  de  estaciones  sanitE^rias  á  cierta  distancia 
de  la  primera;  y  los  estados  limítrofes  al  de  Sinaloa  establecieron  también  estaciones  sani- 
tarias dispuestas  de  esta  manera;  dos  en  el  Territorio  de  Tepic,  dos  en  el  Estado  de  Jalisco, 
tres  en  el  de  Durango  y  una  en  el  de  Sonora. 

La  defensa  por  tieri'a  quedó  establecida  como  sigue: 

En  primer  lugar,  se  hacía  la  inspección  por  la  comisión  de  médicos  de  Mazatlán,  de  todas 
las  personas  que  pretendían  ^alirde  la  ciudad;  si  alguno  de  los  viajeros  se  enfermaba  antes 
del  segundo  día  de  su  salida,  encontraría  la  primera  estación  sanitaria:  si  la  enfermedad 
se  definía  entre  el  segundo  y  el  cuarto  día,  sería  detenido  en  la  segunda  zona,  y  si  hubiera 
aparecido  la  enfermedad  al  salir  el  viajero  del  Estado  de  Sinaloa,  hubiera  sido  detenido  en  las 
estaciones  de  los  estados  limítrofes;  pero  si  aun  en  caso  de  incubación  tardía,  la  enfermedad 
estallaba  antes  del  décimo  día,  el  pasajero  quedaría  vigilado  por  las  autoridades  del  lugar  de 
su  destino,  las  que  habían  sido  anticipadamente  prevenidas  por  la  comisión  de  médicos  de 
Mazatlán. 

Se  cree  que  salieron  más  de  8,000  personas  de  Mazatlán,  en  un  espacio  de  tiempo  relativa- 
mente corto,  y  entonces  se  comprende  que  muchas  se  escaparon  de  la  inspección  en  Mazatlán 
y  evitaron  las  estaciones  sanitarias,  y  así  se  explica  que  se  haj^an  dado  algunos  casos  en  tres 
pueblos  de  que  luego  me  ocuparé;  pero  un  miniero  tan  limitado  de  per-sonas,  que  se  puede 
decir,  sin  peligro  de  exageración,  que  la  peste  quedó  concentrada  en  Mazatlán,  y  que,  por 
consiguiente,  las  medidas  adoptadas  para  impedir  la  propagación  por  la  vía  terrestre,  alcan- 
zaron el  resultado  que  de  ellas  se  esperaba. 

VI.   LUGARES   Á    DONDE    SE   PROPAGÓ    LA    EPIDEMIA   DE   MAZATLÁN. 

Una  aldea  de  400  habitantes,  llamada  " Oso "  y  situada  en  la  margen  izquierda  del  Río  de 
"El  Fuerte, "  fué  el  lugar  de  un  pequeño  foco  que  se  produjo  de  esta  manera:  Una  familia  de 
Mazatlán  salió  de  allí  en  24  de  enero,  y  el  27,  al  llegar  al  pueblo  de  Elota,  se  enfeimó  una 
niña;  para  evitar  la  estación  sanitaria  establecida  en  ese  lugar,  la  familia  huyó  para  "Oso" 
á  donde  llegó  siete  días  después;  allí  murió  la  niña  contagiando  á  la  madre,  y  ésta  á  la  abuela, 
y  las  dos  sucunibieron  también.  Inmediatamente  que  se  tuvo  conocimiento  de  este  hecho  se 
envió  un  médico  de  Culiacán,  capital  del  Estado  de  Sinaloa,  quien  pudo  comprobar  que  el 
enfermo  á  quien  alcanzó  aún  con  vida,  tenía  la  forma  neumónica  de  la  peste.  La  enfermedad 
se  propagó  á  tres  personas  más;  pero  como  se  aisló  á  todos  los  enfermos  v  á  las  personas  que 
los  asistían;  como  se  destruyei-on  por  el  fuego,  no  solamente  las  ropas  y" objetos  que  habían 
podido  infectar,  sino  también  las  casas  que  habitaron;  como  se  vacunó  á  todos  los  individuos 
que  estaban  en  peligro  de  contagio,  por  medio  del  suero  de  Yersin,  que  era  el  único  de  que  se 
podía  disponer  entonces,  y  como  se  hizo  la  destrucción  de  ratas  y  ratones  de  todas  las  casas 
contiguas,  la  epidemia  se  evitó  definitivamente  en  aquel  lugar. 

Debo  advertir  que  la  aldea  de  Oso,  que  está  situada  como  á  107  kilómetros  de  Mazatlán,  es 
el  pueblo  más  distante  que  alcanzó  la  enfermedad. 

La  aldea  de  Villa  Unión,  situada  á  26  kilómetros  al  sudeste  de  Mazatlán,  fué  invadida  por 
las  familias  que  emigraban  del  puerto,  cuando  allí  se  declaró  la  epidemia;  y  á  las  relaciones 
frecuentes  que  conservaron  con  el  puerto  se  debe  la  aparición  de  otro  foco,  c"n  donde  se  enfer- 
maron otras  siete  personas,  habiendo  acaecido  una  sola  defunción.     Apenas  se  descubrió  al 


388  SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL. 

primer  enfermo,  se  enviaron  médicos,  estufas  de  desinfección,  desinfectadores,  y  se  hizo  el 
aislamiento  de  los  enfermos,  el  de  los  sospechosos  y  el  de  los  convalecientes;  se  estableció, 
como  en  Mazatlán,  un  campo  de  observación  para  aislar  á  las  familias  de  los  apestados,  se 
dostruj'cron  las  oixsas  que  habitaron  los  enfermos,  se  pei-siguió  á  las  ratas  y  la  epidemia  se 
sofocó.  Dos  facto;-es  importantes  contribuyeron  á  este  resultado:  fué  el  "primero,  que  se 
estableció  una  orn;anización  sanitaria  semejante  á  la  de  Mazatláa:  el  segundo,  la  vacunación 
por  medio  de  la  vacuna  de  Besredka,  á  personas  que  estaban  645  en  condiciones  de  poder 
adquirir  la  enfermedad. 

Otra  aldea,  llamada  Siqueros,  situada  á  34  kilómetros  de  IMazatlán,  y  á  15  de  Villa 
Unión,  recibió  los  emigrantes  de  esta  última  población,  y  con  ellos  la  enfermedad;  pero  se 
acumularon  en  aquel  nuevo  foco  los  mismos  elementos  de  combate  que  en  Mazatlán  y  que 
en  Villa  Unión,  y  aun  cuando  se  dieron  9  casos,  con  6  defunciones,  también  alh  se  extinguió 
la  epidemia. 

Antes  de  terminar  la  serie  de  medidas  que  se  tomaron  para  evitar  la  propagación  de  la 
epidemia  por  la  visi  terrestre,  debo  mencionar  un  recurso  que  contribuyó  eficazmente  á 
evitar  la  emigración  de  los  enfermos  y  fué  la  organización  de  una  brigada  volante  de  policía 
sanitaria,  acompañada  de  una  ambulancia  y  dirigida  por  un  módico,  que  recorrí  a  los  caminos 
y  .visitaba  los  pequeños  poblados,  haciendo  una  vigilancia  muy  eficaz. 

vil.   CONFIRMACIÓN  DE   LA   NATUEALEZA   DE   LA   ENFERMEDAD. 

Üomo  dijimos  al  principio,  el  Consejo  Superior  de  Salubridad  estableció  el  combate  contra 
la  peste,  fundándose  en  los  datos  clínicos  de  la  enfermedad;  pero  el  estado  actual  de  la 
ciencia  exige  que  se  haga  la  comprobación  bacteriológica,  para  confirmar  su  naturaleza. 
Con  este  fin  el  mismo  Consejo  envió  al  Dr.  Octaviano  González  Fabela,  distinguido 
bacteoriologista  de  la  corporación,  provisto  del  arsenal  suficiente  y  de  pequeños  animales, 
para  hacer  el  estudio  fundado  en  la  experimentación.  El  mencionado  doctor  tan  pronto 
como  llegó  á  Mazatlán,  hizo  el  estudio  clínico  de  un  enfermo  que  tenía  la  forma  neumónica 
de  la  peste,  recogió  el  esputo  y  el  hquido  del  tejido  periganglionar  de  un  bubón,  y  pudo 
comprobar  la  existencia  del  bacilo  de  Yersin.  Con  el  cultivo  de  este  bacilo  puro,  inoculó  á 
unos  "  cu3'0s"  que  poco  tiempo  después  presentaron  los  caracteres  de  la  enfermedad  experi- 
mental. El  Consejo  Superior  de  Salubridad,  al  recibir  este  diagnóstico  por  la  vía  telegráfica 
el  31  do  diciembre,  hizo  la  declaración  pública  de  que  la  epidemia  que  se  había  desarrollado 
en  el  puerto  de  Mazatlán,  era  la  peste  bubónica,  y  as.'  lo  comunicó  á  las  autoridades  federales 
de  la  República,  á  las  de  los  Estados,  á  todos  los  delegados  sanitarios  en  los  puertos,  á  las 
autoridades  sanitarias  de  los  Estados  Unidos  y  al  Comité  Internacional  de  las  Repúblicas 
Americanas,  que  reside  en  Washington.     J 

VIII.    NÚMERO   DE   CASOS    T   DE    DEFUNCIONES. 

El  número  de  casos  de  que  tuvo  conocimiento  la  autoridad,  fué  351  y  el  de  defimciones 
296,  desde  el  día  13  de  diciembre  de  1902  hasta  el  15  de  mayo  de  1903.  El  número  de 
defunciones  es  enteramente  exacto,  porque  conforme  á  las  leyes  de  México,  no  ss  puede 
proceder  á  la  inhumación  de  un  cadáver  sin  el  certificado  del  registro  civil,  en  donde  se 
hace  constar  la  causa  de  la  muerte.  No  sucede  lo  mismo  con  el  número  de  casos  de  la 
enfermedad,  pues  ha  sucedido  en  Mazatlán  lo  que  en  todas  partes  del  mundo;  esto  es,  que 
se  ocultan  muchos  casos  para  evitar  que  los  enfermos  sean  trasladados  al  lazareto.  El 
número  de  ocultaciones  de  enfermos  disminuyó  notablemente  desde  que  se  establecieron 
las  visitas  domiciliarias  y  una  vigilancia  incesante  en  todas  las  casas  de  la  población.  El 
temor  de  la  gente  pobre  é  inculta,  de  ser  conducida  al  lazareto,  indujo  á  algunos  desgra- 
ciados á  salirse  de  la  población  y  á  otros  se  les  recogió  en  los  caminos,  enfermos,  para  con- 
ducirlos al  lazareto;  esto  explica  la  diferencia  entre  los  casos  registrados  y  las  defunciones. 

El  niayor  número  de  casos  que  llegó  á  haber  en  una  semana  fué  de  65,  y  el  mayor  de 
defunciones  de  56.  El  decrecimiento  fué  rápido  y  bien  acentuado  hasta  la  completa 
desaparición  de  la  epidera'~= 

TY.   MEDIDAS   DESTINADAS   Á    IMPEDIR   LA   REAPARICIÓN    DE   LA    ENFERMEDAD. 

Oomo  no  bastó  que  hubiera  desaparecido  la  epidemia,  para  que  cesará  todo  peligro,  fué 
indispensable  dictar  una  serie  de  medidas  destinadas  á  impedir  su  reaparición.  El  carácter 
de  esta  memoria  no  me  permite  entrar  en  detalles  y  me  conformaré  con  indicar  las  medidas 
principales  que  se  han  adoptado  para  tal  fin. 

En  primer  lugar,  se  conservaron  las  visitas  domiciliarias,  muy  especialmente  en  las  casas 
que  fueron  ocupadas  por  los  primeros  enfermos  cuando  aún  no  se  había  establecido  la 
naturaleza  de  la  epidemia.  Esta  visita  se  repitió  también  en  las  casas  en  donde  estuvieron 
los  enfermos  con  diagnóstico  confirmado,  y  en  todas  las  contiguas  y  en  las  que  estuvieron 
habitadas  por  personas  que  tuvieron  contacto  directo  ó  indirecto  con  las  víctimas.     En  todas 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  889 

estas  casas  se  hizo  la  desinfección  por  scíjunda  vez  y  las  aue  eran  de  poco  valor  se  destruyeron 
por  el  fueí!:o,  ai  aquella  operación  no  podía  llevarse  á  cabo  de  una  mano.rn  satisfactoria.  La 
desinfección  do  las  ropas  encontradas  en  todas  las  casas,  se  liizo  también  y  se  rejiitió  la  de 
las  que  so  hallaban  depositadas  en  las  casas  de  préstamos,  conocidas  con  el  nombre  de 
empeños.  So  continuó  la  limpieza  esmerada  de  las  calles,  de  los  rastros,  de  los  mercados 
y  de  los  lufjares  de  reunión,  así  como  la  destrucción  de  las  basuras  por  el  fuego.  Antes  de 
la  reapertura  de  las  escuelas,  que  habían  sido  clausuradas  al  comenzar  la  epidemia,  .se 
desinfectaron  los  locales,  y  para  permitir  los  sei-vicios  religiosos,  se  exigió  &  las  personas  que 
asistían  á  los  templos,  que  se  presentaran  con  ropas  limpias  previamente  desinlectadas,  y  con 
certificado  do  haberse  bañado.  Se  continuó  la  destrucción  de  las  ratas  y  ratones  á  las  que 
se  había  declarado  guerra  sin  tregua  durante  toda  la  epidemia,  hasta  c|ue  una  comisión 
especial,  encargada  de  hacer  el  estudio  bacteriológico  de  la  sangre  y  de  otros  tejidos  de  los 
roedores, '  hubo  demostrado  que  no  estaban  ya  infectados  de  la  peste.  Esta  comisión 
continuó  sus  trabajos  por  cerca  de  un  año.  Continuó  en  ejercicio  activo  la  comisión  de 
médicos  que  expedían  los  certificados  de  sanidad  á  todos  los  viajeros  que  salían  de  Mazatlán, 
y  que  se  encargó  de  la  desinfección  de  sus  ropas  y  equipajes  y  de  la  de  las  mercancías 
enviadas  por  mar  ó  por  tierra.  Continuaron  también  funcionando  por  algún  tiempo  las 
estaciones  sanitarias,  ya  perfeccionadas  en  su  servicio,  que  fueron  establecidas  alrededor 
de  Mazatlán,  y  hacían  la  vigilancia  tanto  de  los  pasajeros  y  mercancías  que  salían  del 
puerto,  como  de  la  de  los  que  volvían  á  él  y  que  habían  emigrado  durante  el  curso  dcí  la 
ej^idcmia. 

En  los  pueblos  en  que  se  dieron  los  casos  de  peste,  que  he  mencionado,  se  siguieron 
tomando  las  mismas  precauciones  que  en  Mazatlán. 

La  exterminación  de  las  ratas  se  aconsejó  no  sólo  en  los  lugares  que  fueron  invadidos, 
sino  que  también  se  llevó  á  cabo  en  muchas  ciudades  de  la  Eepública,  y  especialmente  en 
la  de  Culificán,  que  se  encuentra  como  á  240  kilómetros  de  Mazatlán,  se  hicieron  perecer 
más  de  35,000  ratas. 

Estas  medidas  nos  penniten  asegurar  que  la  peste  no  reaparecerá  en  Mazatlán,  ni  en 
ningún  otro  punto  del  territorio  mexicano. 

Como  se  ve,  esto  no  corresponde  al  año  de  1£04,  pues  no  ha  vuelto  á  presentarse  ningún 
caso  de  esa  enfermedad  después  de  su  desaparición  en  mayo  de  K03;  pero  me  ha  parecido  de 
interés  introducirla  en  este  ini'orme,  para  que  llegue  á  conocimiento  de  todos  los  señores 
delegados.  * 

Como  anexo  No.  3,  va  un  cuadro  de  la  morbilidad  y  mortalidad  por  peste  bubónica 
en  el  puerto  de  Mazatlán. 

II.  FIEBRE  AMARILLA. 

Después  de  la  grave  epidemia  que  se  extendió  del  Estado  de  Veracruz  por  el  interior 
del  litoral  á  los  de  Tamaulipas,  Nuevo  León,  San  Luis  Potosí,  á  algunas  poblaciones  del  de 
Coahuila,  á  una  del  Estado  de  Hidalgo,  al  deOaxaca  y  al  de  Yucatán,  se  logró  extinguirla 
completamente  en  todos  los  lugares  situados  al  Norte  del  paralelo  que  pasa  por  Veracruz, 
de  modo  que  al  comenzar  el  año  de  K04  no  existía  más  que  en  el  mismo  Estado  de  Veracrua, 
en  una  parte  del  de  Oaxaca  y  en  el  de  Yucatán,  como  podrá  verse  en  el  cuadro  que  acompaño 
marcado  con  el  No.  4. 

La  vigorosa  campaña  que  se  ha  seguido  haciendo,  y  cuyo  detalle  consta  en  el  cuadro 
No.  5,  puede  resumirse  en  el  siguiente  informe,  al  que,  por  su  brevedad,  puedo  dar  lectura: 

Para  que  la  fiebre  amarilla  se  transmita,  se  necesita  la  reunión  de  estos  tres  elem.entos: 
Enfermo  de  fiebre  amarilla,  mosquito  del  género  Siegoviyia  que  pique  al  enfermo  y  persona 
no  inmune  que  reciba  el  piquete  del  mosquito. 

El  problema  para  combatir  la  fiebre  amarilla,  consiste,  pues,  en  disociar  estos  tres  elemen- 
tos y  voy  á  exponer  la  manera  con  que  realizamos  la  resolución  del  problema,      i^;.  1-=.. 
■fo-,.  , 

I.    AISLAMIENTO    DEL    ENFERMO. 

Para  poder  aislar  un  enfermo,  lo  primero  que  se  necesita  es  saber  que  existe,  y  para 
encontrarlo,  procedemos  de  la  manera  siguiente :  En  cada  población  en  donde  existe  la  fiebre 
amarilla  ó  se  teme  que  se  desarrolle,  organizamos  una  brigada  sanitaria.  Una  parte  de  ella 
se  ocupa  de  levantar  el  padrón  de  todas  las  personas  no  inmunes  que  existan  en  dicha 
localidad.  En  este  padrón  se  hace  constar  el  nombre,  edad,  sexo  y  nacionalidad  de  cada 
persona  y  el  lugar  de  s^i  residencia.  Los  agentes  sanitaiics  que  forman  este  grupo  de 
la  bridada,  se  dividen  la  ciudad  ó  pueblo  en  donde  se  hace  el  comibate  contra  la  fiebre 
amarilla,  de  manera  de  poder  visitar  diariamente  á  las  personas  no  inmunes.  Cuando  se 
encuentra  una  de  éstas,  con  fiebre,  cualouiera  que  sea  la  causa  que  produzca  esa  fiebre,  se 
le  aisla  inmediatamente  en  el  Hospital  Civil,  en  el  Hospital  Militar  ó  en  la  Casa  de  Salud  v 
se  le  tiene  en  observación  en  una  sala  que  tenga  sus  ventanas  provistas  de  alambrado  fino 
que  impida  la  entrada  de  los  mosquitos  y  una  doble  puerta,  también  de  alambrado,  dispuesta 
de  manera  que  cuando  se  abra  la  puerta  exterior  se  cierre  forzosamente  la  de  afuera.     Esto 


390  SEGUNDA    CONFERENCIA    SANIT.UÍIA    INTERNACIONAL. 

se  consigue  por  medio  de  una  cadena  de  cierta  longitud  que  ligue  las  dos  puertas.  Este 
medio  es  mucho  más  eñcaz  que  el  de  cubrir  las  camas  con  pabellón,  porque  éste  tiene  que 
abrirse  ñ-ecuentemente  para  observar  al  enfermo,  para  darlo  las  medicinas,  los  alimentos, 
etc.,  y  cada  vez  que  se  abre  el  pabellón,  so  corre  el  poligro  de  que  entre  un  mosquito  ó  de 
que  cuando  el  pabellón  esté  aplicado,  por  accidente,  ai  cuerpo  del  enfermo,  el  mosquito 
lo  pique  á  través  de  él;  mientras  que  estando  en  un  cuarto  de  donde  se  han  sacado  previa- 
mente los  mosquitos  y  íi  donde  no  puedan  volver  á  entrar,  el  contacto  con  el  elemento 
transmisor  se  hace  verdaderamente  imposible.  Otra  ventaja  que  tiene  este  medio  de  aisla- 
miento, es,  que  se  pueden  tener  en  la  misma  sala  á  un  enfermo  conlirraado  ya  de  fiebre 
amarilla  y  otro  sospechoso  de  tenerla,  sin  que  este  segundo  esté  expuesto  á  contraer  la 
enfermedad. 

Como  se  acaba  de  ver,  en  nuestro  plan  de  campaña  no  esperamos  á  que  se  confirme  la 
existencia  de  la  fiebre  amarilla,  sino  que  aislamos  al  enfermo  desde  el  día  que  aparece  la 
fiebre  y  por  consiguiente  lo  secuestramos  durante  los  tres  primeros  días  que  son  los  peligrosos 
para  inl'ectar  á  los  mosquitos.  La  experiencia  nos  ha  demostrado  la  eficacia  de  la  manera 
con  que  procedemos  al  aislamiento  de  los  enfermos. 

II.    DESINFECCIÓN    DE    LAS    HABITACIONES   OCUPADAS   POR    EL   ENFERMO. 

En  el  tiempo  que  transcurre  entre  el  momento  en  que  una  pereona  contrae  la  fiebre 
amarilla  y  aquel  en  que  la  descubren  nuestros  agentes,  puede  ser  picada  por  los  mosquitos, 
infectaree  éstos  y  estar  aptos  para  transmitir  la  enfermedad.  Para  evitar  este  peligro  pro- 
cedemos á  la  desinfección  de  la  habitación,  tan  pronto  como  la  desocupa  el  enfermo.  La 
desinfección  en  este  caso  no  tiene  más  que  un  sólo  objeto,  la  destrucción  de  los  mosquitos. 
Para  conseguiíla,  cerramos  á  la  manera  ordinaria  el  cuarto,  cubrimos  todas  las  rendijas  con 
papel  manila  engrudado  y  después  de  hecha  esta  operación  se  procede  á  quemar  el  azufre 
en  la  proporción  de  20  gramos  por  cada  metro  cúbico  de  capacidad,  pero  dispuesto  el 
azufre  en  capa  muy  extendida  para  que  no  deje  de  quemarse  toda  la  cantidad  que  se  ha 
colocado.  En  esta  práctica  que  es  tan  común  y  conocida  hemos  introducido  otra  innova- 
ción que  me  importante  y  es  ésta:  Como  es  muy  difícil  saber  si  la  desinfección  ha  sido  eficaz, 
colocamos  en  el  lugar  más  apartado  del  cuarto  mosquitos  no  iní  ectados,  que  hemos  tomado 
en  el  exterior  de  la  pieza  y  que  colocamos  en  un  tubo  abierto  ó  cenado  solamente  por  una 
tela  burda  para  que  peí  mita  la  introducción  del  ácido  sulfuroso  y  no  la  salida  del  mosquito. 
Estos  mosquitos  nos  sirven  de  testigo.  Si  al  tei minar  la  desinlección  estos  mosquitos  que 
estaban  en  condiciones  desfavorables  para  sufrir  la  acción  del  ácido  sulíuroso  se  encuentran 
muertos,  tendremos  la  prueba  de  que  han  muerto  todos  los  de  más  en  el  mismo  cuarto  y  en 
condiciones  más  favorables  para  recibir  el  ácido  sulíuroso.  Si  por  el  contrario  están  vivos, 
es  la  prueba  que  la  desinfección  no  fué  bien  ejecutada  y  habrá  que  repetirla. 

Ya  en  la  reunión  pasada  expliqué  la  manera  de  hacer  la  desinlección  en  las  chozas  que  en 
nuestro  país  se  llaman  "jacales."  No  tendré  que  repetirla  ahora,  y  que  me  baste  solamente 
consignar  este  hecho,  c¡ue  no  hay  ninguna  habitación  que  no  pueda  ser  perfectamente  pri- 
vada del  mosquito. 

Para  desinfectar  los  coches  Pullman,  los  carros  de  ferrocarril  ó  los  espacios  muy  limitados 
en  donde  hay  objetos  delicados  que  se  puedan  alterar,  empleamos  la  lormaldehida. 

En  los  almacenes  de  ropa  en  donde  el  azufre,  el  piretro  y  hasta  la  formaldehida  pueden 
alterar  los  colores  de  las  mercancías,  hemos  empleado  ya  el  ácido  cianhídrico  cuyo  resultado 
es  tan  eficaz  como  el  del  azufre  y  que  no  tiene  los  inconvenientes  de  éste  para  averiar  las 
mercancías;  pero  que  en  cambio  no  puede  ser  empleado  sino  por  personas  muy  hábiles  en 
su  manejo. 

III.    DESTRUCCIÓN    DE   LAS   LARVAS   DE   LOS   MOSQUITOS. 

Otro  grupo  de  la  brigada  de  los  agentes  sanitarios  se  ocupa  de  visitar  día  á  día  y  casa  por 
casa  los  depósitos  de  agua  cjue  sirven  para  el  consumo  de  cada  familia.  Si  el  depósito  se 
encuentra  con  larvas,  se  le  vacía  y  el  lugar  en  donde  el  agua  se  derrama,  se  cubre  de  petróleo; 
se  lava  el  depósito  restregando  el  interior  de  manera  de  no  dejar  ninguna  larva  viva;  se  le 
llena  de  agua  pura  y  se  le  cubre  con  una  tapa  unida  ó  de  malla  de  alambre,  ó  con  una  capa 
de  petróleo.  Todos  los  otros  depósitos  de  agua  se  cubren  de  petróleo,  cualquiera  que  sea 
la  extensión  que  tengan  y  aun  cuando  sean  muy  pequeños. 

Como  se  acaba  de  escuchar,  las  prácticas  en  las  cuales  hemos  introducido  innovación 
sobre  la  manera  con  que  se  procede  en  otros  países  es  la  siguiente: 

I.  Formar  el  padrón  de  los  no  inmunes. 

II.  Hacerles  visita  domiciliaria  cada  día,  para  poder  descubrir  un  enfermo  el  mismo  día 
en  que  comienza  la  enfermedad. 

III.  No  usar  de  los  pabellones  porque  su  aplicación  para  el  aislamiento  es  ineficaz,  sino 
poner  desde  luego  á  los  enfermos  en  salas  que  tengan  sus  ventanas  alambradas  y  sus  puertas 
dobles,  también  alambradas. 


SEGUNDA    CÜNFEKEJSKJIA    SANI'l'AUiA    INTEUNAGION AL.  ¿J^l 

IV.  Para  convencernos  d(!  qia;  la  desinfección  lia  sido  eficaz,  colocamos  mosquitos  t(!stigo8 
«n  condiciones  muy  desfavorables  para  que  puedan  ser  alcanzados  por  la  acción  del  desin- 
fectante. Si  al  terminar  la  prueba  estos  mosquitos  están  muertos,  podemos  asegurar  que 
la  desinfección  estuvo  bien  hecha. 

V.  Que  tenemos  medio  de  hacer  imposible  el  escape  de  los  mosquitos  de  la  habitación 
que  so  desinfecta,  aun  cuando  esta  habitación  sea  una  clioza  que  ten^a  sus  paredes  y  techfjs 
construidos  de  rama  ó  do  zacate  ó  cual(|uiera  otro  matísrial  permeable. 

Para  impedir  f|uc  la  enfermedad  atafjue  á  una  población  en  donde  hay  Siegomyia, hemos 
procedido  de  esta  manívra: 

En  toda  pol)la(';ón  de  esta  última  clase  establecemos  una  inspección  á  la  llefjada  de  los 
trenes  y  en  aquellas  otras  por  donde  llegan  los  pasajeros  que  caminan  en  automóvil,  en 
coche,  á  caballo  ó  aun  á  pie.  Se  examina  á  todos  los  pasajeros  que  se  lian  de  cjuedar  en 
la  localidad  y  se  les  tiene  en  observación  bajo  la  vigilancia  de  nuestras  brigadas  sanitarias 
6  de  policía  liasta  (|ue  han  transcurrido  (;inco  días  después  de  su  llegada.  En  los  lugares 
ya  invadidos  por  la  íiel)rc  amarilla,  se  hace  la  misma  inspección  con  todos  los  pasajeros  que 
parten  por  los  trenes  de  ferrocairil  y  se  impide  que  se  embarquen  los  (jue  están  enfermos  y 
que  siendo  no  inmunes  tienen  fiebre.  Como  pudiíiran  emijarcarse  en  las  estaciones  inter- 
medias, pasajeros,  hacemos  viajar  incesantemente  agentes  sanitarios  en  los  ferrocarriles 
que  atraviesan  los  lugares  infectados,  que  lo  son  actualmente  los  pueblos  pequeños  del 
Estado  de  Veracruz  y  los  que  atraviesa  el  Ferrocarril  del  Istmo  de  Tehuantepec;  de  tal 
modo  que  viajan  agentes  entre  Veracruz  y  Tierra  Blanca;  de  Córdoba  á  Tierra  Blanca;  de 
Tierra  Blanca  á  Santa  Lucrecia;  de  Coatzacoalcos  á  Santa  Lucrecia;  de  Santa  Lucrecia  á 
Tehauntepec  y  Salina  Cruz.  Si  un  enfermo  se  encuentra  en  cualquiera  de  estos  trayectos, 
es  llevado  á  la  casa  de  salud  más  inmediata  y  en  la  noche  se  hace  desinfectar  el  Pullman  ó 
el  coche  de  ferrocarril  el  cual  se  condujo  al  cnfeimo. 

Organizados  nuestros  servicios  de  esta  manera,  los  hemos  continuado  en  Yucatán  á  pesar 
de  que  desde  el  día  27  del  mes  de  noviembre  último  no  se  ha  dado  un  sólo  caso  de  fiebre 
amarilla  ni  en  Mérida,  ni  en  Progreso,  ni  en  ningún  otro  pueblo  del  Estado  antes  citado, 
desde  juho  24  de  1905,  habiéndose  observado  otro  únicamente  en  febrero  6  de  este  año. 
En  Veracruz  no  se  dio  ningún  caso  de  enfermedad  desde  el  29  de  diciembre  del  año  de  1904 
hasta  el  11  de  julio  del  año  en  curso.  A  pesar  de  la  vigilancia  que  hemos  tenido,  es  posible 
que  algún  enfermo  que  no  llegó  por  el  ferrocarril  ni  por  los  caminos  frecuentados  ordi- 
nariamente, haya  penetrado  clandestinamente  á  la  población  y  haya  podido  permanecer 
oculto,  y  como  no  estaba  en  el  padrón  no  pudo  ser  vigilado  por  los  agentes  sanitarios.  Esta 
es  la  única  razón  que  podemos  darnos  de  la  aparición  de  la  enfermeadd  en  el  puerto  de 
Veracruz.  En  Tehuantepec  tenemos  establecida  una  brigada  sanitaria  y  un  lazareto,  á  pesar 
de  que  el  último  caso  originado  en  la  población  se  observó  en  5  de  .iciembre  anterior,  pues 
otro  que  ha  habido  en  26  de  abril  fué  importado  de  Santa  Lucrecia.  Otro  servicio  estable- 
cido en  Salina  Cruz,  en  donde  el  último  caso  registrado  fué  en  octubre  27  de  1904.  Por 
último,  en  Tierra  Blanca,  en  donde  se  formó  un  pequeño  foco.  Tierra  Blanca  es  una  pequeña 
aldea,  en  donde  se  juntan  tres  ramales  del  Ferrocarril  de  Veracruz  al  Pacífico.  La  pobla- 
ción se  compone  de  personas  no  inmunes,  de  escasos  recursos,  que  son  empleados  y 
trabajadores  del  mencionado  ferrocarril.  Como  la  población  es  cosmopolita  y  muy  pobre,  ha 
sido  difícil  extinguir  completamente  la  enfermedad  y  por  eso  se  ha  establecido  aUí  una 
brigada  sanitaria. 

En  los  demás  lugares  de  la  pequeña  zona  infectada  en  donde  aparecen  casos  aislados,  se 
envía  inmediatamente  á  un  médico  con  agentes  sanitarios  experimentados  á  que  procedan  á 
la  visita  domiciliaria,  á  la  desinfección  de  las  casas  y  la  destrucción  de  las  larvas  de  los 
mosquitos. 

El  adjunto  cuadro  (No.  1)  manifiesta  el  número  de  casos  de  fiebre  amarilla  que  se  regis- 
traron en  las  poblaciones  en  él  mencionadas,  con  expresión  de  los  que  hubo  en  cada  una 
de  ellas  y  el  de  las  defunciones  originadas  por  esa  enfermedad  en  los  mismos  lugares  y  durante 
el  año  de  1904.  Se  ve,  pues,  que  los  casos  registrados  fueron  635  y  las  defunciones  fueron 
197,  en  toda  la  extensión  de  la  República. 

El  adjunto  cuadro  (No.  2)  representa  el  número  de  casos  registrados  y  las  defunciones 
que  causaron  en  cada  una  de  las  poblaciones  en  él  citadas,  desde  el  1°  de  enero  hasta  el  1° 
de  agosto  del  año  actual.  Como  se  ve  por  él,  los  casos  registrados  fueron  70  v  las  defunciones 
33. 

Comparando  las  cifras  de  casos  registrados  en  el  año  anterior  con  los  del  actual,  hay  una 
diferencia  de  565,  como  resultado  de  la  campaña  hecha  durante  este  período  de  tiempo. 

El  mapa  No.  1  representa  en  puntos  amarillos  los  lugares  que  fueron  invadidos  por  la 
enfermedad,  y  con  puntos  rojos  los  lugares  en  que  están  establecidas  las  brigadas  sanitarias. 

El  cuadro  No.  3  representa  el  número  de  visitas  domiciliarias  practicadas  á  los  no 
inmunes;  el  de  depósitos  de  agua,  que  fueron  examinados  y  limpiados  de  larvas:  el  número 
de  depósitos  de  agua  que  fueron  cubiertos  de  petróleo:  el  de  desinfecciones  hechas,  de 
casas  y  de  solares  limpiados;  de  notificaciones  hechas  á  los  propietarios  para  que  mejoraran 
las  condiciones  de  sus  casas. 


392  SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAL. 

Por  todo  lo  expuesto  se  verá  el  éxito  alcanzado  hasta  ahora  en  Méjico  en  la  lucha  contra 
la  ficb'e  amarilla  y  la  seginidad  de  que  en  porvenir  no  lejano,  la  enfermedad  quedará 
definitivamente  extinguida  como  lo  ha  sido  en  la  Isla  de  Cuba. 

El  resultado  de  estas  medidas  ha  sido  que  la  enfermedad  ha  disminuido  en  la  proporción 
que  indica  el  cuadro  No.  4,  correspondiente  á  los  meses  transcuri-idos  del  1°  de  enero  al  31 
de  agosto  de  1905. 

Las  cifras  del  número  de  casos  registrados  en  1904  y  1905  demuestran  el  beneficio  obtenido 
en  la  campaña,  que  se  seguirá  con  mucho  tesón  hasta  hacer  desaparecer  la  fiebre  amarilla 
de  toda  la  República  Mejicana 

(&)  Un  sumario  de  las  leyes  sanitarias  y  de  cuarentena  que  se  hayan  dictado  después  de  la 

primera  convención. 

Las  disposiciones  que  se  han  dictado  en  la  República  Mejicana  después  de  la  convención 
de  1902,  modificando  la  legislación  sanitaria  que  existía  antes  de  esa  época,  están  consigna- 
das en  el  Código  Sanitario  de  los  Estados  Unidos  Mejicanos,  en  el  Título  I,  Capítulo  1°,  y 
en  los  artículos  del  24  al  30,  que  á  continuación  copio: 

"Aet.  24.  Los  cónsules  comunicarán  al  consejo  por  la  vía  telegráfica  la  aparición  del 
cólera,  de  la  poste  bubónica  ó  de  la  fibre  amarilla  en  la  localidad  donde  residan,  indicando  la 
fecha  en  que  se  haj^an  observado  ios  primeros  casos,  y  cuidarán,  mientras  dure  la  epidemia, 
de  comunicar  al  mismo  cuerpo,  á  la  salida  de  cualquier  buque  con  destino  á  la  República,  el 
estado  sanitario  de  éste  y  el  del  puerto  de  donde  sale. 

"AnT.  25.  En  los  puertos  extranjeros  en  donde  es  endémica  la  fiebre  amarilla,  los  cónsules, 
al  visar  ó  expedir  las  patentes  de  sanidad,  anotarán  en  ellas  si  en  el  momento  de  expedirlas 
hay  casos  de  dicha  enfermedad  en  el  puerto. 

"Akt.  26.  Las  medidas  de  profilaxis  en  los  puertos  mejicanos,  con  objeto  de  impedir  la 
importación  de  las  enfermedades  epidémicas  y  transmisibles,  consistirán :  1°,  en  la  inspección 
médica  sanitaria  de  las  embarcaciones;  2°,  en  la  vigilancia  y  aun  aislamiento  de  los  pasajeros 
sospechosos;  3°,  en  el  aislamiento  de  los  enfermos  hasta  su  completa  curación  en  los  laza- 
retos ó  lugares  aislados  de  la  localidad;  4°,  en  la  desinfección  de  las  embracaciones, 
equipajes  y  mercancías  que  lo  requieran,  y  5°,  en  la  destrucción  de  los  animales  conductores 
del  contagio. 

"Art.  27.  Las  medidas  de  profilaxis  á  que  se  refiere  el  artículo  anterior  se  sujetarán  en 
todo  á  lo  que  prevenga  el  Reglamento  de  Sanidad  Marítima-,  quedando  facultados  el  Consejo 
Superior  de  Salubridad  y  sus  delegados  en  los  puertos,  para  detener  las  embarcaciones  por 
el  tiempo  que  fuere  nccessario,  mientras  se  practican  dichas  medidas. 

"Art.  28.  Al  Reglamento  de  Sanidad  ]\iarítima  se  sujetará  el  régimen  sanitario  de  los 
puertos  en  todo  lo  que  se  refiere  á  admisión  de  buques,  visitas  de  entrada  y  salida  ce  éstos, 
expedición  de  patentes,  prohibición  de  introducir  mercancías,  y  su  destrucción  y  desinfec- 
ción, tanto  de  ellas  como  de  los  equipajes  y  de  las  embarcaciones. 

"Art.  29.  Las  materias  peligrosas  para  el  contagio  v  cuya  desinfección  no  ofrezca  garan- 
tías, no  se  iuternaián;  y  si  fueren  abandonadas  por  el  buque  que  las  trajo,  se  destruhán 
por  el  luego. 

"Art.  30.  El  Ejecutivo  de  la  Unión  declarará,  previo  informe  del  Consejo  Superior  de 
Salubridad,  cuándo  se  han  de  considerar  infectados  ó  sospechosos  los  puertos  extranjeros." 

Me  permito  llamar  la  atención  especialmente  sobre  los  artículos  26  y  27,  porque  tienden  á 
abolir  pi  ácticamente  las  cuarentenas,  sustituyéndolas,  como  se  acaba  de  escuchar,  con  la 
inspección  sanitaria  de  las  embarcaciones,  con  la  vigilancia  y  aun  el  aislamiento  de  los 
pasajeros  sospechosos,  con  el  aislamiento  de  los  enfermos  hasta  su  completa  curación,  con  la 
desini'ección  de  embarcaciones,  equipajes  y  mercancías  que  la  requieran  y  con  la  destrucción 
de  los  animales  conductores  del  contagio.  El  artículo  27  declara  que  las  embarcaciones 
serán  detenidas  en  los  puertos  solamente  el  tiempo  necesario  para  practicar  las  medidas  que 
se  acaban  de  mencionar.    . 

Señores,  como  acabáis  de  oír,  la  legislación  mejicana  se  ha  sujetado  á  la  fórmula  que  tuve 
la  honra  de  proponer  en  la  convención  de  1902,  relativa  á  la  doctrina  que  debe  normar  las 
medidas  cuarentenaiias  desde  el  momento  en  que  la  ciencia  ha  servido  de  base  á  las  resolu- 
ciones que  se  tomen  en  congresos  semejantes  al  actual.     He  aquí  esta  fórmula: 

Proteger  los  intereses  de  la  salud  pública,  sin  perjudicar  ó  perjudicando  lo  menos  posi- 
ble los  intereses  del  comercio  y  la  libre  comunicación  de  los  hombers. 

Entre  las  resoluciones  adoptadas  por  esa  convención,  la  segunda  de  ellas  dice: 

"  Se  resuelve.  Que  el  período  de  detención  y  desuif  eCción  en  las  estaciones  de  cuarentena 
marítima  ha  de  ser  el  más  breve  posible,  compatible  con  la  seguridad  pública  y  de  acuerdo 
con  los  preceptos  de  la  ciencia." 

Como  se  ve,  la  República  Mejicana,  al  expedir  su  código  sanitario  en  30  de  diciembre  de 
1902,  se  conformó  estrictamente  con  las  resoluciones  adoptadas  por  aquella  convención  ei 
5  del  mismo  mes  y  año. 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  395 

Ojalá,  señores,  que  los  Gobiernos  de  las  Kepúlilicas  qno  están  aquí  n^unidas  aliora,  ¡nspi- 
randoae  en  la  resolueión  unánime  adoptada  m)  la  convención  de  ]'M¿,  piisiettin  sus  leyes 
sanitarias  de  acuerdo  con  esta  resolución  convertida  ya  en  lej  por  el  (iobiertio  Mejicano. 

Es  pieciso  convencerse!  de  f|LH!  el  estado  actual  de  la  civilización  reclama  de  los  Gol>ierno8 
de  todos  los  países,  que  debe  dejar  de  ser  el  miedo,  el  que  dicte  las  disposiciones  cuarentena- 
rias,  porque  do  esa  manera  serán  siempre  excesivas,  sobrepasarán  cA  íin  rjue  sí;  pioponcn, 
seiári  ineficaces,  como  lo  demostrí'í  en  mi  discuiso  de  1902,  y  deben  ser  sustituidas  por  las 
medidas  que  dicto  la  razón  desapasionada  y  fundadas  por  una  parte  en  los  conocimientos 
preciosos  que  nos  piopoiciona  actualmente  la  ciencia  sanitaria,  y  por  otra  parte,  en  el 
empeño  de  no  peijudicar  ó  perjudicando  lo  menos  posible  los  intereses  del  comercio  y  la  libre 
comunicación  de  los  hombres. 

Como  en  la  reunión  antei-ior  oí  expresar  la  opinión  de  que  mis  propósitos  eran  en  cierto 
modo  idealistas  y  que  encontrarían  un  escollo  en  la  práctica  diaria,  pues  abreviando  los 
períodos  de  detención  de  las  embarcaciones  sospechsas  se  correría  el  peliííro  de  no  resguar- 
dar suficientemente  los  intereses  de  la  salud  púljlica,  voy  á  permitirme^ llamar  la  atención 
de  las  personas  que  bondadosamente  me  escuchan,  sobre  esta  consideracfon : 

Nuestras  leyes  sanitarias,  inspiradas  en  los  dos  preceptos  que  acabo  de  mencionar,  nos 
han  permitido  defender  á  nuestros  puertos  del  litoral  del  Pacífico,  y  por  consifjuiente 
defender  á  los  puertos  extranjeros,  durante  la  epidemia  de  peste  bubónica  que  invadió  el 
pueito  de  Mazatlán,  desde  el  mes  de  octubre  de  1902  hasta  el  mes  de  mayo  de  lí>03.  Estas 
mismas  leyes  sanitarias  nos  han  permitido  impedir  que  la  fiebre  amarilla,  que  reinó  el  año 
pasado  todavía  en  los  puertos  de  Veracruz,  Coatzacoalcos  y  Progreso,  se  propagara  al  de 
Tampico  y  á  nuestros  otros  puertos  del  litoral  del  Golfo;  esas  leyes,  sin  aumento  ni  modifi- 
cación alguna,  nos  han  servido  para  defendernos  de  la  epidemia  de  Belize  y  nos  están 
defendiendo  todavía  en  el  momento  actual  de  la  grande  epidemia  que  reina  en  Nueva 
Orleans,  sin  que  hayamos  tenido  que  aumentar  nuestros  medios  de  defensa  ni  agregar  una 
sola  medida  restrictiva  á  las  embarcaciones  que  llegan  procedentes  de  los  lugares  antes 
citados;  ellas  nos  siguen  protegiendo  todavía  contra  la  peste,  que  ha  seguido  reinando  en  la 
República  de  Chile.  Luego  podemos  asegurar  que  nuestras  leyes  sanitarias,  inspiradas  por 
la  doctrina  que  desde  hace  tanto  tiempo  vengo  sosteniendo,  de  proteger  los  intereses  de  la 
salud  pública  sin  perjudicar  ó  perjudicando  lo  menos  posible  los  intereses  del  comercio  y  la 
libre  comunicación  de  los  hombres,  no  es  una  utopía,  sino  un  precepto  que  se  puede  llevar  á 
la  práctica  y  que  ha  soportado  victoriosamente  la  prueba  de  la  experiencia.  > 

Nuestra  legislación  sobre  policía  sanitaria  internacional  es  tan  libera!  ó  más  que  la  ley 
inglesa,  pero  lo  es  á  no  dudarlo  más  que  la  legislación  Oe  todos  los  demás  países,  y  yo  vengo 
á  suplicar  á  la  Convención  que  las  Repúblicas  que  están  aquí  representadas  adopten  una 
práctica  semejante  á  la  nuestra,  que  está  fundada  en  los  preceptos  de  la  ciencia,  garantizada 
por  la  experiencia  y  que  favorece  más  que  otra  alguna  los  intereses  del  comercio  y  la  libre 
comunicación  de  los  hombres. 

Aun  cuando  no  de  carácter  legal,  pero  sí  por  el  interés  que  tiene  para  todos  los  pueblos 
que  se  encuentran  invadidos  por  la  fiebre  amarilla,  creo  que  tendrá  interés  la  exposición 
de  las  medidas  que  se  han  ido  adoptando  sucesivamente  en  la  República  Mej  icana  para  hjchar 
contra  esa  enfermedad  y  que  van  marcadas  con  los  nombres  de:  "Defensa  contraía 
fiebre  amarilla"  y  "Nuveo  plan  de  campaña  contra  la  fiebre  amarilla,"  y  por  último,  el 
resumen  á  que  di  lectura  al  comenzar  este  informe.  Los  dos  primeros  opúsculos  los  presenta 
como  anexos  y  van  marcados  con  los  Nos.  7  y  8. 

No  quiero  terminar  esta  parte  de  mJ  relación  sin  indicar,  aun  cuando  sea  de  una  manera 
sumaria,  las  medidas  que  se  van  á  adoptar  para  combatir  la  malaria. 

TTL  MALARIA. 

Una  de  las  enfermedades  transmisibles  que  han  hecho  mayor  número  de  víctmas  es  el 
impaludismo.  El  cólera,  la  peste  bubónica,  la  fiebre  amarilla,  no  son  comparables  desde 
este  punto  de  vista,  porque  todas  estas  afecciones  son  agudas  y  localizadas,  su  repartición 
geográfica  es  limitada.  El  impaludismo  es  crónico  y  universal;  todos  los  países  del  mundo- 
han  tenido  que  sufrirlo  y  continúan  sufriéndolo. 

Los  conocimientos  científicos  que  actualmente  se  tienen  sobre  la  etiología,  patogenia, 
diagnóstico,  marcha,  variedades  y  tratamiento  del  impaludismo,  permitirán  obtener  la 
completa  terminación  de  esta  plaga,  que  ha  sido  una  de  las  calamidades  que  más  daño  han 
hecho  á  la  humanidad. 

El  impaludismo  necesita,  para  producirse,  un  enfermo  palúdico,  mosquitos  anopheles  y 
un  indiv'dt'O  predispuesto. 

Cuando  el  enfermo  es  picado  por  un  mosquito  del  género  anopheles,  toma  de  la  s-angre 
un  parásito  de  los  protozoarios  al  estado  de  gameta,  Uamado  por  Laveián,  su  descubridor, 
"hematozoario  del  paludismo." 

El'hematozoario  de  Laverán  se  persenta  en  la  sangre  de  los  palúdicos  en  cuatro  formas 
principales,  que  se  llaman :  Cuerpos  esféricos,  flageUa,  cuerpos  semUuuares  y  cuerpos  segmen- 
tados ó  rosáceos. 


394  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

El  único  medio  infalible  de  saber  que  un  enfermo  tiene  malaria,  es  el  que  da  el  examen 
microscópico  de  la  sanpjre.  Efe  ctivamente,  la  clínica  nos  pns?ña  que  c  1  síntoma  " fibre  inter- 
mitente^" no  (S  exclusivamente  propio  d(^  la  malaria,  sino  que  se  pns  nta  rn  otros  estados 
morbosos  diferent-^s.  Para  as  fjiirar  con  entera  certeza  el  diapi(ístico  de  "malaria,"  el 
examen  miscroscópico  fs  una  n  cesidad.  La  observación  en  un  glóbulo  de  alguno  da  los 
parásitos  que  h^-mos  d  scrito,  basta  por  estabbcr  el  diagnóstico;  porque  estos  parásitos  se 
se  cuentran  única  y  exclusivamente  en  la  sangre  d^'  los  paliidicos. 

El  h' inatozoario  de  Lavtrán,  en  su  evolución,  ti-no  n  c  sidad  de  atravesar  dos  organis- 
mos coiiipl  tanicnte  diferent  s  para  recorrer  todas  las  fases  de  su  ciclo  evolutivo.  Uno  de 
estos  organismos  es  el  bombre;  el  otro  es  el  cuerpo  d  '1  anopli'i'les. 

Las  hembras  de  (  stos  insectos  pon  m  sus  huevos  en  los  d  pósitos  de  aguas  claras  y  límpidas 
y  de  poca  profundidad,  á  la  orilla  dn  las  corrientes  de  aguas  ó  de  los  pantanos  ó  aun  en  las 
pequfi'ias  oquedades  qu'^  d  jan  los  animal  s  al  pisar  en  el  sucio  blando.  Los  huevos,  las 
larvas  y  las  ninfas  nrc  sitan  d- 1  agua  para  drsarrollars:-. 

Como  para  la  propagación  de  la  fiebre  amarilla,  la  del  paludismo  necesita  de  estos  tres 
elementos: 

1.  Enfermo  de  paludismo; 

2.  ^íosquito  del  género  anopheks  que  le  pique,  y 

3.  Peisona  prcdispu  sta  que  n  ciba  la  inoculación  por  el  piquete  del  mosquito  ya  infectado. 
Se  n;  c  sita,  pu  s,  para  imprdir  la  propagación  de  la  malaria,  la  disociación  de  los  dos 

primeros  ilemintos  y  la  iimiunización  de  los  enfermos  y  de  las  prsonas  predispuestas, 
gracias  á  la  quinina  qu'-  tiene  una  acción  especial  sobre  el  hematozoario  de  Lavcrán. 

De  (stas  consideraciones  se  deducen  las  medidas  que  deberán  adoptarse  para  evitar  la 
propagación  de  la  malaria,  y  son: 

1.  Él  aislamiento  y  la  curación  de  los  enfermos; 

2.  La  d  strucción  de  los  mosquitos  ya  infectados; 

3.  La  inmunización  de  las  prsonas  predispui  stas,  j 

4.  Los  medios  destinados  á  impedir  rl  d' sarrollo  de  nuevas  generaciones  de  mosquitos  y 
la  dcstnicción  de  las  larvas  que  ya  se  hayan  formado. 

I.    EL   AISLAMIENTO  Y   LA    CURACIÓN   DEL   ENFERMO. 

El  primero  de  estos  problemas,  el  aislamiento,  es  en  este  caso  menos  fácilmente  ejecutable 
que  en  la  fiebre  amarilla,  porque  ésta  es  una  enfermedad  aguda  que  obliga  á  los  enfermos  á 
guardar  cama.  La  rapidez  con  que  pasa  la  enfermedad  y  la  necesidad  do  guardar  cama, 
hacen  fácil  y  pasajero  el  aislamiento.  Mientras  que  en  la  malaria,  sólo  en  las  formas  de 
marcha  aguda  ó  de  grande  intensidad,  el  enfermo  se  ve  obligado  á  guardar  cama.  Los 
demás  enfermos  entran,  salen,  hacen  sus  ocupaciones  y  pued(  n  sí  r  picados  por  los  anopheles. 

El  recurso  del  aislami;nto,  es,  pues,  un  medio  poco  eficaz  como  destinado  á  impedir  el 
primer  factor;  enfermo  que  el  mosquito  pueda  picar. 

Por  insuficiente  que  s  a  este  medio,  debe  emplearse  siempre  que  se  pueda,  pues  cada 
enfermo  que  ss  pone  en  condiciones  de  no  s-r  picado  por  el  mosquito  anopheles,  es  un  foco 
menos  de  propagación  de  la  enfermedad.  El  aislami.nto  del  enfermo,  para  este  caso,  como 
para  el  de  la  fie  bre  amarilla,  consiste  en  colocarlo  en  un  cuarto  que  t;  nga  sus  ventanas  pro- 
vistas de  mallas  de  alambro  bastante  fino  para  que  no  permita  la  entrada  de  los  mosquitos, 
y  de  puertas  dobles,  también  alambradas  y  dispuestas  de  tal  modo,  que  para  abrirse  al 
exterior,  U  nga  que  ccrrars3  la  interior,  y  que  para  abrirsí  ésta  se  cirrre  forzosamente  la 
exterior.     Esto  se  consigue  por  medio  de  una  cadena  de  determinada  longitud. 

Otro  medio  de  aislamiento  consiste  en  colocar  al  derredor  de  la  cama  un  pabellón;  pero 
ya  al  hablar  de  la  fi'  bre  amarilla  indiejdé  el  inconveniente  que  tiene  este  sistema,  que,  por 
otra  parte,  es  muy  litil  si  se  emplea  como  recurso  profiláctico. 

El  segundo  de  los  problemas,  el  de  la  curación  del  enfe  rmo,  es  reclamado  por  esta  circuns- 
tancia es'pe  cial:  que  la  fiebre  amarilla  determina  la  imuunidad  de  la  persona  ciue  ha  sufrido 
el  primer  ataque  y  el  enfermo  palúdico  no  contrae  esa  inmunidad.  Otra  razón  es  que  el 
enfermo  de  fiebre  amarilla  no  puede  suministrar  el  germen  que  produce  la  enfermedad  sino 
en  los  tres  primeros  días  de  ésta,  mientras  que  el  palúdico  cons  rva  el  hf  matozoario  todo  el 
tiempo  que  dura  la  enfermedad.  De  estos  hechos  de  obs  rvación  S3  deduce :  que  el  enfermo 
de  fiebre  amarilla  d' ja  de  ser  un  foco  de  infección  desde  que  pasan  los  tres  primeros  días  de 
la  enfermedad,  en  tanto  que  el  palúdico  es  un  foco  de  propagacie'm,  mientras  dura  enfermo; 
y  como  la  enfermedad  permite  frecuentemente  á  los  enfermos:  que  entren,  que  salgan, 
que  hagan  sus  ocupaciones,  etc.,  están  constantemente  expu-  stos  á  s  r  picados  por  los  mos- 
quitos á  los  cual  s  infectarán.  De  aquí  proviene  la  nec  sidad  no  solamente  de  aislar  á  los 
enfermos,  sino  de  curarlos  hasta  su  compLto  restabl  ciminto. 

Por  fortuna,  hay  dos  r  cursos  con  que  se  puede  contar:  el  primero,  es  hacerlos  salir  del 
lugar  donde  existan  anopheles  que  puedan  picarlos.  Este  medio  es  conocido  desde  la  más 
remota  antigüedad.  El  otro  r,  curso  es  el  de  la  administración  de  las  sales  de  quinina,  pues  se 
sabe  que  esta  sustancia  medicinal  tiene  la  propiedad  de  destruir  el  hematozoario  en  la  sangre. 


SEGUNDA    CONFERJDNCIA    SANITAlílA    INTERNACIONAL.  895 

No  debo  dctciic.nncí  en  los  flctallfs  <1(5  la  niaiKTa  do  curar  por  niodio  de  la  quinina,  pues 
esto  saldría  d(  1  plan  (|uc,  inc,  lie,  propu< sto  s'ííuir  (  n  ( sta  rni  irioria;  pero  de  lo  ant'S  fxpuf  sto 
so  pueden  sacar  estas  dos  concluoioncs:  primera,  es  pr(  ciso  aislar  al  '  iifi  ririo,  si'inpre  (jue 
esto  s"a  posiblí-;  secunda,  es  preciso  curarlo,  hasta  que  haya  desaparecido  de  la  sangre  e 
hcmatozoario  de  La  verán. 

Como  se  ha  podido  juzgar,  estos  recursos  no  son  tan  eficaces,  tratándose  de,  la  malana 
■como  lo  son  tratándos  'i  de  lo  (jue  se  n  íient  á  la  íi(  bre  amarilla.  VA  idr  al  s-ría  aislar  ab.so- 
lutamtínto  por  todo  el  tiempo  que  dura  la  ení'ennedad  á  los  enfeiirios  de  la  malaria;  pero 
como  e.sto  no  es  ejecutable,  se  hará  en  la  medida  de  lo  posible. 

II.  LA   ÜESTRUCCIÓN    DE    LOS   MOSQUITOS   YA   INI''ECTADOK. 

Este  segundo  problema  queda  tan  eficaz  tratándose  del  paludismo,  como  lo  ha  sido  cuando 
nos  ocupamos  de  61  á  propósito  de  la  fie  bní  amarilla.  En  efe  cto,  í  1  <  nl'ermo  de  paludismo 
no  ts  p;  ligroso  sino  porque^  pueda  ser  picado  por  los  mosquitos  d(  1  género  anophelí  s,  que  se 
infectan,  chupando,  con  la  sangre,  los  hematozoarios  de  Laverán. 

La  d(  strucción  de  estos  mosquitos  so  hace  por  los  mismos  medios  qui;  indique  al  tratar 
de  la  fiebre  amarilla,  y  por  este  motivo  no  me  detendré  en  describirlos. 

III.  LA   INMUNIZACIÓN    DE   LAS   PERSONAS   PREDISPUESTAS. 

Si  no  tenemos  la  fortuna  de  que  un  primer  ataque  de  malaria  haga  inmune  ai  que  lo  ha 
sufrido,  ni  tenemos  aún  ninguna  que  le  dé  esa  inmunidad,  contamos  con  (1  n  curso  de  que 
las  dosis  pequeñas  de  quinina,  largo  tiempo  continnuadas,  le  producen  la  inmunidad.  De 
aquí  se  saca  el  precepto  de  administrar  la  quinina  en  pequeñas  dosis  á  todas  las  p:  rsonas 
que  habitan  los  países  palustres  en  las  épocas  en  que  so  desarrollan  las  epidemia-s  de  malaria. 

Experimentos  repetidos  y  constantes  observaciones  han  demostrado  que  basta  la 
administración  de  10  á  20  centigramos  de  quinina,  cada  día,  para  convertir  en  inmunes  á 
personas  predispuestas.  • 

Los  ensayos  que  en  pequeña  escala  ha  estado  haciendo  el  Consejo  Superior  de  Saluridad  en 
una  finca  de  campo  llamada  "El  Dorado,"  situada  en  el  Estado  de  Sinaloa,  uno  de  los  más 
azotados  por  esta  enfermedad,  como  se  podrá  ver  en  el  mapa  que  como  anexo  presento, 
han  sido  satisfactorios,  como  lo  demuestra  el  siguiente  cuaeko: 

Besultados  projiláticos  de  la  administración  cuotidiana  de  una  dosis  pequeña,  10  centigramos, 

de  quinina  durante  la  zafra. 


Niímero  de  personas^ 


atacadas.     Atacadas. 

■Que  la  tomaron  con  regularidad I  8-5  2 

Que  la  tomaron  sin  regularidad I  33  ¡  12 

En  quienes  no  podo  observarse  el  efecto  por  haber  dejado  la  localidad. i 

Á  quienes  fué  dado  durante  un  período  de  tres  meses  y  medio 


Total. 


150 


rv.    LOS    MEDIOS    DESTINADOS    Á    IMPEDIR    EL    DESARROLLO    DE    NUEVAS    GENERACIONES   DE 
MOSQUITOS   Y   LA   DESTRUCCIÓN   DE    LAS   LARVAS   QUE   YA   SE   HAYAN   FORMADO. 

Como  no  sería  posible  entrar  en  el  detalle  de  cada  uno  de  los  medios  que  ensoñó  pri- 
mero la  observación  j  que  ha  demostrado  después  la  experimentación,  voy  á  enumerarlos 
solamente. 

Una  experiencia  muy  antigua,  pero  que  fué  ejecutada  sistemáticamente  en  Inglaterra, 
hace  ya  tres  cuartos  de  siglo,  ha  demostrado  que  canalizando  los  terrenos  pantanosos;  dando 
fácil  corriente  á  las  aguas;  convii'tiendo  en  tierras  de  labor  los  terrenos  pantanosos  y  hasta 
favoreciendo  la  plantación  de  árboles  de  rápido  crecimiento  j  que  necesitan  para  su  nutrición 
y  desarrollo  de  una  gran  cantidad  de  agua,  como  sucede  con  los  eucaliptus,  s?  han  llegado  á 
sanear  completamente  terrenos  que  habían  sido  por  muchos  años  antes  focos  de  malaria, 
y  se  han  devuelto  esos  terrenos  á  la  agricultura.  Es,  pu  s,  un  medio  de  una  eficacia  incon- 
testable, como  profiláctico  de  la  malaria,  porque  impide  que  se  desarrollen  en  ellos  los 
mosquitos  del  género  anopheles,  transmisores  de  la  enfermedad. 

Los  pequeños  pantanos  y  los  charcos  que  por  las  condiciones  del  terreno  no  puedan  ser 
canalizados  ó  di'enados,  poch'án  rellenarse  con  tierra,  y  se  hacen  desaparecer  por  este  medio 
depósitos  de  agua  en  donde  las  hembras  de  los  anopheles  pochían  poner  sus  huevos. 

En  aquellos  otros  depósitos  de  agua  que  por  cualquiera  otra  circunstancia  no  puedan  ser 
canalizados,  ni  plantados  de  árboles,  ni  rellenados  con  tierra,  queda  el  recurso  de  cubrirlos 
con  una  capa  delgada  de  mezcla  de  petróleo  crudo  y  petróleo  refinado. 


396  SEGUNDA    CONFERENCIA    SANITAEIA    INTERNACIONAL. 

Por  último,  la  destrucción  de  las  larvas  en  los  depósitos  de  agua  del  interior  de  las  habi- 
taciones ó  de  los  lugares  que  las  rodean  inmediatamente,  y  practicada  en  la  forma  que  se 
emplea  [¡ara  destruir  las  larvas  de  los  mosquitos  Siegomyia  y  c'e  la  cual  me  ocupé  con  detalle 
al  tratar  de  la  fiebre  amarilla,  es  Otro  recurso  con  que  se  puede  contar  para  disminuir  las 
generaciones  de  mosquitos  Anofihdes,  en  lugares  en  donde  éstos  viven  habitualmcnte. 

He  aquí  en  un  resumen  brevísimo  las  bases  que  adoptará  el  Gobierno  mejicano  para 
empiender  la  campaña  contra  el  impaludismo. 

Para  cumplii-  con  el  progiama  aceptado  por  la  convención, presento  á  los  señores  delegados 
el  majia  que  señala  la  distribución  geográfica  y  la  intensidad  relativa  de  la  malaria  en  los 
diferentes  Estados  de  la  República;  un  cuadro  que  expresa  la  mortalidad  por  esta  enfer- 
medad en  los  mismos  Estados,  y  por  último,  otro  cuadro  gráfico  que  repiesenta  la  mortalidad 
ocasionada  en  diversos  puertos  de  la  República  Mejicana,  en  un  decenio. 

(c)  Todo  trabajo  sanitario  especial  que  se  está  ejecutando  6  se  trata  de  llera?  á  cabo. 

El  Gobierno  de  ^léjico  tiene  el  propósito  de  sanear  todos  los  puertos  de  importancia  de 
la  República,  y  á  este  respecto  se  ha  conienzado  ya  y  están  á  punto  de  terminarse  las  obras 
de  saneamiento,  abastecimiento  de  agua  potable  en  cantidad  suficiente  para  las  necesidades 
de  los  habitantes  y  pavimentación  conveniente  de  las  calles  que  permita  conservarlas  asea- 
das, y  lo  mismo  en  los  puertos  de  Tampico,  Veracruz,  Coatzacoalcos,  Salina  Cruz,  Manza- 
nillo, teniéndose  en  estudio  las  de  Mazatlán  y  demás  puertos. 

En  Tampico  las  obras  de  saneamiento  tocan  ya  á  su  conclusión,  pues  en  el  sistema  pro- 
yectado de  atarjeas,  que  tiene  un  desarrollo  de  12,500  metros,  se  han  constiuído  ya  10,000, 
y  en  el  de  entuba cióu  de  aguas  ha  quedado  colocada  la  tubería  principal  y  10,500  metros  de 
tubos  de  distribución. 

El  abastecimiento  de  aguas  ha  quedado  prácticamente  concluido,  pues  sólo  falta  construir 
una  porción  de  depósito  de  clarificación  en  el  Camalote  y  otra  del  relleno  en  los  lugares 
bajos  de  la  población.  Se  concluyó  el  dragado  frente  al  muelle  fiscal  y  continúase  el  del 
frente  de  los  muelles  laterales. 

En  Veracruz  se  han  terminado  la  construcción  del  colector  principal,  el  canal  de  desagüe 
ó  desembocadura,  la  instalación  de  bombas  de  la  zona  que  está  en  la  orilla  del  mar,  lo 
mismo  que  las  obras  de  saneamiento  de  la  parte  más  poblada  de  la  ciudad  y  se  ha  comenzado 
la  construcción  de  los  colectores  para  el  drenaje  superficial  de  los  terrenos  ganados  si  mar. 

El  agua  que  sirve  para  las  necesidades  de  la  población  está  captada,  entubada  y  repartida 
á  domicilio. 

Se  ha  procedido  á  contratar  la  pavimentación  de  la  ciudad  y  muy  próximamente  s© 
comenzará  esta  obra,  siendo  el  pavimento  de  las  principales  calles  de  asfalto  y  de  adoquín, 
y  guijarro  el  de  las  demás. 

Existe  ya  concluida  una  estación  sanitaria  que  consta  de  varios  departamentos  que  son: 
Oficinas  de  la  delegación;  almacén,  lugar  de  incineración;  depaitamento  de  desinfección 
por  el  ácido  sulfuroso  ó  la  l'ormaldehída ;  departamento  de  baños  de  primera,  segvmda  j 
tercera  clase  para  caballeros;  excusados  para  señoias  y  para  caballeros;  departamento  de 
las  estufas  de  desinfección,  construcción  de  los  más  gi'andes  modelos  que  se  usan  en  el 
mundo.  Hay,  además,  también  en  Veracruz,  un  lazareto  para  enfermos  y  sospechosos, 
instalado  en  el  islote  que  se  llama  de  Sacrificios. 

En  el  puerto  de  Coatzacoalcos  se  han  emprendido  también  obras  de  saneamiento  que 
permite  tener  ya  á  la  ciudad  en  buenas  condiciones  higiénicas. 

Quedan  i'eílenados  70,000  metros  cuadrados  de  teriaplen  y  se  ha  piocedido  á  Ik 
limpieza  de  todas  las  calles  y  casas.  Se  dispone  de  un  lazareto  bien  acondicionado.  Por 
el  lado  del  litoral  del  Pacífico  se  tiene  el  lazareto  de  Acapulco,  construido  en  la  isla  de  la 
Roqueta. 

En  el  puerto  de  Manzanillo  se  están  emprendiendo  los  trabajos  de  un  canal  de  sanea- 
miento pai.-a  la  introducción  y  conservación  de  las  aguas  del  mar  en  la  parte  norte  de  la 
Laguna  de  Cuyutlán,  dividiéndola  mediante  un  dique  de  la  parte  meridional  de  la  propia 
laguna  ocupada  por  salinas  y  del  desagüe  ó  saneamiento  de  la  Laguna  de  San  Pedrito,  por 
medio  de  un  canal,  ya  sea  de  derivación,  desecación  ó  de  introducción  de  las  aguas  del  mar. 

Se  están  construyendo  estaciones  sanitarias  análogas  á  la  de  Veracruz  en  los  puertos  de 
Tampico,  Mazatlán, Coatzacoalcos,  y  Salina  Cruz,  y  se  tienen  proyectadas  las  de  los  puertos 
de  San  Blas,  Manzanillo  y  Progreso. 

Hav  instaladas  estufas  de  desinfección  en  los  puertos  Tampico,  Veracruz  y  Progreso 
en  el  Golfo,  y  en  Acapulco,  Salina  Cruz,  Mazatlán  y  Guaymas,  del  Pacífico.  Están  para 
instalarse  estufas  en  Manzanillo,  San  Blas,  La  Paz,  Santa  Rosalía  y  Ensenada,  puertos 
del  Pacífico,  y  en  Coatzacoalcos  por  el  lado  del  Golfo. 

Se  tienen,  además,  instaladas  estufas  de  desinfección  en  la  frontera  del  norte,  en  laS 
ciudades  de  Laredo,  Porfirio  Díaz,  Juárez  y  en  la  villa  de  Nogales. 


SEGUNDA    CONFERENCIA    .SANITARIA    INTERNACIONAL. 


:-i<i7 


•Oasos  y  defunciones  ocasionados  por  la  fiebre  amarilla,  en  la  Rejjública  durante  el  añosde 

1905. 


Casos 

Defunciones. 


Veracruz. 

Yucatán. 

Oaxaca. 

Vera- 
cruz. 

Jaltl- 
pan. 

Coatza- 
coaloos. 

Tcxis- 
tepec. 

Acayu- 
can. 

Mérida. 

49 
25 

Progre- 
so. 

Tehuan- 
tepec. 

Salina 
Cruz. 

76 
13 

6 
2 

99 
25 

253 

77 

6 
5 

34 
16 

72 
30 

40 
6 

Total. 


635 
197 


Oasos  tj  defunciones  ocasionados  por  la  fiebre  amarilla  en  la  República,  de  enero  á  aooslo  de 

1906. 


Casos 

Defunciones. 


Veracruz. 

Yucatán. 

Oaxaca. 

Veracruz. 

Coatza- 
coalcos. 

Tierra 
Blanca. 

Progreso. 

Mérida. 

Tehuan- 
tepec. 

Juchitán. 

18 
4 

15 
4 

27 
18 

1 

1 

1 
2 

5 

1 

3  ' 
3 

Total. 


INFORME  DEIi  DR.  J.  L.   MEDINA,  DELEGADO  DE  NICARAGUA. 

Señores  Delegados  de  la  Conferencia  Sanitaria:  Coasidero  como  un  alto  honor 
«1  poder  hacer  uso  de  la  palabra  en  esta  ocasión. 

Da  acuerdo  coa  los  requisitos  del  proo:rama  científico,  tengo  el  gusto  de  hacer  las  siguientes 
breves  declaraciones: 

LA   PESTE    BUBÓNICA. 

Con  satisfacción  digo  que  con  toda  seguridad  no  hemos  tenido  en  Nicaragua  un  sólo 
«caso  de  peste  bubónica. 

Desde  que  apareció  este  mal  en  Panamá  y  en  otros  puntos  del  continente  americano 
se  tomaron  medidas  radicales  en  Nicaragua  para  protergenos  contra  esta  enfermedad  tan 
temida. 

LA   FIEBRE    AMARILLA. 

Durante  el  año  pasado  ocurrieron  en  Managua  dos  casos  de  fiebre  amarilla.  Uno  de 
«líos  fué  un  pasajero  que  vino  en  buque  procedente  de  Panamá,  desarrollándose  la  enfer- 
medad después  de  su  arribo  á  Nicaragua.  El  segundo  caso  fué  expuesto  á  la  infección. 
Ambos  fueron  asistidos  con  los  últimos  métodos,  el  aislamiento  del  paciente  y  su  pj'otección 
con  tela  metálica,  impidiendo  de  este  modo  la  propagación  del  mal. 

En  la  costa  del  Atlántico,  á  pesar  del  hecho  de  que  nuestros  puertos  se  hallan  tan  próximos 
á  Nueva  Orleans,  en  donde  ha  prevalecido  la  fiebre  amarilla  por  espacio  de  algunos  meses, 
no  se  ha  registrado  ningún  caso  de  la  fiebre,  y  esperamos  continuar  libres  de  toda  infección. 


LA  FIEBRE   PALÚDICA. 

Como  en  casi  todas  las  regiones  tropicales,  en  Nicaragua  son  comunes  los  casos  de  infección 
palúdica,  bajo  distintas  formas.  Casi  siempre  tiene  éxito  el  tratamiento  con  las  medicinas 
ordinarias,  pero  es  mucho  mejor  el  cambio  de  clima. 

Nuestro  clima  es  extremadamente  favorable  para  la  salud  general  de  los  indígenas  y 
los  extranjeros.  Durante  todo  el  año  gozamos  de  una  temperatura  casi  uniforme,  que 
varía  de  70°  á  80°  Fahrenheit. 

Nicaragua  tiene  hospitales  bastantes  buenos  en  todas  las  principales  ciudades,  dotados 
de  pabellones  separados  para  el  aislamiento  de  los  casos  de  enfermedades  contagiosas,  y  están 
equipados  con  todos  los  adelantos  modernos  en  manos  de  personas  competentes. 

Los  municipios,  bajo  la  inspección  de  los  gobernadores  de  los  Estados  respectivos,  tienen 
á  su  cargo  la  creación  de  las  juntas  locales  de  sanidad,  desempeñando  sus  deberes  del  mejor 
modo  que  pueden,  y  con  facultades  para  dictar  y  establecer  las  leyes  necesarias  para  la 
eficacia  de  sus  medidas  en  interés  de  la  higiene  de  sus  localidades. 

La  hnportancia  de  la  junta  marítima  de  sanidad,  bajo  leyes  y  reglamentos  uniformes, 
es  mayor  ahora  que  antes  en  la  América  Central,  debido  á  la  construcción  del  Canal  de 
Panamá.  Las  obras  que  se  están  llevando  á  cabo  en  el  Istmo  son  actuahnente,  y  lo  serán 
por  espacio  de  algunos  años  venideros,  una  amenaza  constante  á  la  salud  pública  de  todos 
los  países  vecinos. 


398  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

^endo  este  ua  Congreso  Sanitario  Internacional,  y  puramente  americano,  estoy  seguro 

Sue  cada  una  de  las  naciones  representadas  en  él  harán  todo  lo  posible  para  el  éxito  de  la 
onferencia,  llevando  á  cabo  (iehnonte  y  de  una  manera  práctica  todas  sus  indicaciones. 
Estando  la  República  de  Nicaragua  perfectamente  al  tanto  del  progreso  del  mundo  en 
la  ciencia  m>dica  y  de  saneamiento,  deseamos  hacer  todo  lo  (jue  está  á  nuestro  alcance 
para  dar  al  público  y  á  nuestros  vecinos  la  confianza  que  solamente  un  bien  organizada 
cuerpo  marítimo  sanitario  puede  proporcionar  á  un  país  civilizado. 

Esta  Conferencia  tiene  actualmente  en  estudio  la  adopción  de  tratados  que  obliguen  á 
los  Gobiernos  aquí  representados  á  la  observancia  de  las  reglas  prescritas  relativas  al  servicia 
de  cuaieatenas,  asegurando  de  este  modo  la  salud  del  pueblo  de  estos  países,  y  evitando 
al  mismo  tiempo  la  obstrucción  del  comercio. 

Para  llevar  á  cabo  los  acuerdos  de  esta  Conferencia,  creo  yo  que  nuestras  Repúblicas 
centroaaiericanas  dei^en  hacer  lo  que  ya  Cuba  y  Méjico  han  hecho  con  los  resultados  más 
admirables  y  el  aplauso  del  universo  entero.  El  primer  paso  que  debía  dar  en  Centro 
América  para  llevar  á  cabo  este  proyecto  es  la  reorganización  de  las  respectivas  juntas  de 
sanidad  para  el  servicio  de  cuarentena,  bajo  leyes  y  reglamentos  unifonnes  y  de  bases 
puramente  científicas,  y  si  esta  Conferencia  nos  ayudara  con  este  objeto,  merecería  nuestra 
gratitud  eterna. 


INFORME  DEL  DELEGADO  DEL  PERU,  DR.    DANIEL  EDUARDO 

LAVORERÍA. 

La  República  del  Perú,  en  cuyo  nombre  tengo  el  honor  de  hablar,  por  causas  que  en  mí 
país  se  lamentan,  no  tuvo  representación  oficial  en  la  Primera  Convención  Sanitaria  Inter- 
nacional q\ie  áe  reunió  en  esta  ciudad  en  los  días  2,  3  y  4  de  diciembre  de  1902,  en  la  que 
tan  interesantes  asuntos  se  discutieron  y  en  la  que  tan  importantes  conclusiones  se  adop- 
taron. En  esta  ocasión  el  Gobierno  del  Perú  no  ha  querido  que  suceda  lo  mismo  y  al 
recibir  la  invitación  de  la  Oficina  de  las  Repúblicas  Americanas  para  la  reunión  de  la  segunda 
Convención,  me  ha  confiado  el  alto  honor  de  representarlo  on  esta  ilustrada  asamblea. 

Mi  país  ha  entrado  hace  poco  tiempo  en  una  nueva  era  de  vida.  Después  de  las  desgra- 
cias que  experimentó  en  la  guerra  del  1879  al  1881  y  de  las  convulsiones  intestinas 
que  le  sucedieron,  que  tanto  daño  causaron  á  su  progi'eso  y  á  la  marcha  normal  de  sus 
instituciones,  ha  entrado  por  una  senda  de  concordia  y  de  trabajo  cuyos  benéficos  resultados 
se  aprecian  yá,  no  obstante  el  coi'to  número  de  años  que  han  transcurrido  en  esa  vía.  Los 
distintos  ramos  de  la  administración  pública  se  encarrilan  y  perfeccionan,  tomando  para 
hacerlo  como  ejemplo,  lo  que  se  hace  en  países  más  avanzados  que  el  Perú  en  civilización 
y  en  cultura;  y  entre  los  que  no  se  quedan  rezagados  en  el  movimiento  general  de  avance 
se  encuentra  el  de  la  higiene  pública. 

En  conformidad  con  las  recomendaciones  de  la  Conferencia  Internacional  de  Méjico, 
"todas  las  medidas  sobre  asuntos  relacionados  con  la  policía  sanitaria  internacional,  las 
que  tienen  por  objeto  evitar  la  invasión  de  las  enfermedades  contagiosas  y  el  establecimiento 
y  vigilancia  de  las  detenciones  marítimas  y  terrestres  internacionales,  ó  sea,  las  estaciones 
de  salubridad,  están  por  completo  bajo  la  dependencia  del  Gobierno  Nacional,"  corrienda 
á  cargo  de  una  institución  técnica  especial,  que  forma  parte  del  ministerio  de  fomento, 
la  dirección  de  salubridad  pública,  á  la  que  tengo  el  honor  de  pertenecer.  Esta  oficina, 
creada  por  ley  de  noviembre  de  1903,  pero  que  sólo  comenzó  á  funcionar  en  febrero  de 
1901,  se  esfuerza  hoy  por  colocar  al  país,  desde  el  punto  de  vista  sanitario,  en  la  situación 
más  avanzada  posible  dentro  de  los  recursos  con  que  para  ello  cuenta,  y,  merced  á  su 
establecimiento,  me  es  posible  consignar  los  datos  que  contiene  este  informe,  en  el  que 
procuro  ceñirme  al  programa  publicado  por  la  Oficina  de  lasRepúblicas  Amerna    s. 

I. 

(a)  datos  sobre  la  prevalencia  de  las  enfermedades  contagiosas,  espeolalmentb 
la  plaga,  la  fiebre  amarilla  y  la  malaria. 

Las  eifermsdides  infecciosas  que  existen  en  el  Perú  son,  con  muy  poca  diferencia,  las 
que  se  eicuentran  ei  los  demás  países  americanos.  Sólo  una,  la  verruga  peruana  6 
emfermeiad  de  Carrióa,  es  peculiar  al  país,  y  aún  en  él,  sólo  se  encuentra  en  unas  pocas 
quebrad  is  de  la  sierra,  como  soi  algunas  de  la  Proviacia  de  Huarochirí,  en  el  Depárta- 
me ito  de  Lima,  otras  de  la  Provincia  de  Canta  del  mismo  Departamento,  y  algunas  del 
C;allejón  de  Huailas,  en  el  Departamento  de  Ancachs.  Su  distribución  geográfica  limitada 
hoy,  parece  que  no  lo  fué  tanto  en  épocas  remotas,  pues,  al  decir  de  los  historiadores  de 
los  tiempos  de  la  conquista  del  país  por  los  españoles,  la  hubo  también  en  otros  lugares 
del  Perú,  del  Ecuador  y  aun  de  Colombia.     De  todos  modos  hoy  se  encuentra  sólo  en  los 


SEGUNDA   CONFERENCIA    SANITARIA   INTERN  AC!  JÜN  AL.  otí^ 

valles  ó  quebradas  de  las  Provincias  citadas,  soa  por  f(nc  lits  cirfimHtancias  del  medio 
hayan  cambiado,  sea  por  otras  causas  desconocidas. 

Esta  curiosa  enlermedad,  que  es  inoculable,  que  ataca  al  lioiiibro  y  á  al{^j ñas  especies 
animales,  no  es  contagiosa  do  [)orsoiia  á  persona  y  no  desariolla  el  carácter  epidéinico; 
para  adquirirla  hay  que  ir  á  las  zonas  on  que  se  produce,  zoaíi^  que,  como  queda  dicho, 
son  pequeños  valles  do  la  región  montañosa  del  país.  Se  caracteriza  clínicame.ite  por 
fiebre  de  tipo  muy  varial)lo,  por  anornia  ó  disminución  co  siderable  de  los  glóbulos  rojos 
de  la  sangré,  cuyo  m'nnero  llega  á  veces  á  descender  á  1,ÜÜÜ,ÍXKJ  ó  aún  menos  i)or  mil. metro 
cúbico,  por  dolores  óseos  y  ail,i(;ulares  y  poi'  una  ei-upcion  que  se  verifica  en  l.i  i)i(;l  y  aún 
en  las  mucosas,  especialmente  en  las  partes  descubiertas,  constituida  por  bidones  de 
apariencia  carnosa,  de  volumen  variable  oitre  el  de  un  grano  de  mijo  y  el  de  una  naninja, 
que  sangran  fácilmente,  se  desocan  tomando  una  aparie  .cia  cornea  y  caen  sin  dejar  huellas 
y  que  están  constituidos  por  tejido  conj'untivo  y  vascular,  que  .semeja  por  su  disposición 
una  producción  sarcomatosa.  Ésta  enlermedad,  como  se  ha  dicho,  no  es  contagiosa;  en 
los  hospitales  de  Lima  se  vé  constantemente  casos  de  veiruga  sin  que  nunca  se  haya 
comprobado  su  transmisión  á  las  personas  que  rodean  ó  asisten  á  los  enlermos. 

La  malaria  es  endémica  en  el  Perú  en  muchos  lugaies  de  la  costa  ó  región  cisandina  de 
país.  Los  valles,  es  decir,  las  zonas  do  terreno  irrigadas  por  los  ríos  que  vienen  de  la 
cordillera  de  los  Andes  á  desaguar  en  el  Pacífico,  zonas  que  en  su  mayor  parte  se  apro- 
vechan para  el  sembrío  de  azúcar,  algodón,  arroz  y  algunos  otros  vegetales,  son  los  lugares 
en  que  el  paludismo  reina  de  preferencia.  Aún  cuando  ha  dismir.uido  algo  en  los  últimos 
años,  muy  especiahneute  en  Lima,  es  todavía  la  enlermedad  que  mayor  cilra  de  moibilidad 
causa  en  el  Perú  y  aunque  poi'  lo  general  las  fomias  más  comur.mente  observadas  son  las 
intermitentes  del  "tipo  terciana  ó  cuartana,  que  se  curan  con  facilidad  por  el  r-  gimen  quí- 
nico  cuando  son  atendidas  á  tiempo,  se  vé  todas  las  otras  foi-mas  hasta  hoy  descritas,  no 
siendo  raro,  sin  ser  frecuente,  er.contrar  las  perniciosas  y  las  crónicas  con  caquexia  y 
denutrjción  extremas.  Esta  última  forma  no  se  observa  siiio  cuando  el  eníermo  descuida 
el  someterse  oportunamente  al  tratamiento  apropiado.  La  dirección  de  salubridad  se 
ocupa  actuahnente  de  estudiar  los  procedimientos  más  adecuados  para  destmir  los  Anopheles 
á  fin  de  extirpar  ó  reducir  á  su  mínimum  posible  el  paludismo. 

La  malaria  se  presenta  también  pero  en  reducido  número  de  localidades  en  la  sierra, 
región  andina  ó  montañosa  del  país,  en  algunas  quebradas  ó  valles  que  por  su  clima  cálido, 
no  obstante  su  altura,  permiten  el  desarrollo  del  Anopheles  y  que  por  sus  cor.dicioncs 
topográficas  especiales,  presentan  lagunas  pequeñas  ó  charcos  donde  estos  se  reproducen; 
pero,  por  regla  general,  puede  decirse  que  la  sierra  del  Perú  no  es  una  comarca  palúdica. 

En  la  montaña,  es  decir,  en  la  región  transandina,  donde  el  clima  es  cálido  y  húmedo 
y  la  vegetación  exuberante  y  lujuriosa,  en  la  región  de  las  selvas  y  del  caucho,  existe 
también  el  paludismo  en  algunas  localidades,  pero  hay  otras  Ubres  por  completo  de  malaria. 

Si  la  morbilidad  del  paludismo  es  relativamente  grande  en  el  Perú,  la  mortalidad  en 
cambio  es  pequeña.  Salvo  en  los  caseríos  ó  poblaciones  muy  atrasadas,  cuyos  habitantes 
ignoran  ó  rechazan  el  tratamiento  quínico,  las  defanciones  por  paludismo,  aún  en  las 
formas  perniciosas,  son  relativamente  raras. 

La  fiebre  amarilla  no  existe  en  ninguna  zona  del  territorio  peruano.  Después  de  las 
epidemias  que  tuvieron  lugar  en  la  costa  del  Peni  en  los  años  de  1854,  1868  y  1881,  no 
han  vuelto  á  presentarse  casos  de  esta  enfennedad.  En  raras  ocasiones,  escapardo  á  las 
restricciones  sanitarias,  han  llegado  á  nuestros  puertos,  procedentes  de  Guayaquil  ó 
Panamá,  pasajeros  ó  tripulantes  atacados  de  esta  dolencia,  pero  aislados  inmediatamente 
en  los  lazaretos  y  protejidos  contra  las  picaduras  de  los  Stegomyia,  no  han  iormado  locos. 

El  pehgro  para  el  Perú  de  ser  infectado  por  la  fiebre  amarilla  previere  de  su 'proximidad 
al  Ecuador  y  á  Panamá,  países  en  donde  esta  enfermedad  es  endémica,  proximidad  que 
hace  que  sea  corta  la  duración  de  la  travesía  por  mar  de  Panamá  ó  Guayaquil  á  Paita 
ú  otros  puertos  peruanos  del  norte,  á  los  que,  por  consiguiente,  pueden  llegar  persoras 
sanas  en  apariencia  pero  ya  infectadas  y  en  el  período  de  incubación  de  la  fiebre.  Por 
otra  parte,  el  Stegomyia  existe  en  algunos  de  nuestros  puertos,  y  picando  á  un  pasajero 
que  llegara  enfermo  á  nuestra  costa,  podría  en  cualquier  momento  generar  una  epidemia 
más  ó  me-Aos  seria.  Para  evitarlo,  el  Gobierno  del  Perú  encamina  sus  esfuerzos  en  el 
sentido,  primero,  de  evitar  la  importación  de  enfermos  ó  de  zarcudos  i'^fectados,  y,  segundo, 
de  destruir  los  zancudos  susceptibles  de  infectarse.     Con  tal  fin,  al  llegar  los  buques  al 

Euerto  de  Paita,  que  es  el  primer  puerto  de  arribo  de  los  buques  que  hacen  el  tráfico  de 
i  costa  peruana,  son  sometidos  á  una  desinfección  hecha  con  anhídrido  suliuroso,  que 
tiene  por  objeto  destmir  los  zancudos  que  pudieran  venir  á  bordo  del  buque  y,  á  partir 
de  esta  desinfección,  es  decir,  á  partir  del  momento  en  que  las  personas  que  vienen  á  bordo 
no  pueden  infectarse,  se  pennite  al  buque  cargar  ó  descargar  libremente  y  admitir  nuevos 
pasajeros,  pero  se  somete  á  los  que  traírt  á  una  observación  de  siete  días:  y,  por  otra  parte, 
na  expedido  la  resolución  suprema  de  11  de  agosto  del  año  en  curso,  que  comisiona  al 
Dr.  A.  Barton  para  que  estudie  y  lleve  á  cabo  las  obras  que  deben  emprendei-se  con  el 
objeto  de  destruir  los  zancudos  transmisores  de  la  fiebre  amarilla  en  las  principales  locali- 
dades de  la  costa. 


400  SEGUNDA   CONFERENCIA    SANITARIA    INTERNACIONAL. 

Con  el  mismo  objeto  y  siendo  el  comercio  de  frutas  de  Guayaquil  y  Panamá  en  la  costa 
peruana,  un  peligro  de  importación  de  mosquitos  que  pudieran  estar  infectados,  se  ha 
expedido  la  resolución  suprema  de  P  de  setiembre  del  año  en  curso,  que  prescribe  que  esas 
frutas  deben  Uevai-se,  en  los  buques,  en  compartimentos  que  permitan  la  destrucción  de 
los  zancudos,  que,  como  es  sabido,  en  los  climas  tropicales  se  esconden  entre  la  fruta  y 
aun  se  alimentan  con  ella,  principalmente  con  los  plátanos  ó  bañarías  {Bañaría  edulis). 

En  cuanto  á  la  peste  bubónica,  fué  desconocida  en  el  Perú  hasta  el  mes  de  abril  de  1903. 
Las  incuivio  íes  que,  en  ese  año  y  los  anteriores,  había  hecho  en  la  parte  occidental  de 
América  1 1  m:iesta  plaga  del  Ganges,  no  habían  alcanzado  á  la  costa  penuxna.  San  Fran- 
cisco de  California  y  Mazatlán  habían  sido  atacados  antes  que  nosotros,  pero  es  difícil 
decir  con  seguridad  si  fué  de  una  de  esas  localidades  ó  si  fué  de  los  puertos  de  Australia 
ó  de  la  India,  de  donde  se  importó  la  epidemia  al  Perú,  por  que  el  comercio  de  productos 
susceptibles  de  vehicular  al  germen  de  Yersin  ó  á  roedores  con  él  infectados,  se  hacía  en 
esa  época  tanto  co  i  unos  como  con  otros  de  los  puertos  citados.  Es,  sin  embargo,  muy 
posible  que  la  peste  viniera  al  Perú  con  un  cargamento  de  arroz  y  de  trigo  que  un  vapor 
alemáa  dejó  en  varios  puertos  penianos  y  chilenos 

La  primera  aparición  de  la  enfermedad  en  el  hombre,  tuvo  lugar  el  28  de  abril  de  1903 
en  el  puerto  de  Pisco;  casi  simultáneamente,  el  29  de  abril,  enfermaba  un  operario  del 
molino  de  Santa  Rosa  en  el  Callao. 

En  Pisco,  que  cuenta  una  población  de  5,000  habitantes,  más  ó  menos,  no  hubo 
epidemia:  fueron  atacadas  sólo  cuatro  personas  que  habían  estado  en  contacto  con  ratas 
enfermas  ó  muertas.  De  estas  cuatro  personas,  tres  fallecieron  y  una  salvó.  El  último 
caso  falleció  el  3  de  mayo  de  1903.  Desde  entonces,  es  decir,  hace  veintinueve  meses,  no 
ha  habido  peste  ni  en  eí  hombre  ni  en  los  animales;  ese  puerto  esta  pues  indemne. 

En  el  Callao,  cuya  población  es  de  33,000  habitantes,  hubo  entre  el  23  de  abril  y  el  1°  de 
junio  de  1903,  diez  enfermos:  después  de  esa  época  no  ha  sido  necesario  abrir  el  lazareto 
del  puerro  por  que  los  pocos  casos  que  en  el  cui'so  de  los  veintiochoeraeses  transcurridos 
desde  entonces  se  han  presentado,  han  sido  trasladados  para  su  asistencia  á  Lima,  que 
dista  sólo  veinte  minutos  por  ferrocarril.  No  obstante  la  ruda  compaña  emprendida  contra 
ella,  la  enfermedad  no  ha  desaparecido  del  Callao,  pues  de  tarde  en  tarde;  á  veces  coa 
intervalos  de  tres  meses,  se  presentan  casos  de  peste  en  el  hombre  ó  roedores  muertos  de 
esa  enfermedad. 

El  número  total  de  casos  ocurridos  en  el  Callao  desde  el  29  de  abril  de  1903  hasta  el  30 
de  junio  de  1605  ha  sido  de  65,  con  37  defunciones,  lo  que  dá  una  mortalidad  bruta  de 
58.92  por  ciento  para  la  peste  bubónica  en  el  Callao;  pero  debe  tenerse  eti  cuenta,  al  anotar 
esta  mortalidad,  que  muchas  defunciones  ocurridas  por  peste,  principalmente  en  los  primeros 
días  de  la  aparición  de  esta  enfermedad  en  el  Callao,  tuvieron  lugar  por  que  los  enfermos 
no  se  sometieron  al  tratamiento  específico,  por  ignorancia  unas  veces,  por  temor  al  aisla- 
miento otras,  lo  que  se  confirma  considerando  que  los  cuatro  únicos  casos  ocurridos  en  el 
Callao  en  el  primer  semestre  de  1S05,  que  fueron  atendidos  en  el  lazareto  de  Lima,  no  han 
dado  sino  una  dcñmcion,  lo  que  correspondería  á  una  mortalidad  de  25  por  ciento. 

En  Moliendo,  puerto  principal  del  sur  de  la  costa  peruana,  con  algo  más  de  4,000 
habitantes,  la  peste  se  presentó  también  en  el  año  de  1903.  El  26  de  julio  ocurrió  el  primer 
caso  en  el  hombre  y  la  epidemia  duró  hasta  el  8  de  octubre,  produciéndose  durante  ella  51 
casos  y  20  defunciones,  ó  sea  una  mortalidad  absoluta  de  39.60  por  ciento.  Después  de 
diez  y  siete  meses  de  indemnidad,  en  marzo  de  1905,  hubo  una  nueva  epidemia  que  duró 
hasta  el  14  de  junio  último;  durante  ella  ocurrieron  125  casos,  con  49  defunciones,  lo  que 
da  una  mortalidad  de  39.28  por  ciento.  De  los  125  casos,  115  fueron  tratados  por  el  suero 
antioestoso  del  Instituto  Pasteur  de  París,  en  diversos  períodos  de  su  enfermedad  y  dieron 
40  defunciones,  ó  sea  una  mortalidad  de  34.78  por  ciento,  y  no  tuvieron  este  tratamiento  10, 
que  dieron  9  defunciones,  ó  sea  una  mortalidad  de  90  por  ciento.  Sumadas  estas  cifras 
con  las  de  la  epidemia  anterior  dan  para  Moliendo  un  total  de  176  casos,  con  69  deÍTinciones, 
que  hacen  una  mortalidad  absoluta  de  39.20  por  ciento.  De  ellos,  148  fueron  tratados  por 
suero,  con  49  defunciones,  lo  que  corresponde  a  una  mortalidad  de  33.10  por  ciento,  y 
28  no  tratados,  con  20  defunciones,  ó  sea  71.42  por  ciento  de  mortalidad. 

Después  de  Moliendo  la  enfermidad  invadió  la  Provincia  de  Pacasmayo,  comenzando 
en  ella  por  el  puerto  del  mismo  nombre  y  propagándose  después  á  San  Pedro,  capital  de 
la  Provincia,  á  los  caseríos  de  los  alrededores  de  ésta  y  á  los  distritos  de  Jequetepeque, 
Guadalupe  y  Chepén.  En  esta  Provincia  la  enfermedad  adquirió  más  que  en  ninguna 
otra  caracteres  de  endemicidad,  pues  desde  el  mes  de  agosto  de  1903  hasta  el  5  de  abril 
del  año  en  curso,  hubo  siempre,  salvo  pequeños  intervalos  de  tiempo,  casos  de  peste  en 
algimas  de  las  poblaciones  que  la  componen.  Desde  el  5  de  abril  esta  Provincia  está 
indemne.  El  número  total  de  casos  ocurridos  en  esos  veinte  meses  fué  de  366,  que  dieron 
211  defunciones,  lo  que  representa  una  mortalidad  absoluta  de  57.65  por  ciento;  de  ese 
total  de  casos  hubo  234  tratados  por  suero,  con  117  defunciones,  ó  sea  50  por  ciento  de 
mortalidad,  y  132  casos  que  no  sofrieron  el  tratamiento  específico  y  produjeron  94 
defunciones,  lo  que  dá  una  mortalidad  de  71.21  por  ciento. 


SEGUNDA    CONFERENCIA    SANJTAIilA    INTERNACIONAJ..  401 

Estas  cifras  rcforidas  á  las  distintas  localidades  do  la  Piíjvinciu  se  descomponen  como 
sigue : 

Pacasrnayo. — Do  aj^osto  do  1Ü03  á  octubre  do  1ÍJ04  (con  cortos  intervalos  do  indenniidad): 
Casos  65,  (lol'unciones  35,  mortalidad  absoluta  53.84  por  ciento;  tratados  44,  defunciones 
20,  mortalidad  45.45  por  ciento;  no  tratados  21,  d(!Í'un<;iones  15,  mortalidad  71.33  por 
ciento.  Em  onoro  do  1ÍJ05:  Casos  3,  defunciones  3,  mortalidad  aljsoluta  HXJ  por  ciento; 
tratado  1,  defunción  1 ,  mortalidad  100  por  ciento;  no  tratados  2,  defunciones  2,  mortalidad 
100  por  ciento.  Totid  de  Pacasmayo:  (Jasos  OÍS,  defuficioncs  38,  mortalidad  absoluta  55.88 
por  (liento;  tiatados  45,  defunciones  21,  mortalidad  40.üG  por  ciento;  no  tratados  23, 
defunciones  17,  mortalidad  73.91  por  ciento. 

San  Pedro  y  alrededores. — -De  octubre  do  1903  á  1"  de  febrero  de  1905:  Casos  135,  defun- 
ciones 92,  mortalidad  absoluta  08.14  por  ciento;  tratados  01,  defunciones  45,  mortalidad 
73.77  pof  ciento;  no  tratados  74,  defunciones  47,  mortalidad  63.51  por  ciento. 

Jeq'ietepeqiie. — Do  1°  de  setiembre  á  8"  de  noviembre  de  1904:  Casos  48,  defunciones  28, 
mortalidad  absoluta  58.50  por  ciento;  tratados  24,  defunciones  7,  mortalidad  29.16  por 
ciento;  no  tratados  24,  defunciones  21,  mortalidad  86.66  por  ciento. 

Gvadaliipe. — De  13  de  noviembre  de  1904  á  12  de  marzo  de  1905:  Casos  105,  defunciones 
45,  mortalidad  absoluta  42.85  por  ciento;  tratados  97,  defunciones  39,  mortalidad  40.20 
por  ciento;  no  tratados  8,  defunciones  6,  mortalidad  75  por  ciento. 

Chepén. — Do  23  de  enero  de  1905  á.  5  de  abril  de  1905:  Casos  10,  defunciones  8,  mortalidad 
absoluta  80  por  ciento;  tratados  7,  defunciones  5,  mortalidad  71.42  por  ciento. 

En  Lima  ocurrió  el  primer  caso  de  peste  el  6  de  octubre  de  1903,  en  las  inmediaciones 
del  depósito  de  carga  de  uno  de  los  ferrocarriles  que  unen  Lima  con  el  Callao,  y,  en  los  días 
sucesivos,  ocurrieron  nuevos  casos  en  el  mismo  barrio,  lo  que  hace  suponer  que  la  enferme- 
dad se  importó  del  Callao  á  Lima  con  ratas  infectadas  que  vinieron  entre  las  mercaderías 
que  se  traían  del  Callao,  ratas  que  á  su  vez  infectaron  á  las  demás  de  la  población,  princi- 

{ñando,  como  era  natural,  por  las  del  barrio  en  que  está  situado  el  depósito  de  la  carga  del 
errocarril  que  es  también  uno  de  los  barrios  menos  higiénicos  de  Lima  y  en  el  que  se  encon- 
traron por  primera  vez  ratas  muertas.  Desde  entonces  no  han  dejado  de  presentarse 
casos  de  peste,  aunque  en  algunas  ocasiones  con  intervalos  de  diez,  quince,  veinte  y  hasta 
veinticinco  días  entre  uno  y  otro;  los  meses  más  castigados  en  el  año  1904,  fueron  los  de 
marzo  y  abril,  meses  que  corresponden  al  principio  del  otoño. 

El  número  total  de  casos  en  la  provincia  de  Lima,  es  decir,  en  la  ciudad  y  sus  alrededores, 
á  la  que  se  puede  calcular  200,000  habitantes  «  ha  sido  hasta  el  30  de  junio  de  1905,  ó  sea 
en  veintiún  meses  de  463,  de  los  que  222  fueron  fatales,  lo  que  corresponde  á  una  mortalidad 
absoluta  de  47.94  por  ciento.  De  los  463  casos,  415  fueron  tratados  por  suero  y  48  no 
tuvieron  este  tratamiento,  dando  los  primeros  174  defunciones,  equivalentes  á  un  41.93 
por  ciento  de  mortalidad  y  los  otros  48  defunciones,  ó  sea  100  por  ciento  de  mortalidad. 

En  Paita,  puerto  situado  al  norte  de  la  costa  peniana,  que  cuenta  ima  publacion  de  3,500 
habitantes,  ha  habido  dos  epidemias  de  peste.  La  primera  se  inició  en  el  mes  de  abril  de 
1904  y  duró  hasta  el  9  de  setiembre  del  mismo  año,  en  cuyo  tiempo  dio  lugar  á  174  casos,  con 
73  defunciones,  lo  que  hace  una  mortalidad  absoluta  de  41.95  por  ciento.  Estos  casos  se 
descomponen  así:  Tratados  por  el  suero,  132,  con  40  defunciones;  no  tratados  por  el  suero, 
42,  con  33  defunciones;  lo  que  dá  una  mortahdad  de  30.30  por  ciento  para  los  primeros  y 
de  78.57  por  ciento  para  los  segundos.  De  septienlbre  de  1904  á  maj^o  de  1905,  es  decir 
durante  ocho  meses,  la  peste  desapareció  de  Paita,  pues  no  hizo  víctimas  ni  en  el  hombre 
ni  en  los  roedores;  en  mayo  del  año  en  curso  se  presentó  de  nuevo  y  hasta  el  30  de  junio 
había  producido  6  defunciones  en  10  casos  (mortalidad  absoluta  60  por  ciento),  de  los  que,  8 
tratados  con  suero  dieron  4  defunciones  y  2  no  tratados  2  defunciones,  ó  sea  una  mortalidad 
de  50  por  ciento  para  los  primeros  y  de  100  por  ciento  para  los  segundos.  El  número  total  de 
casos,  sumando  los  de  las  dos  epidemias,  alcanzaba  el  30  de  junio  á  184  con  79  defunciones, 
equivalentes  á  44.02  de  mortalidad  bruta;  de  ellos  140  tratados  por  suero  con  44  defun- 
ciones y  44  no  tratados  con  35  defunciones,  que  equivalen  á  31.42  por  ciento  j  79.54  por 
ciento  de  mortalidad  para  unos  y  otros  respectivamente.  Hasta  mi  salida  de  Lima  no 
había  desaparecido  la  epidemia,  al  pasar  por  ese  puerto  había  algunos  enfermos  en  el 
lazareto. 

El  puerto  de  Salaverry,  que  cuenta  una  población  de  1,000  habitantes  aproximadamente, 
fué  invadido  después  que  el  de  Paita,  presentándose  el  prinier  caso  en  el  hombre  el  27  de 
junio  de  1904;  el  último  ocurrió  el  4  de  setiembre  del  mismo  año  y  en  los  sesentaiocho  días 
comprendidos  entre  estas  dos  fechas,  ss  produjeron  36  casos  de  peste  con  20  defunciones, 
lo  que  da  una  mortalidad  absoluta  de  55.55  por  ciento.  De  los  36  casos,  27  fueron  tratados 
por  suero  y  dieron  11  defunciones  y  9  no  tratados  dieron  9  definiciones,  lo  que  hace  una 
mortalidad  de  40.74  por  ciento  y  de  100  por  ciento  respectivamente.  En  la  actuahdad  este 
puerto  está  indemne. 

a  El  censo  de  1903  dá  para  la  ciudad  sola  130,289  habitantes. 
1112a— 06 26 


402 


SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL. 


La  pcquofia  caleta  do  Iluanchaco,  inmediata  íl  SalavciTV,  quo  constituye  un  casorio  de 
unes  <!00  Imbitantcs,  estuvo  indemno  durante  la  cpidomia  U'^  Salavorry;  poro,  aunque  ésta 
había  terminado  á  principios  do  setiembre  do  1001,  como  queda  dicho,  en  el  mes  do  enero  do 
1£05,  fs  decir,  cuatro  mises  dispuós,  so  presentó  en  líuanchaco,  dando  31  casos  con  13 
dcíuncioma,  hasta  el  2  do  febrero  del  mÍHitio  aflo  en  que  oeurri»^  d  último;  la  mortalidad 
absoluta  fuó,  pu(  s,  do  41 .03  por  ciento,  Los  31  chhob  fueron  tratados  por  suero,  do  modoque 
la  mortalidad  con  relación  ni  tnitamiento  ( spi  oiíiciido  Íu6  la  misma  seflalada  como  absoluta. 

En  el  Dípaitamento  de  Lnnibaveque  hizo  la  pi  ste  su  aparición  el  14  do  s.  tiembro  do  1H04 
en  la  villa  do  Kten,  quo  cu(  nía  (lo  3,000  i'i  4,000  habitantes;  el  20  do  8(  tiembro  invadió  la 


ciudad  de  Lambayeciuo  y  ( 1  2  do  f(  bn  ro  de  IfiOf)  la  de  Uhie.layo,  que  ( s  la  cajiital  del  dopart- 
,  epidemia  terminó  en  Eten  y  en  Lambayequo  en  el  mes  do  abril  yen  Chiclayo 

.      '  '    "  1p(  ■    ■  '  "  .     ■ 

Los  casos  ocurridos  fueron;  En  Eten,  103  con  07  defuncioni s,  lo  quo  liaoo  06.04  por 


amento,    Lai,  .,    ,  ,    ,    ^  ^, 

el  28  do  mayo  del  año  en  curso,  fecha  disde  la  cua'l  permaneoo  indenmo  el  Departamento. 


1 


ciento  do  mortalidad  absoluta.  Tratados  con  suero  03  con  29  defunciones;  sin  tratamiento 
40,  con  38  d<  funcionís;  mortalidad  entro  los  primeros  40.31  por  ciento,  entro  los  segundos 
95  por  ciento,  lun  Lanibayqui^,  01  con  28  di  funcloius;  mortalidad  absoluta  45.60  por 
ciento.  Tratados  53  con  kX)  deftineione s,  mortalidad  37.73  por  ciento;  no  tiatat'ios  S,  con  8 
defunciones,  mortalidad  100  por  ciento.  En  OhieJayo,  107  con  122  defunciones,  ó  sea 
73.0')  por  ciento  do  mortalidad  absoluta.  Tratadotí' S2  con  40  defuncioms,  mortalidad 
66.09  por  ciento;  no  tratados  85  con  70  defunciones,  inoi'talidad  89.41  por  ciento. 

Por  último  el  pequeño  cas;  río  dc  Yttminclmd,  del  distrito  do  San  Pablo  en  la  Provincia  do 
Cajaniarca,  fué  invadido  por  la  ptsto,  prooedento  indudablemente  do  la  pj'ovincia  de 
Pacasmayo  con  la  que  está  limítrofo,  en  2  do  marzo  de  ISOñ;  la  epidemia  so  extinguió  el  31 
del  mismo  mts,  después  do  haber  ocasionado  entro  sus  £00  haoitantes  14  casos  con  14 
defunciones,  do  los  fiuo  7  íuoroa  tratados  por  el  suero  y  7  no,  sucumbiendo  todos  y 
desapareciendo  la  epidomia. 

Si  baceoTos  un  resumen  de  los  datos  consignados  antiriorm@nte  sobre  la  peste  butdnica, 


Loeeliáad. 


Flgeo 

Otúlao.... 
Mellando. 


Lima  (f  fsviaela  ái) .  = . 


2§  de  Síbú]  á  S  de  mayo  de 
im. 

m  d©  abril  de  I90a  á,  10  de 

Junio  dg  leoa, 
2ñ  de  Julte  de  1903  d  8  de 

eetubre  de  Mfi.  y  1»  de 

fflftve  de  1605  &  U  de  juale 
■  de  ft03, 
AgoitodeigoadSdeaMl 

le  um, 
6  de  octubre  de  llOiá,  10  de 

juBle  de  i60S. 
Afirlldeifi04á9de§etleffl= 

tere  de  1904,  maye  de  190§ 

dHO  de  Junio  del908. 
%7  de  Junio  de  1904  d  4  de 

getlefflbft»  de  1904,  II  de 

e)ie?0  de  WQñá2  de  febfere 

de  1909. 
14deBC'tíeinl3redel904á,Oi 

díí  maye  de  190a. 
iáaidemai'iedil90i...,  =  . 


2 añoi  3 
1?§  días 


1 
? 

S7  4[a8... 

TJíBeieB. 
Í9dlaB... 


Poblaeldfl 
aprexl= 


1,400 


347,400 


Total  de 


4 

65 
176 


463 
114 

67 


14 


1,670 


Me?feill= 

dad  per 

1,000  liftfei= 


eallae 
m' 

Fa „-,--- 

Lifflft  (í^roviseift 
pftiia. 

ialayéfryygai 
í/aflihayeíai  ( 
de).=.  =  =  =  =  =  ============ 

¥flfiiiiefead=  =  ========== 

f§taii8=  =  ::  ====== 

^  8  faltas  laseifTftse©!-: 


i:  §7 
44:00 

g:Íl 

11.67 


107 
ili 
§41 
iOi 
14 

114 


Mertali= 
dad  ftl58e= 
luía  per 


por  iuero. 


P6f 


(9) 


47.94 


100.00 


415 
140 


ij 


Curaroa. 


(9) 


117 
341 


14 


ee  tT«)tdá@«  mt  %mi<d  ^  %l  Oalla@«  p@¥  que  muebei 


SEGUNDA.   COINTFERENCIA  SAJNTITARIA  INTERN  ACIÓN  AL. 


403 


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dad  por 

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404:  SEGUNDA   CONFERENCIA    SANITARIA   INTERNACIONAL. 

El  sarampión  determina  también  periódicamente,  en  Lima  y  otras  ciudades  de  la  Repú- 
blica, pequeñas  epidemias.  No  reviste — salvo  rarísimas  excepciones — formas  graves.  Ataca 
casi  exclusivamente  á  los  niños. 

La  escarlatina  y  la  difteria  son  enfermedades  rarísimas  en  el  Perú.  -La  primera,  en  Lima, 
produjo  en  el  año  de  1903  sólo  tres  defunciones  y  cinco  en  el  de  1904,  habiendo  años,  como 
el  de  1902,  1900,  etc.,  en  que  no  se  ha  registrado  una  sola  defunción  por  esta  enfermedad. 
La  difteria  dio  12  defunciones  en  1903  y  S  en  1904. 

La  grippe  fué  desconocida  en  el  país  hasta  1890.  A  partir  de  ese  año  no  ha  dejado  de 
presentaren",  dett-rininando  en  1892  una  epidemia  notable  c|ue  dio  en  Lima  solamente  354 
defunciones;  en  1900  hubo  otra  que  produjo  195,  y  en  1004,  la  última,  que  ocasionó  103. 

La  tuberculosis  pulmonar  es  la  enfermedad  qut'  más  estragos  causa  en  la  costa  del  Perú. 
En  Lima  puedo  calcularss  en  un  25  por  ciento  la  cifra  de  mortalidad  por  tuberculosis  referida 
á  la  mortalidad  general.  Las  cifras  de  letalidad  por  tuberculosis  pulmonar  en  Lima,  en  los 
años  de  1903  j  1904,  han  sido  288  y  228  respectivamente.  Es  de  esperar  que  mediante  las 
obras  de  saneamiento  realizadas  yÁ.  ó  en  actual  ejecución,  esta  cifra  bajó  considerablemente, 
como  se  nota  yá  comparando  las  de  los  dos  últimos  años.     En  la  sierra,  la  tuberculosis 

Ímlmonar  es  una  enfermedad  rarísima,  lo  que  se  explica  por  la  altura  á  que  están  situadas 
as  poblaciones  y,  sobre  todo,  por  el  régünen  de  vida  al  aire  libre  y  la  escasez  de  la  población. 

La  uta  es  una  enfermedad  peculiar  á  ciertas  regiones  cálidas  de  la  sierra  del  Perú;  ha  sido 
confundida  por  nmchos  observadores  con  el  lupus  ó  tuberculosis  de  la  piel,  pero  existen 
entre  una  y  otra  ciertas  pequeñas  diferencias  que  quizás  serían  razón  suficiente  para  sepa- 
rarlas. Su  forma  es  la  de  ulceraciones  con  tendencia  al  fagedenismo,  cjue  llegan,  cuando  no 
se  la  trata  á  tiempo,  á  mutilar  los  órganos  atacados,  produciendo  lesiones  irreparables  y 
deformaciones  de  aspecto  repulsivo,  pues  se  presenta  de  preferencia  en  la  cara  ó  en  las  partes 
descubiertas.  Las  investigaciones  llevadas  á  cabo  por  los  observadores  del  país  no  han 
dicho  la  última  palabra  al  respecto,  pero  la  mayoría  considera,  como  queda  dicho,  á  la  uta 
como  una  tuberculosis  cutanea,  como  un  lupus. 

El  cólera  no  ha  invadido  nunca  el  territorio  nacional  no  obstante  haber  existido  en  Chile 
y  otros  países  de  Sud-América. 

El  beri-beri  no  existe  en  el  Perú,  por  lo  menos,  en  la  costa  y  en  la  sierra.  En  la  montaña 
(región  de  las  selvas)  es  probable  que  exista,  pues  lo  hay  en  las  provincias  limítrofes  de  la 
República  del  Brasil.  Con  la  inmigración  japonesa  que  en  pequeña  escala  se  ha  hecho  en 
los  últimos  tiempos  en  el  Perú,  se  ha  podido  conocer  prácticamente  en  nuestros  hospitales  de 
Lima  esta  enfermedad,  que  sólo  de  nombre  se  conocía  antes,  y,  los  casos  observados  en  inmi- 
grantes japoneses,  han  hecho  ver  que  la  enfermedad  ó  no  es  contagiosa  ó  no  encuentra  en  la 
costa  del  Perú  un  medio  propicio  á  su  propagación,  pues,  á  pesar  de  no  haberse  adoptado 
precauciones  de  ningún  género,  no  se  ha  podido  nunca  ver  su  contagio  á  los  enfermeros  ó  á 
los  otros  enfermos. 

La  kpra  es  también  entidad  completamente  desconocida  en  mi  país,  no  obstante  su 
abundancia  en  Colombia  y  el  Ecuador.  En  el  departamento  de  Piura  que  limita  con  el 
Ecuador  y  en  el  de  Loreto  limítrofe  con  el  Brasil,  se  vé,  en  algunas  ocasiones,  leprosos 
ecuatorianos  ó  brasileros  que  vienen  á  buscar  un  clima  favorable  á  su  mal.  En  Lima  se  ha 
visto  también  algunos  chinos  leprosos.  No  existiendo  la  enfermedad  entre  los  peruanos  y 
siendo  fácil  que  se  desarrolle  por  inmigi-acion  de  leprosos  extranjeros,  dado  el  carácter  con- 
tagioso reconocido  á  la  lepra  por  la  mayor  parte  de  los  tratadistas,  el  Gobierno  de  la  Repú- 
blica ha  expedido  recientemente  una  resolución  que  prohibe  el  ingreso  al  territorio  nacional 
á  los  leprosos  y  ordena  el  aislamiento  de  los  que  existen  en  el  departamento  de  Loreto,  que, 
como  queda  dicho,  son  casos  importados,  en  una  leprosería  que  se  ha  mandado  establecer. 

En  años  ya  remotos  ha  habido  en  diversas  regiones  del  Perú  epidemias  de  disentería.  Hoy 
esta  enfermedad  no  existe  como  endemia  ni  como  epidemia  en  ninguna  sección  del  territorio 
peruano.  En  algunas  ocasiones  se  observa  en  nuesti'os  hospitales  casos  de  disentería  espo- 
rádica, poro,  la  mayor  parte  de  las  veces,  las  llamadas  disenterías  no  son  sino  colitis  ulcerosas 
ó  ulcero-membranosas  que  ceden  fácilmente  al  régimen  alimenticio  y  medicamentoso 
adecuado,  sin  manifestar  nunca  carácter  contagioso. 

El  anquilostoma  duodenalis  existe  en  el  Perú  en  la  zona  conocida  con  el  nombre  de  la 
montaña  (región  trasandina  ó  de  las  selvas)  y  se  adquiere  casi  siempre  bebiendo  agua  de 
mala  calidad  sin  filtrarla  ó  tomando  crudas  legumbres  que  regadas  con  dicha  agua  pueden 
como  ella  ser  el  vehículo  de  introducción  en  el  tubo  digestivo  de  los  huevecillos  de  este 
parásito.  Su  persistencia  y  reproducción  en  el  intestino  humano  determinan  fenómenos  pa- 
tológicos conocidos  entre  nosotros  con  el  nombre  de  anemia  de  la  montaña  y  con  el  de  anqui- 
lostomiasis  ó  anquüostomacia  en  otros  países.  Consisten  esencialmente  en  anemia  profunda 
con  soplo  aórtico,  edemas,  fatiga,  palpitaciones,  derrames  en  las  serosas,  diarrea  y  fenómenos 
consumptivos  que  conducen  á  una  terminación  fatal,  cuando  no  se  emprende  á  tiempo  un 
tratamiento  racional.  En  nuestros  hospitales  produce  muy  buenos  resultados  el  timol 
como  parasiticida  en  el  caso  especial  del  anquilostoma.    Su  profilaxia  estriba  esencialmente 


SEGUNDA    CONFERENCIA   SANÍTAIUA    INTERNACIONAL.  405 

en  beber  sólo  agua  filtrada  (filtros  Pastcur-Chambf^rland)  ó  cocida  y  coiruT  la-s  legumbres 
cocidas,  on  las  localidades  en  donde  existe  el  parásito  frecuentemente. 

No  existe  en  el  Perú  la  rabia.  El  carbón  liurnano,  relativamente  frecuente  en  otra 
época,  ha  disminuido  eonsiderablemente.     El  tí'itanos  existe,  pero  es  raro. 

11. 

(b)  SUMARIO  DE  LAS  LKYKS  gANTrARIAS  Y  DE  OtlAIlENTENA  QUE  SK  JIAVAN'  I)IC:TADO  DESPUÉS 

DE   LA   PRIMERA   CONVENCIÓN. 

(c)  TODO    TRABAJO    SANITARIO    ESPECIAL   QUE    SE    ESTÉ    EJECUTANDO    Ó    QUE    SE    TRATE    DE 

.  LLEVAR   Á    CABO. 

Aún  cuando  el  programa  científico  publicado  por  la  Oficina  Sanitaria  Internacional  para 
los  informes  de  los  delegados  en  esta  segunda  conferencia  prescribe  í|ue  .se  indií(uen  sólo 
las  leyes  y  i'csoluciones  sanitarias  y  de  cuarentena  dictadas  después  de  la  primera,  que 
tuvo  lugar  en  diciembre  de  1902,  no  habiendo  tenido  en  ella  el  Perú  un  representante  j 
queriendo  dar  una  idea  tan  completa  como  sea  posible  de  la  oiganización  sanitaria  de  mi 
país,  algunas  de  cuyas  instituciones  y  leyes  son  anteiiores  á  esa  fecha,  me  apartarí-  algo 
en  este  punto  del  programa  referido,  pidiendo  por  ello  excusas  á  la  conferencia,  así  como 
las  pido  también  por  tratar  en  el  infonne  juntos  los  temas  (6)  y  (c)  á  lo  que  me  obliga  el 
estar  en  el  Perú  en  ejecución  actual  los  trabp.jos  sanitarios,  tanto  los  que  se  refieren  á  legis- 
lación como  los  referentes  á  obras  de  saneamiento,  lo  que  hace  difícil  de  separar  las  leyes, 
reglamentos  ó  resoluciones  de  sanidad  de  los  trabajos  6  instalaciones  del  mismo  ramo,  que 
las  complementan. 

1.  Organización  sanitaria.— hos  servicios  de  sanidad  pueden  considerarse  separados  en 
dos  clases:  generales  y  locales. 

Los  primeros,  que  comprenden  la  dación  de  una  reglamentación  sanitaria  marítima  y 
terrestj-e,  la  vigilancia  de  su  cumplimiento  y  el  de  las  leyes  existentes,  el  estudio  y  ejecu- 
ción de  las  reformas  y  obras  necesarias  para  mejorar  las  condiciones  sanitarias  del  país,  la 
profilaxia  de  las  enfermedades  exóticas  y  la  lucha  contra  las  endemias  j  epidemias  que 
existen  en  el  país,  la  organización  de  la  estadística  demogi-áfica  médica  y  la  clasificación 
de  las  enfermedades  para  los  efectos  del  registro  de  la  morbosidad  en  el  territorio  nacional, 
etc.,  corren  á  cargo  de  la  Dirección  de  Salubridad,  que  es  una  de  las  tres  ramas  que  forman 
el  Ministerio  de  Fomento. 

Los  segundos,  es  decir,  los  locales,  corren  á  cargo  de  las  municipalidades. 

La  Dirección  de  Salubridad,  creada  por  ley  de  6  de  noviembre  de  1603,  pero  que  comenzó 
á  funcionar  solamente  en  febrero  de  1904,  se  compone  de  dos  secciones:  La  de  Higiene  y 
la  de  Demografía.  Al  frente  de  la  Dirección  se  encuentra  el  Doctor  Julián  Arce,  bien  cono- 
cido en  el  país  por  sus  publicaciones  en  materia  sanitaria.  El  Director  de  Salubridad 
depende  directamente  del  Ministro  de  Fomento,  y,  por  su  intermedio,  del  Presidente  de  la 
Repúbhca. 

La  Sección  de  Higiene  y  la  de  Demografía  cuentan  cada  una  con  un  jefe  técnico  y  con 
los  empleados  necesarios  para  su  servicio;  jefe  de  la  Sección  de  Higiene  es  el  suscrito; 
jefe  de  la  Sección  de  Demografía  el  Doctor  Rómulo  Eizaguirre.  Está  además  en  forma- 
ción especial  para  la  dirección  y  ejecución  de  todos  los  trabajos  de  agua  potable  en  el  país, 
y  se  ocupa  de  este  ramo  el  Dr.  Abel  S.  Olaechea,  médico  adscrito  á  la  Dirección  de 
Salubridad. 

Como  cuerpo  consultivo  de  la  Dirección,  funciona  la  Junta  Suprema  de  Sanitad,  presi- 
dida por  el  Ministro  de  Fomento  y  compuesta  por  profesores  de  la  Facultad  de  Medicina, 
miembros  de  la  Academia  Nacional  de  Medicina,  el  Director  de  la  Sociedad  de  Benefi- 
cencia Pública,  el  Director  de  la  Marina,  el  jefe  de  la  Sección  Consular,  un  ingeniero  de 
Estado,  el  Presidente  de  la  Cámara  de  Comercio  y  el  alcalde  dé  Lima. 

Como  se  vé,  la  Dirección  de  Salubridad,  asesorada  cuando  es  necesario  por  la  Junta 
Suprema  de  Sanidad,  forma  la  oficina  central  de  la  que  dependen  todos  los  servicios  gene- 
rales de  higiene  y  de  demografía  públicas  en  el  país.  Su  creación  reciente  y  las  circun- 
stancias especiales  originadas  en  el  país  por  la  existencia  de  la  peste  bubónica,  no  le  han 
permitido  aún  desarrollar  su  actividad  en  toda  la  esfera  de  acción  que  la  ley  le  asigna, 
pero  existen  en  el  Gobierno  de  la  República  y  en  el  personal  que  compone  la  Dirección, 
los  propósitos  de  ensanchar  el  radio  de  sus  atribuciones,  creando  secciones  especiales  para 
los  distintos  ramos  que  de  ella  dependen,  á  fin  de  especializar  su  personal  en  cada  uno  de 
ellos  j  conseguir  así  el  mayor  aciarto  en  sus  determinaciones.  El  primer  paso  en  ese  sen- 
tido se  ha  dado  já  con  ia  creación  del  cargo  de  médico  adscrito  á  la  Sección  de  Higiene, 
encargado  del  estudio  de  las  cuestiones  de  agua  potable  exclusivamente.  Con  el  mismo 
fin,  la  Dirección  de  Salubridad,  en  virtud  de  ley  y  reglamento  especiales,  envía  anualmente 


406  SKGIJXDA  COHSTFERKEiCIA  SAJSTITABTA    USTEBOÍACIONALu 

á  Europa  ó  á  los  Estados  Unidc»,  á  voluntad  de  los  interesados.  ¿  dos  jóvenes  médicos,  j 
los  sostiene  por  dos  años  estudiando  una  especialidad,  y  mantiene  en  Europa  un  agente 
sanitario  que  le  iníomie  sobre  los  asuntos  que  pueden  interesarle.  Con  el  mismo  criterio, 
ha  solicitado  y  obtenido  de  la  benevolencia  del  Gobierno  Americano  el  envío  ¿  Panamá, 
formando  parte  de  la  Comisión  Sanitaria  del  Canal,  de  un  médico  y  uu  ingemero  peruanos, 
que  aprendan  de  sus  colegas  americanos  los  métodos  y  procedimientos  que  so  pongan  en 

Eractica  en  la  obra  de  civilización  y  de  humanidad  que  el  Gobierno  de  este  gran  país  va  á 
evar  á  cabo  en  el  istmo. 

La  Dirección  de  Salubridad  tiene  á  su  cargo,  y  le  dá  preferente  atención,  el  estudio  de 
todas  las  cuestiones  referentes  á  las  obras  de  agua  potable  y  desagüe  de  las  poblaciones  del 
Perú.  Este  ramo  de  la  higiene  púbUca,  uno  de  los  más  importantes,  exije  im  personal 
especialmente  pieparado,  con  el  que  aún  no  cuenta,  pero  que  tiene  el  pi-opósito  de  adquirir 
en  breve  plazo,  contratando  en  Eiuopa  ó  en  los  Estados  L'nidos  ingenieros  sanitarios  que 
presten  sus  servicios  mientras  se  forman  los  nacionales.  No  obstante  esta  carencia  de 
personal,  se  llevan  á  cabo  actualmente  estudios  y  obras  de  este  género  valiéndose  de 
ingenieros  exti-anjeros  y  aún  de  algunos  pocos  nacionales  que  han  estudiado  este  ramo  en 
otros  países.  Así  se  lleva  actualmente  á  cabo  los  estudios  de  dotación  de  agua  potable, 
desagüe  y  desecación  y  la  implantación  de  estos  servicios  en  Iquitos,  Moquegua,  Cuzco, 
Puno,  etc. 

La  Sección  de  Higiene  se  ocupa  tanto  del  servicio  de  sanidad  marítima  como  del  sanidad 
terrestre.    Para  el  primero  cuenta  con: 

(a)  Las  estaciones  sanitarías  del  Callao,  Paita  é  Ho. 

(6)  Los  servicios  sanitanos  de  ios  otros  puertos. 

(c)  Los  médicos  sanitarios  y  titulares. 

(d)  IjSl  policía  de  salubiidad. 

Para  el  servicio  de  sanidad  terrestre  cuenta  con:  .  , 

(a)  Las  juntas  de  sanidad  departamentales  y  provinciales. 
(6)  Los  médicos  titulares  y  sanitanos. 

(c)  Los  lazaretos. 

(d)  El  servicio  de  vacunación  y  seroterapia. 

(e)  La  policía  de  salubridad. 

I^ximamente  contará  también,  como  queda  dicho,  con  personal  de  ingenieros  sanitarios. 

SERVICIO  MABÍmiO. 

(a)  Las  estaciones  sanitarias  de  Paita,  Callao  e  Oo,  es  decii-,  de  uno  de  los  puertos  más 
septentrionales  de  la  costa  peruana,  de  imo  de  los  más  meridionales  y  del  puerto  principal 
y  central,  fueron  creadas  por  ley  de  20  de  noviembre  de  1£03,  pero  sólo  comenzaron  á 
instalarse  una  vez  establecida  la  Dirección  de  Salubridad,  cuando  se  consignaron  en  el 
presupuesto  de  la  Kepúbhca  los  fondos  necesarios  para  comenzar  su  ejecución.  Estas 
estaciones,  destinadas  á  servir  de  ültro  contra  la  importación  al  país  de  enfermedades  pes- 
tilenciales exóticas  por  via  marítima,  no  están  todavía  completamente  instaladas,  en  el 
sentido  de  que  no  comprenden  aún  todos  los  servicios  ó  secciones  de  que  deben  componerse. 

(a)  La  estación  sanitaria  del  Callao. — Comprende: 

1.  Servicio  de  visita  sanitaria  de  ¡ruques  á  su  Uegada. — ^Antes  de  ser  recibidos  á  libra 

filática,  los  buques  que  ll^an  al  Callao,  como  á  cualquier  puerto  de  la  costa  peruana,  sufren 
a  visita  sanitaria,  que,  en  el  Callao,  es  practicada  por  el  médico  titular  de  esa  provincia. 
Este,  después  de  examinar  las  patentes  y  documentos  de  sanidad  y  de  observar  á  los 
pasajeros  y  tripulantes  comprobando  el  estado  de  su  salud,  visita  los  distintos  comparti- 
mentos de  la  nave  para  darse  cuenta  de  su  estado  de  higiene  y  para  determinar  los  casos  en 
que  hay  necesidad  de  adoptar  alguna  medida  precaucional  y  la  naturaleza  de  ésta. 

Si  el  buque  viene  de  un  puerto  indemne  y  no  conduce  enfermos  ni  carga  sospechosa,  la 
única  medida  que  se  adopta  es  la  de  vacunar  á  los  pasajeros  ó  tripulantes  que  no  lo  hayan 
sido  recientemente.  Cuando  se  trata  de  naves  que  conducen  inmigrantes,  se  examina 
ademas  á  estos  desde  el  punto  de  vista  de  la  lepra,  por  cuanto  se  ha  prohibido,  por  resolución 
suprema  de  17  de  irarzo  del  año  en  curso,  el  ingreso  de  leprosos  al  territorio  de  la  República. 

2.  Servido  de  desinfección  de  los  buques  y  su  carga. — Si  el  buque  viene  de  un  puerto  infectado 
ó  sospechoso  de  fiebre  amarilla,  peste  bubónica,  cólera  ó  viruela,  ó  conduce  enfermos  ó 
sospechosos  de  una  de  estas  enfermedades,  ó  cai^a  procedente  de  una  locahdad  en  la  que 
exista  una  de  ellas  en  forma  epidémica,  lo  que  se  comprueba  por  la  visita  sanitaria  y  el 
examen  de  los  documentos  del  buque,  se  somete  á  este  á  medidas  precaucionales  que  varían 
s^ún  los  casos,  pero  que  consisten  por  lo  que  se  refiere  al  buque  mismo  y  su  carga  en  una 
desinfección  de  los  compartimentos  del  buque  que  inspiren  desconfianza. 

Para  esta  operación  la  estación  sanitaria  del  Callao  cuenta  con  dos  aparatos  "Clayton" 
del  tipo  B,  que  producen  23  metros  cúbicos  de  gas  por  minuto  cada  uno,  montados  en 
embarcaciones  especiales,  una  de  ellas  á  vapor,  y  manejados  por  el  personal  técnico  nece- 
sario. Con  eDos  se  hace  la  desinfección  de  las  bodegas  del  buque  y  de  las  mercaderías  que 
encierra,  así  como  la  de  los  pañoles  que  contienen  artículos  del  buque,  cuando  se  trata  de 


SEGUNDA   CONFERENCIA   SANITABIA   INTERNACIONAL.  407 

destruir  las  ratas  de  la  nave,  los  dopartaraontos  de  los  marineros,  y  en  general  todos  los 
compartimentos  del  buque  que  puedan  cerrarse  para  evitar  la  salida  del  gas. 

La  desinfección  por  el  gas  "Clayton"  (mezcla  de  aire,  anhídrido  sulfuroso  y  pequeñas 
cantidades  de  anhídrido  suirúrico)  se  ejecuta  llenando  de  gas  los  departamentos  que  se 
quiere  desinfectar,  al  mismo  tiempo  que  se  extrae  aire  de  ellos,  y  cerrándolos  luego  para  que 
las  mercaderías  permanezcan  cinco  á  seis  horas  on  contacto  del  gas.  La  duración  total  de 
esta  operación  varía  naturalmente  con  la  capacidad  del  buque,  poro,  para  los  mayores  de 
los  que  llegan  al  Callao,  no  pasa  de  ocho  á  nuevo  horas,  roducióndose  á  seis  ó  siete  para  los  de 
tonelaje  corriente.  Esta  desinfección  se  realiza  al  mismo  tiempo  ciue  las  demás  operaciones 
sanitarias  del  buque,  de  modo  q^ue  la  duración  señalada  para  ella  es  el  máximum  de  la 
demora  que  las  medidas  de  sanidad  hacen  sufrir  á  una  nave  en  el  Callao,  antes  de  per- 
mitirle la  descarga. 

Para  la  desinfección  de  los  otros  departamentos  del  buque,  camarotes,  salones,  cámaras, 
etc.,  se  hace  uso,  cuando  es  necesario,  de  aparatos  formoladores  á  presión;  la  estación 
sanitaria  del  Callao  cuenta  con  cuatro  de  estos  aparatos  del  tipo  más  grande  que  fabrica  la 
Kny  Scheerer  Co.  de  New^York.  La  desinfección  de  los  equipajes,  ropa  de  la  tripulación, 
etc.,  se  hace  en  la  estufa  á  vapor  del  buque,  ó  en  la  de  tierra  si  los  equipajes  sospechos  son 
desembarcados,  empicándose  el  formol  ó  el  anhídrido  sulfuroso  para  los  objetos  que  no 
podrían  resistir  la  desinfección  por  la  estufa  de  vapor  de  agua  á  presión. 
|í  En  los  casos  en  que  se  trata  de  buques  manifiestamente  infectados,  se  lavan  también  los 
pisos,  paredes,  techos,  muebles,  etc.,  con  soluciones  desinfectantes  (cloruro  de  cal,  bicloruro 
de  mercurio,  lysol,  creolina,  ácido  fénico,  etc.)  manejadas  por  medio  de  bombas  á  presión. 

Todas  estas  operaciones  son  dirigidas  por  un  médico  sanitario  y  ejecutadas  por  los 
empleados  técnicos  que  el  servicio  exige.  El  personal  que  estaba  encargado  de  este  servicio 
á  mi  salida  del  Callao,  era  el  siguiente: 

Jefe  módico  Dr.  Fabio  M.  Reynoso. 

Un  ayudante  del  mismo. 

Un  rñecánico  para  el  manejo  de  la  lancha  á  vapor  y  uno  de  los  aparatos  "Clayton" 
montado  en  ésta. 
:-  Un  ayudante  del  mismo. 
f  Un  patrón  de  la  embarcación  (timonel). 
íi'  Un  fogonero. 
^  Un  guardián. 
íTs  Dos  marineros. 
j5»  Dos  peones. 

íí.  Un  mecánico  para  el  manejo  del  otro  aparato. 
^~  Un  ayudante. 
íti  Un  guardián. 

P  El  precio  de  las  desinfecciones  se  cobra  á  las  compañías  á  que  pertenecen  las  naves,  pero 
este  precio  es  poco  elevado,  por  cuanto  no  se  cobra  sino  el  valor  de  los  materiales  usados. 
La  desinfección  de  los  grandes  vapores  de  pasajeros  y  carga  que  hacen  ordinariamente  el 
tráfico  del  litoral  peruano — "Pacific  Steam  Navigation  Company,"  "Compañía  Sud- 
Americana  de  Vapores,"  "Compañía  Kosmos,"  "Lamport  &  Holt,"  "Merchant  Line," 
etc. — ocasiona  á  estas  un  gasto  de  35  á  100  soles  de  plata,  ó  sea  de  $17  á  $50  cada  una,  por 
término  medio.     Alas  embarcaciones  de  pequeño  tonelaje  se  las  hace  el  servicio  gi'atuito. 

La  desinfección  de  las  naves  y  la  de  su  carga  se  realiza  según  los  casos  á  la  llegada  de  ellas, 
para  prevenir  la  importación  de  enfermedades  exóticas,  ó  á  la  salida,  cuando  se  trata  de  un 
puerto  peruano  infectado,  para  evitar  que  los  demás,  puertos  peruanos  ó  extranjeros  á  los 
que  el  buque  se  dirija  puedan  infectarse  á  su  vez.  Á  mi  salida  del  Callao,  se  desinfectaba 
¿1  salir  á  los  buques  en  este  puerto,  inmediato  á  Lima,  donde  había  casos  de  peste  y  en  el  de 
Paita,  donde  los  había  también,  siempre  que  hubieran  recibido  en  ellos  carga  peligrosa. 

3.  Semcio  de  desinfección  de  equipajes. — Este  servicio  se  hace,  en  la  estación  sanitaria  del 
Callao,  en  tierra,  en  una  instalación  provisional  que  cuenta  con  una  estufa  á  vapor  de  agua 
á  presión  de  fábrica  alemana  y  aparatos  generadores  de  formaldehida  gaseosa.  Junto  con 
el  material  del  edificio  de  la  estación  sanitaria  del  Callao,  se  ha  pedido  á  Europa  seis  estufas 
más,  de  gran  tamaño,  dos  de  las  cuales  se  destinarán  á  este  puerto,  para  hacer  más  rápido  el 
servicio  que  hoy  se  hace  con  una  sola  estufa. 

Los  equipajes  se  desinfectan  á  la  estufa  ó  al  formol,  según  su  naturaleza,  cuando  es  nece- 
sario hacerlo;  pero  todos  son  revisados  por  el  médico  sanitario  encargado  de  este  servicio, 
antes  de  permitir  su  embarque  en  el  Callao,  para  evitar  que  con  ellos  pudieran  ir  gérmenes 
pestígenos  á  otras  localidades  del  país  ó  del  extranjero. 

El  personal  que  se  ocupa  de  este  servicio  en  la  estación  sanitaria  del  Callao  se  com- 
pone de: 

Un  médico  jefe,  Dr.  Justo  L.  Castro  Gutiérrez. 

Un  ayudante,  estudiante  de  medicina. 

Un  mecánico  para  la  estufa. 

Un  empleado  para  los  formoladores. 

Un  guai'dian,  dos  peones. 


408  SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL. 

Este  personal  se  aumentará  cuando  lleguen  y  queden  instaladas  las  nuevas  estufas.  El 
servicio  es  gratuito.  Su  eficacia,  tanto  para  la  estufa  como  para  la  desinfección  al  formol 
se  ha  comprobado  experimentalmente  en  divereas  ocasiones. 

4.  Servicio  de  asistencia  de  contagiosos. — Entre  los  edificios  pedidos  á  Inglaterra  á  la  casa 
Humphreys,  de  Londres,  para  la  estación  sanitaria  del  Callao,  se  comprende  dos  pabellones 
de  12  camas  cada  una  para  el  tratamiento  de  2  enfermedades  distintas  simultáneamente  y  1 
pabellón  de  dos  camas  para  cnformos  en  observación.  Estos  edificios  de  hierro  y  madera 
vendrán  listos  para  ser  annados  é  instalados  inmediatamente.  Deben  llegar  al  Callao  en  el 
mes  de  diciembre- ó  en  el  de  enero  próximo,  y  la  instalación  tendrá  todos  los  anexos  indis- 
pensables á  este  servicio. 

Por  ahora  se  lleva  á  cabo,  provisionalmente,  en  un  lazareto  flotante;  es  decir,  en  un  buque 
nacional  que  se  ha  destinado  á  este  objeto,  dotándolo  de  los  elementos  más  indispensaWes 

[)ara  el  caso.  En  él  se  ha  estado  asistiendo  á  los  enfermos  de  viiiiela  llegados  al  Callao  en 
os  buques  procedentes  de  la  costa  chilena,  durante  la  última  epidemia  que  ha  habido  en  ese 
f)aís.  Play  también  en  tierra,  en  la  zona  que  ocupará  la  instalación  de  los  pabellones  de 
a  estació  sanitaria,  barracas  de  madera  que  se  construyeron  el  año  de  1903,  cuando  se  pre- 
sentó en  el  Callao  la  peste  bubónica,  las  que  se  encuentran  cerradas  pero  listas  para  abrirse 
nuevamente  si  llegaran  al  Callao  buques  portadores  de  enfermos  de  esa  naturaleza. 

El  lazareto  flotante  cuenta,  «demás  del  personal  de  marina  necesario  para  la  "conservación 
y  cuidado  del  buque,  con  un  médico,  un  eufennero  fai-macéutico  y  un  asistente.  Las  barra- 
cas ó  lazareto  de  tierra,  clausuradas  como  están,  no  tienen  actuaUíiente  personal  de  asisten- 
cia, pero  en  el  caso  de  cjue  llegaran  á  abrirse,  estarían  bajo  la  dirección  técnica  del  médico 
titular  del  Callao,  según  lo  dispone  el  reglamento  de  sanidad.  El  sei-vicio  de  asistencia  de 
contagiosos  es  gratuito. 

5.  Servicio  de  aislamiento  y  vigilancia  de  los  contactos. — La  estación  sanitaria  del  Callao 
comprenderá  entre  sus  edificios  un  pabellón  de  cuarentena  para  pasajeros  sanos,  compuesto 
de  40  habitaciones  separadas,  para  una  ó  dos  personas  (pasajeros  de  primera  clase),  un 
comedor,  una  sala  de  reunión,  cocina,  habitaciones  para  sirvientes,  water-closets,  baños,  etc., 
independientes  de  todos  los  otros  servicios  de  la  estación  sanitaria  y  con  instalación  seme- 
ción  semejante,  pero  menos  cómoda,  para  los  pasajeros  de  tercera.  Actualmente  no  hay  una 
instalación  en  que  hacer  este  servicio  y  el  Gobierno  procura  adquirir  con  ese  objeto  un 
pontón,  que,  una  vez  instalado  el  servicio  en  su  edificio  propio,  servirá  para  la  observación 
sanitaria  de  los  inmigrantes. 

Careciéüdose  por  el  momento  de  local  de  obsei-vación  de  pasajeros  en  el  Callao,  se  recurre,, 
según  los  casos,  bien  sea  á  la  obseivación  á  bordo  del  mismo  buque  que  los  conduce,  hasta 
completar  el  período  peligróse  (esto  se  hace  en  la  actualidad  con  los  pasajeros  de  Panamá  y 
Guayaquil  que  llegan  al  Callao  después  de  cinco  ó  seis  días  de  su  salida  de  esos  puertos,  á  los 
que  se  prohibe  desembarcar  por  uno  ó  dos  días,  á  fin  de  que  completen  los  siete,  que  se  toman 
como  término  medio  del  período  de  incubación  de  la  fiebre  amarilla),  bien  sea  al  pasaporte 
sanitario,  ciue  permite  á  los  pasajeros  bajar  á  tierra,  con  sólo  la  obligación  de  dar  su  dirección 
para  se  visitados  por  los  médicos  sanitarios  diariamente  hasta  completar  su  período  peligroso 
(esto  se  hace  actualmente  con  los  pasajeros  que  vienen  de  puei-tos  sospechosos  de  peste 
bubónica). 

El  sei-vicio  de  vigilancia  médica  de  los  pasajeros,  cuando  éstos  hacen  su  cuarentena  á 
bordo,  está  á  cargo  del  médico  titular  de  Callao;  en  tierra,  el  servicio  corre  á  cargo  de  los 
médicos  sanitarios  de  las  ciudades. 

6.  Servicio  de  inspección  de  pasajeros  á  la  salida. — Aun  cuando  el  CaDao  no  puede  consi- 
derarse como  un  puerto  infectado  de  peste  bubónica,  puesto  que  no  hay  en  él  epidemia,  sino 
que  de  tarde  en  tarde  se  presentan  casos,  no  bien  filiados,  muchos  de  los  cuales  han  tomado 
origen  probablemente  en  Lima,  esta  circunstancia  y  la  de  su  pequeña  distancia  á  la  capital 
(14  kilómetros)  con  la  que  mantiene  tráfico  constante  y  en  la  que,  aunque  pocos,  no  han 
faltado  casos  desde  1903,  hace  que  se  considere  como  sospechoso  y  que  se  obhgue  á  los  pasa- 
jeros que' en  él  se  embracan  á  ser  inspeccionados  al  salir,  como  medio  de  evitar  que  algunos 
de  ello.s  puedan  llevar  consigo  á  los  demás  puertos  peruanos  ó  extranjeros  los  gérmenes  de 
ese  enfermedad.  No  se  premite  seguir  viaje  á  los  febriscitantes  ni  á  aquellos  que  presentan 
síntomas  sospechosos  desde  el  punto  de  visita  de  la  peste  ú  otra  de  las  enfermedades  epidémi- 
cas graves,  así  como  á  los  que  no  estén  vacunados  ó  revacunados  recientemente.  Esta  pre- 
caución unida  á  la  inspección  y  desinfección  de  los  equipajes  que  salen  del  Callao,  hecha  tan 
rigurosamente  como  es  posible,  constityue  una  garantía  contra  la  infección  de  la  nave  y  se 
adopta,  no  solo  en  el  CaUao,  sino  en  todos  los  puertos  que  por  cualquier  motivo  se  hacen 
sospechosos. 

El  servicio  corre  á  cargo  de  un  médico  sanitario  que  entrega  al  buque  á  su  aslida  del  CaDao 
una  lista  ó  rol  de  pasajeros  y  tripulantes  examinados  por  él  y  cuyos  equipajes  ha  desinfec- 
tado, para  que  el  médico  del  puerto  al  que  el  buque  se  dirije  sepa  cuales  son  los  pasajeros  á 
los  que  puede  permitir  el  desembarque  libremente  y  cuales  aquellos  á  quienes  debe  vigilar 
antes  de  hacerlo. 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  409 

7.  Otros  servicios  de  la  eslaciím  sanitaria. — En  la  actualidad  los  servicios  anexos  á  los  ya 
indicados,  como  son  laboratorio,  ambulancia,  moroturio,  lavandería,  administración,  etc.,  so 
hacen,  provisionalmente,  en  locales  prestados.  La  estación  sanitaria  pedida  íl  Europa 
comprenderá  un  pabellóu  para  habitación  del  personal  médico  y  ayudantes,  oficina,  botica, 
lavandería,  desinleccióii,  ambulancia,  laboratorio  y  mortuorio. 

8.  La  policia  de  salubridad. — Es  un  eueipo  orf^anizado  en  la  forma  de  la  fjolicía  de  las 
ciudades.  En  la  estación  sanitaria  del  Callao,  presta  sus  servicios,  garantizando  el  cumpli- 
miento en  tierra  ó  á  bordo  de  las  naves,  do  las  disposiciones  sanitarias  que  se  dictan.  Para 
el  sei-vicio  de  esta  estación  se  destacan  regulannente  12  inspectores  al  mando  de  un  oficial 
y  bajo  la  dependencia  de  los  médicos  del  sei-vicio. 

(b)  Estación  sanitaria  de  Paita. — Con  las  diferencias  originadas  por  el  menor  tráfico  de 
este  puerto,  la  estación  sanitaria  está  organizada  á  semejanza  de  la  del  Callao  y  comprende 
casi  los  mismos  sei-vicios  que  esta.  En  la  de  Paita  funcionan  actualmente  los  servicios 
siguientes: 

El  de  visita  sanitaria  de  buques  y  pasajeros,  vacunación,  etc. 

El  do  desinfección  do  buques  y  carga  por  medio  de  un  aparato  "Clayton"  tipo  B,  igual  á 
los  del  Callao,  montado  en  una  embarcación  especial. 

El  desinfección  de  equipajes  por  el  gas  "Clayton"  y  por  el  formol,  en  cámaras  especiales  y 
por  medio  de  aparatos  á  presión  de  la  Kny  Scheerer  Co. 

El  de  asistencia  de  contagiosos,  en  un  lazareto  construido  últimamente  en  tierra  y  que,  á 
mi  paso  por  ese  puerto,  se  utilizaba  en  la  asistencia  de  los  pestosos  de  Paita. 

El  de  la  inspección  de  los  pasajeros  á  la  salida,  por  haber  peste  bubónica  en  esa  población ;  y 

El  de  policía  de  salubridad. 

Próximamente  funcionarán  también :  El  de  aislamiento  cuarentanario  de  passajeros,  cuyo 
local  debía  principaar  á  construirse  en  los  días  en  que  salí  de  Lima,  según  un  plan  semejante 
al  del  Callao;  es  decir,  el  de  habitaciones  separadas  para  pasajeros  de  primera  clase  y  salas 
para  los  de  segunda,  comedores,  baños,  etc. 

El  de  desinfección  por  estufas  de  vapor  de  agua.  A  Paita  está  destinada  una  de  las  seis 
grandes  estufas  pedidas  á  Europa  y  próxhíias  á  llegar. 

El  personal  que  corr'e  á  cargo  de  la  estación  sanitaria  de  Paita  se  compone  de  un  médico 
sanitario,  jefe  de  la  estación,  del  médico  titular,  encargado  de  la  asistencia  de  los  enfermos 
en  el  lazareto,  de  un  mecánico,  un  fogonero  y  un  guardián  para  el  servicio  del  aparto  "Clay- 
ton," de  un  empleado  á  cargo  ele  los  formoladores,  de  los  enfermeros  y  asistentes  del  lazareto, 
cujo  número  varia  con  el  de  enfermos,  de  los  peones  para  las  operaciones  de  desinfección  y  de 
cuarto  inspectores  de  la  policía  de  salubridad. 

Las  medidas  adoptadas  con  los  buques  cjue  llegan  á  Paita  procedentes  del  Norte,  tienen 
por  objeto,  principalmente,  evitar  la  importación  de  la  fiebra  amarilla  de  Panamá  ó  Guaya- 
quil, por  ser  Paita  el  puerto  mayor  situado  más  al  norte  de  la  costa  peruana,  y  se  encaminan 
sobretodo  á  la  destrucción  de  los  zancudos.  Las  c(ue  se  adoptan  á  la  sahda  de  Paita  tienen 
por  objeto  principal  evitar  la  propagación  á  otros  puertos  de  la  peste  bubónica  que  existe 
actualmente  allí,  y  se  orientan  sobretodo  en  el  sentido  de  destruir  los  roedores. 

Los  precios  cobrados  por  las  desinfecciones  de  las  naves  grandes  son  los  mismos  cjue  en  el 
Callao,  es  decir,  ss  cobra  sólo  el  valor  de  los  gastos  que  producen.  Las  primeras  desinfec- 
ciones de  buques  en  Paita  las  verificó  el  suscrito  personalmente,  en  el  mes  de  junio  d?  1904. 

(c)  La  estación  sanitaria  de  lio. — Que  es  uno  de  los  puertos  más  meridionales  de  la  costa 
peruana,  está  destinada,  sobretodo,  á  impedir  la  importación  al  Perú  de  las  enfermedades 
epidémicas  que  puedan  existir  en  los  países  situados  al  Sud.  Debe  comprender  los  mismos 
servicios  que  comprenden  las  de  Paita  y  el  Callao,  pero  en  proporciones  menores  que  las  de 
este  último,  por  cuanto  su  tráfico  comercial  es  menor.  En  la  actualidad,  y  con  un  personal 
compuesto  de  un  médico  sanitario,  jefe  de  la  estación,  un  ayudante,  encargado  principal- 
mente de  la  vacunación,  un  mecánico,  un  fogonero,  un  guardián  y  los  necesarios,  funcionan 
los  siguientes  servicios: 

El  de  visita  médica  de  los  buques,  vacunación,  etc. 

El  de  desinfección  de  buques  y  su  carga,  por  medio  de  un  aparato  "Clayton,"  tipo  B. 

El  de  desinfección  de  equipajes  por  el  gas  "Clayton"  ó  el  formol  (formoladores  KJny 
Scheerer). 

Próximamente  se  agregarán : 

La  desinfección  por  una  de  las  estufas  de  vapor  de  agua  á  presión. 

El  servicio  de  asistencia  de  enfermos  en  un  lazareto. 

El  de  aislamiento  cuarentenario  de  pasajeros  sanos  pero  sospechosos.  El  local  para  este 
servicio  debe  estar  actualmente  en  construcción. 

Siendo  el  puerto  de  lio  de  escaso  tráfico  comercial,  la  mayor  parte  de  las  embarcaciones  que 
á  él  arriban,  lo  hacen  sólo  para  ser  desinfectadas:  para  evitar  á  éstas  toda  demora  innece- 
saria y  estando  el  puerto  de  Moliendo — que  es  el  que  sigue  á  lio  yendo  al  Norte — á  cuatro  ó 
cinco  horas  de  este  último,  se  permite  á  las  naves  que,  una  vez  llenas  de  gas  sus  bodegas, 
sigan  su  viaje  al  Norte  sin  esperar  las  cinco  horas  necesarias  de  contacto  del  gas  con  las  mer- 
caderías, pero  llevando  sus  bodegas  cerradas  y  selladas  para  ser  abiertas  en  Moliendo  en 
presencia  del  médico  sanitario  de  ese  puerto. 


410  SEGUNDA  CONFEBENCIA  SANITAEIA  INTERNACIONAL. 

El  precio  de  las  drsinfoooionos  es  el  mismo  quo  en  el  Callao  y  Paita. 

B.  Servicios  sanitarios  d«  los  otros  puertos, — Además  de  las  estaoionrs  sanitarias  de  Paita, 
Callao  (5  lio,  existen  servidos  sanitarios  marítimos  en  otivs  puertos  del  litoi-al  peruana. 
Yendo  do  Norte  «1  Sud  tenemos; 

Eten. — Hay  un  ni(5dieo  sanitario  encargado  del  st  rvieio  marítimo  del  puerto  y  so  hace  la 
desinfecci^^n  de  la  caj'jía  y  equipajes  de  loa  bumu^  en  oiVuai'as  esp.^ciales  oonstruiclas  en  tii^rra 
y  por  medio  de  un  apamto  "Clayton,"  tipo  II,  y  de  fonnoladon^s  Kny  Sol\ee«M\ 

A  pocos  kilóiui  tixM  de  distancia  del  puerto,  y  unida  A  é\  por  ferrocarril,  so  oncu:>ntra  la  villa 
del  mismo  noníbn>,  on  la  que  hay  vm  lazaixto  construido  viltiiuainento  quo  pu.^do  utilizarse, 
en  caso  de  ni  ccsidad,  pam  el  tatitamionto  do  los  contagiosos  que  so  pivsentaran  &  bordo  de 
un  buque  surto  en  el  puerto. 

Pacasma¡to, — Hay  un  médico  sanitario  para  el  servicio  marítimo,  un  lazareto  paiti  conta- 
giosos (I  cai-go  dt-1  medico  titular  v  sorvioio  de  desinf(Tci<5n  de  equipajes  al  formol. 

Salaverri), — Hay  un  médico  sanitario  paia  el  siTvioio  marítimo,  un  lazan^to  para  asistencia 
de  contagiosos,  sin-vioio  do  drsinfecoiiSn  d;>  carga  por  medio  de  un  apamto  "Clayton,"  tipo  H, 
y  de  equipajes  por  medio  dol  formol  y  cilmai-as  especiales  j>ara  este  objeto. 

Hvadw. — Hay  un  miJdico  sanitaiio  encai^\do  del  servicio  marítimo  y  una  c&mara  y  for» 
molador  pam  la  desinfección  de  equipaj(»s. 

MoUcmo. — Hay  un  nitSdioo  sanitario  para  el  puerto  ^  funciona  un  lazareto  para  contagiosos 
V  un  servicio  de  desinfecoiiln  al  fonnol  pai-a  los  equipajes.  Se  constituye  actualmente  un 
local  de  observación  pai-a  pasajeixis  en  cuarentena  y  se  mstalara  una  estufa  &  vapor  do  las 
pedidas  &  Europa. 

ígnitos. — ^Aun  cuando  no  es  un  puerto  marítimo,  debe  indicai^si^  aqvii  quo  este  puerto  fluvial, 
situado  en  el  Amazonas  peruano,  cuenta  también  con  un  servicio  sanitaiño  dotado  do  un 
aparato  "Clayton, "  tipo  B,  para  la  desinfección  de  las  naves  que  &  él  llegan  y  do  su  cai-ga  y 
equipajes. 

C.  ÍÁ>s  mt'dicos  sanitarios  y  títitlares. — ^Además  de  los  mencionados  ya,  hay  médicos  sani- 
tarios ó  titúlanos  en  los  puertos  siguientes:  Casma,  Ancón,  Cerro  Azul,  Tainbo  de  Mora  y 
Pisco,  todos  bajo  la  depondoncia  de  la  Dirección  de  Salubridad.  En  estos  puertos,  en  los 
que  todavía  no  hay  medios  de  desinfi  eciún,  se  haco  sólo  lo  visita  sanitaria  de  los  buques. 

D.  La  pdiáa  de  salubridad. — En  virtud  de  la  ivsolución  suprema  de  10  de  junio  d;\l  año 
en  cvnso,  se  ha  organizado  un  cuerpo  do  policía  de  salubridad,  como  di^pendencia  do  la  direc- 
ción del  mismo  nombre,  que  presta  sus  servicios  tanto  en  la  sanidad  marítima  como  en  la 
terrestre.  Es  una  fuerza  armada  cuyo  objeto  es  asegurar  el  cumplimiento  de  las  medidas 
sanitarias  que  se  dicten. 

El  servicio  de  sanidad  terrestre,  es  mucho  mas  difícil  do  organizar  y  mucho  más  dispendioso 
que  el  mailtimo.  Es  relativamente  fácil  evitai'  que  la  seiíiilla  llegue  al  terreno,  cerrando  las 
puertas  de  entrada  ó  colocando  en  ellas  filtros  más  ó  mt^nos  estrechos,  p'.>ro  os  muy  difícil 
impedir  que  esa  semilla,  una  vez  sombrada,  germine,  ó  hacerlo  tan  hostil  á  ella  quo,  aun 
cuando  se  siembix»,  no  vegete. 

Además,  como  so  ha  dicho  ya,  la  creación  do  la  Dirección  de  Salubridad  on  el  Perú  es  de 
fecha  tan  luciente,  que  no  lo  ha  permitido  emprt^nder  obi-as  do  gran  aliento  en  esto  sontido, 
como  son  las  que  exijo  el  saneamiento  de  las  poblaciones  de  un  país  tan  dilatado,  tan  escaso 
en  elementos  aprovechables  para  ello  y  en  el  que,  antes  do  ella,  no  se  había  hecho  nada  ó  casi 
nada  por  la  higiene.  Sin  embargo,  se  ha  entrado  va  en  esa  vía  y  en  el  cureo  del  año  1904  y 
meses  vencidos  do  1905,  se  ha  realizado  una  labor  profiláctica  quo  ha  dado  resultados 
mayores  que  los  que  hubiera  podido  esperarso  del  período  de  oi^anización  quo  atraviesa  la 
sanidad  en  ol  Perú,  merced  á  lo  cual  se  lia  logrado  contener  dentro  do  límites  restringidos  la 
funesta  epidemia  de  peste  bubónica,  que  la  Dirección  de  Sanidad  encontró  difundida  en  todo 
el  país,  haciéndola  desaparecer  do  unas  localidades  y  reduciéndola  en  otras  á  proporciones 
insignificantes. 

Para  el  servicio  de  sanidad  terrestre  la  Dirección  do  Salubridad  cuenta  con: 

A.  Las' juntas  d^  sanidad  departamentales  y  provinciales,  que  el  anticuado  reglamento 
de  sanidad,  vigente  en  parte,  seílala,  que  se  conservarán  probablemente  en  la  leo;islación 
sanitaria  moderna  que  se  dó  al  país,  sea  con  el  mismo  nombro,  sea  con  nombro  diferente, 
porque  la  práctica  ha  hecho  ver  que,  bien  utilizadas,  pueden  prestar  importantes  servicios. 

Las  juntas  de  sanidad  dopartanientalos,  en  los  departamentos  y  las  provinciales,  en  las 
provincias,  tienen  las  mismas  atribuciones:  velai'  por  la  salubridad  de  las  secciones  terri- 
toriales de  su  jurisdicción,  dependiendo  las  primeras  de  la  Dirección  de  Salubridad  directa- 
mente, y  las  segundas  de  las  departamentales.  Están  constituidas  por  las  autoridades 
políticas  y  municipales  de  las  respectivas  localidades,  los  directores  de  las  sociedades  de 
beneficíencia,  los  médicos  titulares  y  dos  ó  más  personas  notables  del  departamento  ó  de  la 
provincia,  y  á  ellas  corresponde  hacer  cumplir  las  disposiciones  sanitarias  dictadas  para 
toda  la  República,  dictar  las  de  carácter  local,  proponer  las  refoiinas  ó  mejoras  en  los  ser- 
vicios sanitarios,  etc.  Durante  la  campaña  emprendida  contra  la  peste  bubónica  las  juntas 
de  sanidad  locales  han  desempeñado  un  papel  importante,  asumiendo  la  dirección  de  las 


SEGUNDA   CONFERENCIA   SANITARIA   INTERN ACIONAl..  411 

medid»»  profiJioÜcas  en  cada  ae«c«?.!óo  iorr¡t«»r¡».I  j  la  adniinfetmoíán  do  loa  rwuraoa  votados 
para  ese  objeto  j,  con  nvi-as  exwpioiones;,  Imn  correspondido  á  los  fines  tie  su  ínsUtución. 

B.  Lm  midicm  tMuSurt'S  y  sawkmim. — Hay  un  niedioo  tiluJar  en  cada  provincia,  t|ue 
tiene  á.  su  cai-go  la  asistencia  gratuita  íí  laclase  nienesterosi»  en  los  hospitales  locaJes,la  vacit- 
nación  autivari<5Uca,la  pmlilaxiade  l«is  enifennedades  infecciosas,  la  iiis|)ecci«5n  sanitaria  de  Iva 
ferrocarriles  y  la  dirección  técnica  de  totlas  las  medidas  sanitaiias  Iwales  que  se  adoptan 
en  épocas  normales.  Catando  se  presientan  epidemias,  s».  envía  &  las  provincias  en  que  esto 
sucede  m«klicos  sanitarios  enca,i>gíido8  de  com  latirlas,  de  acuerdo  con  I»ü  juntas  de  sanidad 
y  conforme  á  las  instrucciones  que  les  intpai  te  la  DÍJt>cción  de  Salubridad. 

C.  Lmlamrdm. — ^En  el  curso  délos  aiTios;lü04y  líJOa se,  han  construido  algimoa,  dotán- 
dolos de  todos  los  elen>eutos  hidispensí\bles;  á  su  tin,  que  han  pnnitido  los  í-ecursc«  del 
país;  entie  otros,  el  de  Lima,  dedicado  por  alionv  á  la  asistencia  de  jiestosos?,  cuenta  con 

Sabellón  de  administración,  otro  de  cocina,  otro  de  lavandería,  otro  de  disinlfección,  otro 
o  autopsias  y  laboratorio,  otro  de  asistentes,  otro  de  trasporte  de  enfermos  y  caballeriza, 
otit>  de  ootica,  uno  con  habitaciones  separadas  pam  enfermos  de  pa|ta  (12  camas)  y  ocho 
para  enfermos  gi-atuitos,  cuya  capacidaa  varia  entre  IG  y  24  camas  cada  uno,  con  servicios 
anexos  de  baños,  W.  C,  et«s.,  el  de  Trujillo,  no  terminado  aún  (faltan  el  pabellón  de  admi- 
nistractón,  el  de  disinfeccióu,  el  mortuorio  y  una  part*  do  los  servicios  de  pa|;a) ;  el  de 
Mdlendo,  que  existía  en  parte  desde  1V03;  el  de  Paita,  el  de  Salaverry,  el  de  Eten,  el  de 
Arequipa  (comenzado  solamente)  y  algunos  otros  más  de  meJior  importancia. 

D.  El  servicio  de  vacunaciim  antíeariúUca  y  tfe  sen^terafia. — Está  establecido  hat^e  algu- 
nos años,  vaüendoss  sólo  de  vacuna  animal  prepai-ada  en  el  i>ais,  que  dá  muy  buenos  resul- 
tados. El  Instituto  de  Vacuna  y  Serotempia  se  halla  instalado  en  un  local  propio,  i-ocien- 
temente  construido  y  comprende  establos  para  animales  vacunados,  para  animales  en 
observación  y  para  animales  de  experiencia,  sala  de  vacunación  de  terneras,  sala  do  reco- 
leóción  de  la  linfa,  sala  de  preparación  de  la  emulsión  glicéiica,  labomtorio  bacteriológico, 
oficinas  y  salas  para  vacunación  al  público.  El  instituto  está  dirigido  por  un  personal  tóc- 
nico  corñpetente  y  imo  de  sus  jefes,  el  Dr.  Ramón  Riln^iro,  se  encuenti-a  actualmente  en 
Europa,  enviado  por  el  Gobierno  &  estudiar  los  mejores  institutos  vaccinales  de  ese  conti- 
nente y  las  reformas  qiie  deben  introdxicirse  en  el  de  Lima. 

Para  la  práctica  de  la  vacAinación,  que  es  obligatoria  en  el  Perú  po  ley  de  3  de  enero  de 
1896,  el  Lastituto  de  Vacuna  remite  y  periódicamente  á  todas  las  provincias,  las  cantidades 
de  emulsión  de  vacima  animal  fresca  que  son  necesarias,  y  ésta  es  moculada  por  los  médicos 
titulares  ó  sanitaiios,  por  médicos  vacunadores  que  sostienen  algunas  municipalidades  y 
por  un  cuerpo  de  cuarenta  vacxmadores,  prepai'ados  en  el  instituto,  de  creación  reciente, 
y  que,  hasta  mi  salida  del  país,  recorrían  los  depai'tamentos  del  siu,  los  más  an\enazados 
entonces  por  la  viruela,  á  causa  de  la  existencia  de  una  epidemia  de  esa  enfeimedad  en 
Chile. 

Aim  cuando  por  su  creación  el  Instituto  Nacional  de  Vacima  lo  es  también  de  seroterapia, 
no  se  fabrican  todavía  sueros  en  el  Perú.  Al  regieso  de  Emopa  del  jefe  del  laboratorio 
de  dicho  instituto,  que,  como  se  ha  dicho  fué  mandado  á  estudiar  la  fabricación  de  vacunas 
y  sueros,  regreso  que  debe  realizarse  en  enero  del  año  próximo,  se  instalarán  probablemente 
los  laboratorios  para  fabricíwíión  de  sueros  específicos.  Mienti-as  tanto,  el  instituto,  por 
contrato  celebrado  con  instituciones  análogas  en  Europa,  está  siempre  provisto  de  los  sueros 
que  no  puede  fabricar,  para  atender  á  las  necesidades  de  la  República.  Dichos  sueros,  en 
confomddad  con  la  resolución  suprema  de  20  de  enero  de  1S05,  son  suministrados  por  el 
instituto  gratuitamente  á  los  menestei-osos  que  lo  solicitan  con  pi^escripción  facultativa. 

E.  La  policía  de  Salubridad.— <iom.o  ya  se  ha  dicho,  está  encargada  de  garantizar  cum- 
plimiento de  las  medidas  de  sanidad,  tanto  en  el  servicio  terrestre  como  en  el  marítimo. 

La  sección  de  demogi-afia  está  encargada,  por  la  ley  que  creó  la  Dirección  de  Salubridad 
de  formar  especialmente  la  demografía  sanitaria  del  país,  pero  se  ha  ocupado  también  de  la 
demografía  general,  valiéndose  pai-a  ello  de  los  datos  que  pueden  suministrarle  las  cien 
municipalidades  de  las  provincias  de  la  RepúbUca,  las  que,  por  ley  de  1873,  están  encargadas 
de  llevar  los  registros  de  estado  civil  y  la  estadística  de  sus  respectivas  jurisdicciones. 

Apesar  de  esta  ley  de  1873,  soló  ima  parte  de  las  provincias  de  la  República  tiene  iniciados 
trabajos  de  estadística  y  en  la  mayor  parte  de  las  provincias  las  oficinas  de  registro  de  estado 
civU  han  adolecido  de  serios  defectos  en  la  formación  de  éste,  especialmente  en  lo  que  se 
refiere  á  nacimientos  y  defunciones,  defectos  que,  merced  á  los  foimularios  suministrados 
por  la  sección  de  demografía,  vienen  corregiéndose,  al  mismo  tiempo  que  se  unifican  y 
centralizan  los  datos  recogidos. 

Iniciadas  las  labores  de  la  Sección  de  Demografía  sólo  en  los  primeros  meses  del  año 

E asado  y  trascurrido  casi  todo  el  año  en  labor  preparatoria  ó  de  organización,  sólo  en  1S05 
an  principiado  á  obtenerse  los  datos  pedidos  á  las  municipalidades  de  las  provincias,  de 
modo  que  al  fin  de  este  año,  se  podrá  tener  conocimiento  del  movimiento  demográfico  de 
las  provincias  del  Perú,  aunque  probablemente  no  serán  todavía  datos  completos. 

En  la  actualidad  la  sección  de  demografía,  además  de  las  operaciones  sobre  nacimien- 
tos, matrimonios  y  defunciones,  con  sus  derivados,  de  la  estadística  de  las  enfermedades 


41 '2  SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL. 

infecciosas,  de  la  de  las  vacunaciones  practicadas,  etc.,  lleva  á  cabo  la  demografía  de  Lima 
desde  1SS4  hasta  la  fecha,  la  que  pondi-á  en  claro  muchos  puntos  demográficos,  sani- 
tarios ysociales  hasta  hoy  discutidos,  que  han  girado  alrededor  de  cift-as  no  comprobadas 
científicamente. 

En  junio  del  año  en  curso,  la  Dirección  de  Salubridad  levantó  el  censo  de  la  población  del 
Callao  cuyo  trabajo  no  está  terminado  aún,  pero  que  arrojó  34,436  habitantes:  con  los 
documentos  de  este  censo  y  con  los  del  que  llevó  á  cabo  en  Lima  la  municipalidad  en  1903,  la 
sección  do  demografía  podrá  formar  el  legajo  sanitario  de  los  habitantes  de  Lima  y  el 
Callao. 

Los  servicios  locales  de  sanidad  en  el  Perú,  como  yá  se  ha  dicho,  corren  á  cargo  de  las 
municipalidades  de  provincia  y  de  las  de  distrito.  Son  ellas  las  que  dirigen  y  llevan  á  cabo 
los  servicios  de  agua  potable,  desagües,  canalización,  pavimentación,  baja  policía,  constnic- 
ción  de  casas  de  habitación,  mercados,  establecimientos  públicos,  escuelas,  etc.,  aún  cuando 
todos  ellos  son  vigilados  y  aprobados  por  el  Gobierno,  y  desde  el  punto  de  vista  sanitario  por 
la  Dirección  do  Salubridad. 

Entre  ellas,  como  es  natural,  es  la  municipalidad  de  Lima  la  que  más  ha  hecho  hasta  ahora 
por  mejorar  las  condiciones  sanitarias  de  su  jurisdicción  y  en  el  curso  de  los  años  1£04  y  1£05 
ha  llevado  á  cabo  la  instalación  de  un  Instituto  Municipal  de  Higiene,  compuesto  de  una 
sección  de  química,  una  sección  de  bacteriología,  de  una  biblioteca  3'  de  un  pequeño  museo 
de  higiene,  en  el  que  se  realizan  importantes  trabajos  de  química  y  bacteriología  referentes  á 
los  servicios  locales.  Este  Instituto,  aunque  modesto  en  sus  proporciones,  está  montado  con 
todos  los  elementos  modernos  y  en  él  se  realizan,  gratuitamente  para  los  menesterosos  y 
con  una  módica  remuneración  para  los  pudientes,  exámenes  de  esputos,  de  productos  de 
secreción  ó  de  excreción  fisiológicos  ó  patológicos,  de  piezas  anatómicas,  de  muestras  de 
aguas,  bebidas  alimentos,  medicamentos,  etc.,  además  de  los  trabajos  que  para  los  servicios 
de  sanidad  local  y  aún  para  los  de  otras  localidades  practica  el  Instituto,  por  su  propia 
cuenta  ó  por  encargo  de  la  municipalidad  de  Lima  ó  de  la  Dirección  de  Salubridad. 

La  municipalidad  de  Lima  ha  instalado  también  en  el  año  en  curso  un  desinfectorio  público 
dotado  de  los  principales  elementos  cjue  exige  un  establecimiento  de  esa  índole  y  que  satisface 
las  necesidades  de  la  población  de  Lima;  ha  llevado  á  cabo  también  la  construcción  de  un 
mercado  central,  cuya  planta  baja  se  ha  inaugurado  ya  y  que,  desde  el  punto  de  vista  de  la 
higiene,  no  deja  nada  que  desear. 

Mediante  éstas  y  otras  obras  de  importancia,  como  la  prolongación  del  alcantarillado  á  las 
calles  que  no  lo  tenían,  la  pavimentación  de  la  ciudad  con  asfalto  comprimido  y  adoquines 
de  piedra,  etc.,  las  condiciones  sanitarias  de  Lima  han  mejorado  notablemente. 

Obras  semejantes  llevan  á  cabo  las  municipalidades  de  las  demás  provincias  de  la  República 
dentro  de  los  límites  que  les  permiten  sus  recursos  y  los  cjue  con  tal  fin  vota  el  Gobierno 
Nacional:  la  del  Callao,  realiza  en  la  actualidad  las  obras  de  canalización  para  desagües  y 
desecación  de  que  carecía  y  termina  su  instalación  de  agua  potable. 

2.  Legislación  sanitaria. — No  se  ha  dado  todavía  en  el  Perú  una  ley  sanitaria  fundamental. 
Su  formación  está  actualmente  encomendada  á  una  comisión  nombrada  con  tal  objeto  y  el 
proyecto,  cuyas  bases  ha  formulado  la  Dirección  de  Salubridad,  se  presentará  probable- 
mente para  su  aprobación  al  Congreso  Nacional  en  la  próxima  legislatura.  La  única  ley 
sanitaria  que  existe  en  la  República  hasta  ahora,  es  la  de  3  de  enero  de  1896  que  hace 
obligatoria  la  vacuna. 

El  reglamento  de  sanidad  expedido  en  1887,  que  fué  el  primer  ensayo  hecho  en  el  país  en 
materia  de  legislación  sanitaria,  ha  estado  en  vigencia  hasta  la  creación  de  la  Dirección  de 
Salubridad,  y  aún  cuando  no  ha  sido  derogado  expresamente  por  resolución  alguna,  ha 
dejado  de  tenerse  como  norma  por  lo  menos  parcialmente,  desde  que  esta  institución 
comenzó  á  funcionar,  porque  los  principios  de  higiene  pública  que  lo  inspiraron  están  en 
armonía  con  las  ideas  que  dominaban  en  la  época  en  que  se  expidió,  pero  son  en  el  día  inad- 
misibles en  gran  parte.  Este  reglamento  señala,  entre  otras  cosas,  las  cuarentenas  á  los 
buques  infectados  ó  sospechosos,  cuarentenas  que  la  Dirección  de  Salubridad  ha  suprimido 
desde  que  cuenta  con  los  medios  de  desinfectar  el  buque  y  su  carga  tan  pronto  como  llegue 
á  la  costa  peniana. 

Esta  falta  de  legislación  y  reglamentación  sanitaria  se  suple  por  el  momento,  mientras  se 
expidan  las  leyes  y  reglamentos  que  están  en  estudio  con  resoluciones  generales  expedidas 
por  el  Gobierno  nacional,  ó  con  disposiciones  transitorias  dictadas  para  los  casos  particulares 
por  la  Dirección  de  Salubridad,  dentro  de  la  esfera  que  la  ley  de  su  creación  le  señala.  Entre 
las  resoluciones  dictadas  en  los  últimos  años  que  se  refieren  á  asuntos  sanitarios,  pueden 
mencionarse  las  siguientes : 

La  resolución  suprema  de  2  de  octubre  de  1903,  que  vota  fondos  para  los  estudios  de  la 
aeroterapia  y  la  vacuna  antiverrucosa  (verruga  peruana). 

La  ley  de  6  de  noviembre  de  1903,  que  crea  la  Dirección  de  Salubridad  pública  y  señala  sus 
atribuciones. 

La  resolución  suprema  de  20  de  noviembre  de  1903,  que  ordena  el  envío  á  Europa,  por 
cuenta  del  Estado,  del  jefe  del  laboratorio  del  Instituto  de  Vacuna  y  Seroterapia  Dr.  Ramón 
E.  Ribeiro  para  que  estudie  allá  la  fabricación  de  sueros  y  vacunas. 


SEGUNDA    CONFERENCIA    KANITARTA    INTERNACIONAL.  413 

La  ley  de  20  de  noviembre  do  1903  (|uc  crea  las  tres  estaciones  sanitarias  de  Paita,  Callao,  é 
lio. 

La  resolución  suprema  de  8  de  marzo  de  1904,  cjue  impone  á  las  compañías  de  vapores 
que  hacen  el  tráfico  de  los  puertos  peruanos,  la  oh]¡í.^aci()n  de  tcíier  á  bordo  aparatos  de 
desinfección . 

La  resolución  suprema  de  4  de  ai)ril  de  H304,  f|uo  impone  á  los  pasajeros  que  se  embar- 
quen en  el  Callao,  la  desinfección  do  sus  equipaj(!s  y  la  inspección  módica,  á  fin  de  evitar 
que  de  eso  puerto  do  Lima  pueda  llevarse  á  otros  de  la  Kopública  ó  del  extranjero  los 
gérmenes  de  la  poste  bubónica.  (Aún  cuando  esta  resolución  se  dictó  en  una  época  en 
que  la  existencia  constante  de  la  peste  en  el  Callao  la  bacía  indispensable  y  las  condi- 
ciones sanitarias  de  ese'  puerto  han  cambiado  después,  continúa  en  vigencia.) 

La  resolución  suprema  de  4  de  abril  de  1904,  que  ordena  las  mismas  precauciones  para  los 
pasajeros  y  equipajes  que  so  dirijen  de  Lima  al  interior  del  país  por  ferrocarril,  también 
como  medio  <lo  evitar  la  difusión  do  la  posto.     (Continúa  en  vigencia.) 

La  resolución  suprema  de  15  de  abril  de  1904,  nombrando  una  junta  directiva  de  la  cam- 
paña contra  la  poste  bubónica  de  la  provincia  de  I.'ima.  Junta  presidida  por  el  Director  de 
Salubridad,  que  es  la  que  ha  dirijido  la  labor  de  saneamiento  hociía  en  Lima  en  los  últimos 
tiempos. 

La  resolución  supremo  de  27  de  mayo  de  1904,  que  ordena  la  formación  del  cen-so 
general  de  la  República  y  prescribe  que  la  Dirección  de  Salubridad  formule  el  proyecto  y 
presupuesto  de  la  obra. 

La  resolución  suprema  de  1°  de  julio  de  1904,  que  ordena  que  el  Ministerio  de  Relaciones 
Exteriores  solicite  del  Gobierno  de  los  Estados  Unidos  la  incorporación  de  un  médico 
peruano  en  el  cuerpo  de  sanidad  que  se  envíe  á  Panamá  para  el  saneamiento  del  Istmo, 
ampliada  por  la  del  8  del  mismo  mes  y  año  en  el  sentido  de  que  la  solicitud  sea  para  la  incor- 
poración de  un  médico  y  un  ingeniero. 

La  resolución  suprema  de  2  de  julio  do  1904,  que  dispone  que  los  concejos  municipales 
remitan  periódicamente  á  la  Dirección  de  Salubridad  los  datos  demogi'áficos. 

La  resolución  suprema  de  2  de  julio  de  1904,  comisionando  al  jefe  de  la  sección  de  higiene 
Dr.  D.  E.  Lavorería  para  que  estudie  el  informe  sobre  la  instalación  de  la  estación  sanitaria 
de  Paita. 

La  resolución  suprema  de  la  misma  fecha,  que  crea  un  agente  sanitario  del  Perú  en  Europa, 
encargado  de  remitir  las  informaciones  y  adquirir  los  elementos  que  sean  necesarios  á  la 
Dirección  de  Salubridad. 

La  resolución  suprema  de  la  misma  fecha,  que  crea  una  comisión  encargada  de  estudiar 
y  proponer  un  plan  para  la  construcción  de  casas  de  inquilinato. 

El  decreto  supremo  de  16  de  setiembre  de  1904,  expidiendo  el  reglamento  sanitario  de 
ferrocarriles. 

La  resolución  suprema  de  9  de  diciembre  de  1904,  ordenando  la  desinfección  de  los  buques 
procedentes  del  sur  en  la  estación  sanitaria  de  lio. 

La  resolución  suprema  de  22  de  diciembre  do  1904,  que  dispone  que  el  Perú  esté  repre- 
sentado oficialmente  en  el  Congreso  Médico  Panamericano  de  Panamá  y  nombrando  como 
delegado  del  Perú  al  Dr.  Ugo  Biffi. 

La  resolución  suprema  de  23  de  diciembre  de  1904,  que  reglamenta  el  envío  á  Europa 
anualmente  de  los  médicos  jóvenes  que  más  se  hayan  distinguido  en  su  carrera  escolar  para 
perfeccionar  sus  conocimientos. 

La  resolución  suprema  de  30  de  diciembre  de  1904,  que  dispone  que  el  Perú  tome  parte  en 
la  constitución  de  la  Oficina  Sanitaria  Internacional  de  Washington  y  contribuya  á  su 
sostenimiento  con  la  suma  que  le  corresponda. 

La  resolución  suprema  de  20  de  enero  de  1905,  que  ordena  que  el  Instituto  de  Vacunan  y 
Seroterapia  suministre  gratuitamente  á  los  pobres  que  lo  soliciten  por  prescripción  médica, 
los  sueros  específicos  (antidiftérico,  antitetánico,  antiestreptocócico,  etc.). 

La  de  la  misma  fecha,  que  dispone  la  instalación  de  un  servicio  de  desinfección  de  las 
naves  en  el  puerto  de  Iquitos. 

La  de  10  de  marzo  de  1905,  que  crea  un  médico  adscrito  á  la  Dirección  de  Salubridad, 
para  el  estudio  de  las  cuestiones  referentes  al  agua  potable. 

La  de  10  de  marzo  de  1905,  que  manda  levantar  el  censo  de  la  provincia  del  Callao. 

La  del  17  de  marzo  de  1905,  que  crea  un  cuerpo  de  vacimadores  para  que  recorran  las 
provincias  y  distritos  de  la  República,  ayudando  á  los  médicos  titulares  y  sanitarios  y  á  los 
vacunadores  municipales  en  la  labor  de  la  vacunación. 

La  de  la  misma  fecha,  que  prohibe  el  ingreso  de  leprosos  al  territorio  nacional  y  ordena 
la  creación  de  una  leprosería  en  el  departamento  de  Loreto  para  el  aislamiento  de  los 
leprosos  que  existe  en  ese  departamento  limítrofe  con  otros  países  en  que  hay  lepra. 

La  de  24  de  marzo  de  1905,  que  aprueba  los  planos  de  las  obras  de  desagüe  del  Callao  y 
ordena  el  estudio  de  las  de  desecación  del  subsuelo  de  ese  puerto. 

La  de  31  de  marzo  de  1905,  que  nombra  una  comisión  encargada  de  estudiai"  el  proyecto 
de  ley  sanitaria  que  debe  someterse  á  la  aprobación  del  Congreso  Nacional. 


414  SEQTJKDA  CONFERENCIA  SANITAMA  INTERNACIONAL. 

La  de  7  d«  abrU  áa  1@0S,  qu<i>  ordena  que  los  etünsules  de  la  RepxtMiea  en  el  extranjero 
eoí«umqxio«  á  la  Direwi<án  de  Salubridad,  poi  eaUe  <á  por  correo,  st^ln  los  eas»s  la  aparí> 
ei<5n  ea  su  jurisdimáft  eons^üar  de  las  enfi^^medades  contagiosas  gr*ves,  tjrasaidsiUe<s  por  ú 
tráfico  comercial. 

La  de  10  de  tt\ayo  de  19(X5,  que  manda  ejecutar  las  obr^  de  dotaci^  de  agua  potaMe 
del  Cuítco, 

La  df  la  misjxia  fic^ha,  que  aprueW  el  j>royecto  de  la  cas*  Humphreys  de  Londres,  pawt 
los  e<litici«>s  de  la  estaci^'ín  s^uulana  del  t\dlao  y  manda  adquiriíless 

La  de  10  de  Junio  de  lí»©,»,  que  ors^aitiaa  la  policía  de  saluWidads 

La  de  21  de  julio  de  l!ííÓ.x  que  manda  ejecutar  los  estudi*^  de  dottaci<Sn  de  agua,  desagües 
y  de^^acivUx  del  puerto  de  IquitoSs 

La  de  7  de  agosto  de  1§0S,  que  esíaWece  las  precauciones  4  que  debe  sdnteters^  Íl  ka 
pasajeros  procedentes  de  Panaiuá  y  Guayaquil,  nueniras  exista  en  esas  puertos  la  fiebi« 
amarilla  cotuo  epidemia. 

La  de  1 1  de  agosto  de  ISOS,  que  di^^pone  que  se  estudie  y  Heve  4  caba  en  la  costa  del  Pwú 
los  tí-abajos  necesarios  pam  destmr  los  szancudos  siegomia,  contentando  por  el  Callao  y 
üma. 

I^a  de  I"  de  septiembre  de  \^%  que  ^^ala  las  condiciones  en  que  del>e  llevarse  al  P^ 
la  fnua  de  G\>a\^quil  ^  Panaí^a,  sixseeptíWe  de  Tehicular  szancudos,  mientras  dur^n  las 
condicioixes  saniuwias  de  esos  puertosí  y  muchas  otí«s  que  seria  largo  enumerar. 

Terminado  el  informe  que  me  corre^>ondia  px-^^sentar  4  la  Oonier^cneia,  en  conlWmidad 
con  el  programa  de  la  Oficina  Sanitaria  de  las  feepíiblicas  Americanas,  y  en  nombre  de  mi 
país,  sSlo  me  rí«ía  deciros  qxxe  el  Perxí,  haciendo  por  su  parte  todos  los  esfuetaos  p^Wea 
par«i  mejorar  las  condicivínes  higii&tieas  de  sus  puertos,  habiendo  establecido  sas  elaciones 
y  servicios  sanitai^ios  á  lo  lax^^  de  su  exten,^)»  litoral  y  adoptado  en  ellas  medidas  qu© 
garantiaaii,  hasta  donde  es  5(>(0^ble  haí-«eílo,  no  sélo  sus  propios  pxtertos,  sino  h?®  tk  los 
países  \''eeinos,  y  puWieando  sisieináticaíííenie  la  aparici<án  de  casos  de  eniferiuedades  oonta» 
f iosas  pai'íi  «]|ue  estos  adoplen  las  medidas  de  defensa,  que  crean  conx-enientes,  ságue  en 
materia  de  higiene  internacional  una  política  de  ír^nqueaa  v  de  bxtena  M  y  qxie,  teniendo  en 
euení^  las  trabas  y  los  per|xweios  que  4  su  propio  coiYtercio  y  al  de  los  países  vecinos  ocasionan 
las  medidas  de  saaidad  vigentes  hoy  en  Panaíxná,  el  Ecuador,  el  Perú  y  Ohfle,  desearía  qu© 
esta  Conferencia  diera,  entre  otros  x^esultados  bentlficos,  el  de  la  íormacién  de  un  convenio 
inteinacional  entre  los  países  que  con  el  Pero  tienen  tráLfic©  fr«cx»ente,  á  fin  de  que  los 
pror^mientos  sanitarie^  seguidos  en  cada  uno  de  eüos  fueran  uniformes  y  txxvier«n  valor 
en  ks  (iexxxás  y  pai-a  qxxe  la  ací-ián  eomto  de  todos  lop-^'^i  lo  qxxe  la  lalíor  aislada  de  cada 
uno  de  ellos  haee  difíeil  de  r^iísar,  esto  es,  extirpar  de  la  costa  occidental  de  Sad-Aüaiiica, 
las  enfermedades  trasmisibles  por  vía  marítima. 


INlt>BME  imt,  Ui^WSmABQ  ^On  EMILIO  C,  J017B£RT.  I^SLIEGABO 

DE  "Ul  SlEJB'-ÚBIJtCA  ISOMINICAKAs  .  ^^^ 

Jm  Bepública  Dominicana  no  lyaorta  4  este  Cteavesíci^  ift4s  cseatiEgeatfe  qme  síjs  teeeiaas 
dispc^eioííes  en  favor  de  la  causa  de  la  salad  pública,  qxie  es  causa  aobfe  y  ^mpátiea  y  dfeft* 
de  ocupar  la  ateftci<Sn  de  GoMemos  <l  individúes  de  altas  nuras.  Mo  aporta  ai  "áeem&ri» 
ffiieati^  científicos,  m  experieaücias,  ni  datos'  que  cosutribuyaa  al  adetot®  de  la  <émmb 
sanitaria  ^  de  sa  aplicaci^  4  las  siece^dades  de  les  pueMiag;  y  no  es  que  affl  «o  se  dé  iísupor- 
tancia  4  esas  materias,  qxxe  son  por-  su  naturalessi  ti«isc^<fe4tafe  mmm  que  ataStea  4  fe, 
salud  pública,  íío  sélo  de  uxía  í^i^kí  sfeo  de  la  hxiiíaaííidad  eateim,  mo  que  dotasáo  el  paífe 
de  coíxdiciowes  naturales  eseepcíonalmeate  favoítsbtes  paí*  la  eoeaservaieiéft  <é^  un  ^tad© 
sanitario  satMact^o,  no  ha  sentido  la  necesidad  usgmtie  de  detücas^  a)  e^fmd&o  e^^e^iai 
de  esas  materias, 

Mii«ida  la  «aaestién  sanitaria  de  la  República  DomÍMcana  d^de  el  puntio  de  vfeta  de  sa 
l^felacién,  ^  observa  qxxe  salo  exfeten  en  el  pafe  ordeaansas  ínunicipalte,  leyes  de  cairájeter 


m4s  amplio  y  de  mayor  importancia,  dice,  que  <m  el  pafe  no  ^  ha  experiíftentaJd©  la  ne««^^feiíl 
de  una  protección  íx\ayor  que  la  que  aqu<éHes  ofrecen,  ESn  electo,  esfetíend©  «n  %oe«« 
pasadas,  no  muy  lejanas,  cerca  de  sus  Cíestm,  foccs  en  que  se  producía  y  de  émét.  se  «sfceei^ 
la  fiebre  amarilla-.  Santo  Domingo  se  mantuvo  siempre  libre  de  esa  epdemia.  Uno  qu* 
otr^  caso  se  presentaba  c^n  intervalo  de  diea  é  doce  añc®,  pero  nunca  <fe  tal  modo  que  sfe 
ludiera  coasíderaí  ^a  enfermedad  m4s  temibíe  que  otras  no  ^d^ieas,  Mo  »fe  r^Bteí^ 
4  la  época  en  que  el  ejército  espaM  importaba  k  fiebre  y  k.  proj^ig^  eatí%  sos  inéNtéa«i» 
por  Mta  de  precauciones  sanitaiias. 


SEGUNDA  GONFBRKNOIA  SANITARIA  INTERNACIONAL.  415 

Hornos  ttMiido  tamhi^J»  la  vinu^la  m  twUvtlo  oíulóinie?e»  mtm.  do  lunvstnus  vmU\.\  y  haa 
bastado  nvuwtrtw  hym  dü  polída  y  Iva  tnodídos  tonuufiíH  por  Iiuh  ]Wúm  do  »<u»idad  de  la 
lto|)iM)lHu  paiu  imuitonor  Itis  pobliMsíonoM  libit«  do  t?í!l,m,}?txH.  Kl  8t>rvioio  pmlilAotitso  do  1a 
vtuMiütidtíu,  or^JUUKiulo  do  tiompo  on  tiempo,  ha  oontrihuído  podorosvunonto,  no  hubiondo 
©uooatwdo  \\\v.\m  msiíítoiioirt  ou  o4  puoblo,  i\  impodir  l.v  I»vu.sk1»  y  propuiftieitSu  do  es» 
eníoruunlíul.    Uftoo  mníi^,  do  un  ouarto  tío  siglo  quo  uo  so  pitísenU  un  c*\ao  de  viniela  en 

el  pais.  ...  ,        ,   ,  , 

lian  tmusourrldo  euaTOuta  años  dolido  la  rtitima  invsMudn  dol  odlora,  onformotlad  quo  ai 
80  pj"opast$  y  oaus(5  gran  dafto  M,  debido  kwnbiéa  &  \m  m\m\»t  quo  bacitu»  frecuenUia  on  la 
misma  dpo«a  bw  oíwos  de  ílobi'o  amarilla. 

Como  se  vé,  ftl  oslado  Siudtarit»  dol  pais  no  ba  i'oquorido  mila  de  lo  quo  so  ba  boebo  para 
mantoiíor  la  poblaeid»  Ubm  de  la  aooi»1n  dosol.vdt»ra  do  bis  opidomiasu  I^vs  nmbdas  tran- 
sitorias He  euaTOiitetuw  ban  eontribuido  tambi<5n  oflojiRmonto  al  resultado  quo  mo  oomphueo 
%n  aoíiabtr,  peix>  por  muy  aatisfaetorío  quo  soa  reforirse  al  pi\sado,  os  no<^ojí«vrio  tondor  la 
Tista  hacia  adelante  eou  a-eeuojioia,  no  wa  que  las  mintdas  reti^osjieotivas  no»  prodiapongan 
&  \»na  indolenda  ej^imivuil. 

Una  vea  terminmío  el  tJanal  de  Panaiiíé,  eata»^  Santo  Dominp  on  oJ  oamint»  do  las  naves 
de  todsxs  la«t  naeionea  pmeedentes  de  todos  \m  puert«>s  deJ  mundo  (5  mt\  dosti»ío  ti  oilos.  En 
esa  8it\uiei«1n,  i  sus  eostas  han  de  ariibir  nMieluvá  naves;  el  trá,n«H>  ennunvial  ajunont^rá, 
j  mn  él  el  peliam  del  eonte^gi©  y  la  diíusión  de  todas  \m  enfernio,dadt>s  infocoiosita.  La 
pi'evisiáa  aeonseja  prepararse  para  satisíaeer  las  exigeneias  que  esa  nueva  oondioj<5n  traerá 


Una  medida  eámoda  se  tenia  á  la  maiio  pava  evitar  la  irrupeidn  de  las  opídojnias,  qino  ojpa 
k  de  eermí  lo§  puerti>s  á  los  buques  prwedentes  de  lupinos  i«ieet^dos  j  poro  \in  ptüs  eoioeado 
&&  medio  de  una  eorrieiite  eomoi^ial  aetiva  y  p©deit4sa,  no  puede  recurrir  4  esas  medidas 

trimitivas  y  hasta  eiert©  punto  nugatorías  y  por  tanto  injustifieables,  sin  provocar  el  enojo 
e  ks  naeiojíes.  Desde  el  Congres©  de  Tim%  basta  esti>  Conveí  eióin  de  Wáslñngton  qu« 
trabaitmi  sobre  la  misma  base,  todas  las  e©»íereii>m8  sawtariías  ban  adoptado  en  principio 
las  ideas  que  prevalecían  en  Inglaterra  e©a  anteri©»idad  á  aquel  Congreso,  ]^r<ju©  esas 
ideas,  convenientemente  aplicadas,  poiíen  &  salvo  los  iattrtses  del  eomerei©  urJv«ísal  i  la 
vei  que  pi'oteien  las  vi^       *"~  '"^  .»„í„-»i»™ 


vida  de  relacién  de  la  República,  y  ha  nombrad©  ya  una  eomisién  de  expertos  pam  estudiar 
las  leyes  sanitarias  de  ©tres  países  más  adelai^.tados  en  esa  matem  y  preparar  un  cuerpo 
de  leyts,  asi  e©m©  pr©ytet©s  para  k  ©i'ganigaeiái^  del  servid©  de  inspecdén  y  cuai^entenas. 


aquí  se  ban  de  dilucidar  luffiffi©san\ente  las  cue§ti©nes  de  la  deneia  sanitaria  que  conciemea 
medidas  preventivas  que,  e@a  carácter  ií  ttrnaeional,  conviene  adoptar  para  impedir 


Disotrmso  faonüNOiABO  ai*  fihai*  de  la  oontsnoión  por  sl 

Sm.  SMIMO  o.  ^0\71EBT,  DSLE&ABO  SE  ZiA  BSPl^BLIOA  SOMINI- 


sue  decir  en  esta  hora  <m  qu©  derra  sus  sesiona  esta  0©av%a- 
ái©  qu©  baeier  durante  sus  imp©rtantisim©s  trabajos,  al  ser 

t8t©s,  por  su  aaturaíesa,  muy  distintos  de  los  que  p©drían  estar  4  mi  aleaact  p©r  la  Mnea 

d©  estudios  qu©  be  seguido  y  por  mis  ©eupadones  babitualts. 

Si,  pued©  espitsar,  com©  I©  bago  c©n  gust©,  k  gran  satisfe,cdáa  que  be  esperimeatad© 
al  estar  m  e©ata©t©  coa  pers©aas  eminente  y  notables  p©r  sus  vast©s  e©nocimieat©8, 
p©rs©<ias  que  ban  puest©  su  talent©  y  su  eorasáa  al  servid©  de  su  país  y  de  la  humanidad» 


vor  que  dl©s  merecen  y  puestas  %a  práctiea  las  disp^doaes  sanitarias  que  ti  convenio 


Saat©  Demiuf©,  ©uaad©  est<l  aM%rt©  %l  Ctoal  d©  Pasasai,  qu©  s©  aferiri.  estará  en  el 
©amia©  d©  todas  la«  aacioaes;  <^m  aav©s  t.©©aí4a  ©a  sus  puertíiíg^  y  ©s  b©<5©^íí©  que  estos 
puerta  ©stla  p¥©parad^  para  i©dMtias  y  a©  «©rrad^  p©r  ía©<t*v©s  d©  mal  ©at©ndida8 
pr©eaud@a©s  saaitkrias» 

Ooa  ts@s  s©ntimi©at©s  y  ©sta  ^peraii^  m©  si©at©  satfefeá^©  á©  bafeer  1^^  ©I  b.©B©r  át 
asistir  á  esta  0©av©adéa  ©a  i©pí^ataei©a  d©  la  Eepúbliea  D©miai©aaa» 

H©  dlebe» 


416  SEGUNDA   CONFERENCIA    SANITARIA    INTERNACIONAL. 

INFORME  DEL  DR.  H.  D.  GEDDINGS,  CIKTJJANO  GENERAL  AUXI- 
LIAR, SERVICIO  DE  CUARENTENA  Y  HOSPITALES  MARÍTIMOS 
DE  LOS  ESTADOS  UNIDOS,  DELEGADO  DE  LOS  ESTADOS  UDIDOS. 

Señor  Presidente,  Señores:  El  programa  científico  provisional  incluye  los  informes 
sobre  la  peste  bubónica,  la  fiebre  amarilla  y  la  palúdica.  Con  satisfacción  podemos  decir 
que  el  último  caso  de  pest'^  bubi5nica  ocurrido  en  los  Estados  Unidos  tuvo  lugar  en  San 
Francisco  hace  dieciocho  meses.  El  número  de  casos  ha  sido  publicado,  de  tiempo  en 
tiempo,  en  los  informes  de  sanidad  pública  por  el  Servicio  de  Sanidad  Publica  y  Hospitales 
Marítimos,  así  como  las  medidas  que  si'  tomaron  para  la  supresión  de  la  enfermedad,  la 
inspección  cuidadosa  que  se  ejerció  en  aquella  parte  de  la  ciudad  de  San  Francisco  que  fué 
atacada  por  la  peste,  y  una  relación  de  las  observaciones  do  los  fallecidos,  la  inspección  de 
los  cadáveres  en  los  distintos  establecimientos  funerarios  do  la  ciudad,  y,  como  medida 
sanitaria  especial,  la  destraceióu  de  ratas  y  ratones  y  el  examen  cuidadoso  de  los  cogidos  en 
ratoneras  ó  hallados  nuiertos  vn  varias  partes  de  la  población.  Podemos  felicitarnos  por 
el  hecho  de  que  la  peste,  no  sólo  quedó  limitada  ñ,  una  parto  de  la  ciudad,  sino  que  también 
se  impidió  su  propagación  á  otras  secciones  de  la  misma  y  absolutamente  á  ninguna  otra 
parte  fuera  de  los  límitt's  de  California,  lo  cual  demuestra  la  eficacia  de  las  medidas  tomadas, 
y  la  posibilidad  de  poderse  atacar  sin  miedo  una  enfermedad  de  este  género,  y  sin  serios 
detrimentos  á  los  intereses  comerciales  de  la  ciudad  en  que  prevalece;  y  sobre  todo  la  pmeba 
del  triunfo  de  la  ciencia  higiénica  moderna  ¿n  su  lucha  contra  una  de  las  enfermedades 
más  temidas  que  conocemos. 

Con  respecto  á  la  fiebre  amarilla,  no  es  necesario  decirles,  señores,  que  esta  enfermedad 
prevalece  en  la  actualidad  en  la  ciudad  de  Nueva  Orleans,  en  otros  puntos  del  Estado  de 
Luisiana  y  del  adyacente  Estado  de  Mississippi.  Hasta  la  fecha  han  ocurrido  en  la  ciudad 
de  Nueva  Orleans  3,21-1  casos  de  la  enfermedad,  con  409  defunciones.  En  los  varios  partidos 
del  Estado  de  Luisiana,  fuera  del  de  Nueva  Orleans,  se  han  registrado  2,778  casos,  con  232 
defunciones,  y  en  Mississippi,  según  los  partes  recibidos  hasta  el  27  de  septiembre,  se  han 
registrado  332  casos  y  13  defunciones.  Cómo  se  importo  esta  enfermedad  en  Nueva  Orleans, 
que  así  es,  ís  una  cuestión  que  aún  se  está  investigando,  y  el  método  de  su  introducción  y  la 
época  de  su  primera  aparición  están  aún  por  saberse,  y  el  que  yo  exprese  una  opinión  positiva 
en  la  presente  ocasión  sería  inmodesto  é  impropio;  pero  debe  entenderse  claramente  que  en 
todos  los  demás  puntos  de  los  Estados  Unidos  en  donde  prevalece  la  fiebre  amarilla,  se  cree 
que  fué  introducida  por  ciertas  excursiones  ferroviarias  que  conducían  gente  de  varios 
Estados  adyacentes — Mississippi,  Alabama  y  Florida — á  Nueva  Orleans,  después  que  la 
enfermedad  prevaleció  allí,  pero  antes  de  que  fuera  ri^conocida  ó  anunciada.  Las  medidas 
adoptadas  en  Nueva  Orleans  para  la  supresión  de  la  enfermedad  son  las  mismas  que  la 
Comisión  Americana  puso  tan  notablemente  en  práctica  en  la  ciudad  de  la  Habana,  Cuba, 
cuyo  benéfico  trabajo  ha  sido  continuado  por  algunos  de  los  caballeros  presentes  en  esta 
Convención.  Las  medidas  tomadas  para  atacar  la  enfermedad  han  sido  dirigidas  única  y 
simplemente  contra  el  mosquito  Stegomyia  fasciata  como  el  único  medio  de  trasmisión  de  la 
fiebre.  Se  ha  iniciado  una  campaña  contra  este  mosquito.  Las  medidas  adoptadas  han 
sido  la  fumigación,  con  azufre  ú  otras  sustancias,  y  el  aislamiento  de  las  personas  tanto 
afectadas  como  sospechosas  en  hospitales  perfectamente  resguardados  ó  habitaciones  com- 
pletamente resguardadas  en  las  casas  en  donde  ^e  las  ha  hallado  enfermas.  También  se  han 
tomado  precauciones  contra  las  cisternas  y  aguas  estancadas,  y  los  sitios  en  que  no  se  podía 
dar  salida  al  agua  han  sido  rellenados;  se  ha  tomado  la  precaución  de  echar  sal  en  las 
alcantarillas  de  Nueva  Orleans,  basándose  esta  medida  en  el  hecho  de  que  el  óvulo  del 
mosquito  Stegomyia  no  so  incuba  en  el  agua  cuya  sexta  parte  sea  salada. 

Decir  que  los  experimentos  han  sido  coronados  con  el  éxito  sería  anticipar  los  resultados 
que  creemos  tendrán  efecto  dentro  de  las  dos  próximas  semanas.  Eso  sí,  han  sido  coronados 
con  éxito  en  cierto  modo,  lo  cual  es  grato  por  la  originalidad  de  los  métodos.  La  enfermedad 
no  se  ha'  propagado  con  la  rapidez  y  en  la  extensión  que  se  han  observado  en  epidemias 
anteriores,  y  se  cree  que  ello  es  debido  al  jefe  del  servicio  que  tengo  el  honor  de  representar 
aquí  y  á  los  funcionarios  á  quienes  se  ha  encomendado  la  misión  de  llevar  á  cabo  las  medidas 
antiepidémicas  en  Nueva  Orleans,  así  como  también  á  ellos  se  deberá  el  que  los  resultados 
que  se  obtengan  dentro  de  un  período  de  tiempo  relativamente  corto  sean  una  evidente 
prueba  de  la  exactitud  de  la  doctrina  que  sustenta  que  el  mosquito  es  el  único  agente 
trasmisor  de  la  fiebre  amarilla. 

Ahora  me  ocuparé  de  la  fiebre  palúdica.  Como  Vds.  saben,  este  es  un  país  de  mucha 
extensión.  La  palúdica  es  algo  que  está  perennemente  entre  nosotros  y  que  se  manifiesta 
bajo  distintas  formas.  Es  imposible  decir  qué  medidas  han  sido  tomadas  para  combatir  la 
fiebre  palúdica,  pero  sí  se  puede  decir  que  es  una  cuestión  que  ha  ocupado  la  atención  de  las 
juntas  de  sanidad  de  varios  Estados  de  la  Unión,  y  la  exactitud  de  la  doctrina  de  que  el 
mosquito  es  el  trasmisor  de  la  fiebre  ha  quedado  grabada  y  se  ha  justificado  en  las  mentes  de 
las  autoridades  de  sanidad  de  los  Estados.     Este  asunto  ha  excitado  el  más  vivo  interés  en 


SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL.  417 

casi  todos  los  Estados  do  la  Unión.  Actual-n  '.nfc  >,  a  >  ha  iniciado  una  campaña  contra  el 
mosquito  anopheles  como  el  único  trasinisor  ds  la  palúdica,  y  grandes  or^^anizacionc-s  do 
varios  Estados,  y  on  una  ocasión  una  asociación  nacional,  Sfj  han  ocupado  en  trabajar  por  la 
total  supresión  do  todos  los  mosquitos,  en  lo  posible.  Esa  asociación,  la  Sociedad  Ameri- 
cana para  (1  Exterminio  del  Mos([uito,  cflebríí  en  Nueva  Orlcjans,  hace  cosa  d^,  un  año,  su 
segunda  reunión,  recibiéndose  buenas  noti(;ias  d",  varias  comunidadi^s  y  (astados  inter(!sados, 
demostrando  el  espíritu  de  emulación  que  existía  entre  varias  comunidades  en  los  mismos 
Estados,  y  entre  las  mismas  ciudad(^s,  para  la  supresión  del  mal  que  nos  ocupa  y  la  elimina- 
ción de  esa  fecunda  íuente  de  la  propagación  de  una  enfermedad  qu(!,  cuando  se  dice  todo, 
produce  mas  insalubridad,  si  no  jnortandad,  que  la  liebre  amarilla,  que  nosotros,  como 
higienistas,    tomemos    tanto. 

Siento,  Señor  Presidente,  no  haber  podido,  por  ahora,  poner  mis  observaciones  en  forma 
escrita,  pero  con  su  permiso  el  informe  compl(;to  será  sometido,  ó  bien  antes  de  la  clausura 
de  la  Convención,  ó  bien  á  tiempo  para  poderse  publicar  con  los  trabajos. 


INFORME    DEL   DR.  J.  T.    FULTON,   DELEGADO    DE    LOS    ESTADOS 

UNIDOS. 

Señor  Presidente,  Señores:  Obedeciendo  á  la  indicación  que  se  me  hizo  hace  unos 
días,  comparezco  ante  esta  Convención  para  hacerles,  tan  breve  y  claramente  como  pueda, 
una  relación  de  los  métodos  de  organización  que  se  observan  en  los  Estados  de  la  Unión 
para  los  fines  de  gobierno  sanitario.  Hay  unos  seis  sistemas  distintos  en  nuestra  nación, 
de  los  cuales  no  todos  son  buenos  y  ninguno  del  todo  malo.  Para  empezar  con  la  forma 
más  primitiva,  citarímos  primero  el  estado  de  la  parte  sur  más  extrema  de  la  Unión.  Allí 
el  gobierno  sanitario  se  halla  investido  en  un  sólo  individuo.  El  Estado  de  Tejas  no  tiene 
junta  de  sanidad;  no  tiene  otra  base  de  organización  sanitaria  que  la  cuarentena.  Por 
esta  razón  el  gobierno  sanitario  del  Estado  de  Tejas  es  á  mi  juicio  el  de  la  forma  más  primitiva 
que  puede  hallarse  en  nuestro  país.  El  funcionario  de  cuarentena  de  Tejas  reúne  en  sí 
todas  las  facultades  sanitarias  del  Estado,  y  hasta  el  presente  esta  autoridad  se  ha  ejercido 
contra  una  enfermedad  solamente,  enfermedad  que  no  siempre  prevalece  en  Tejas.  El 
funcionario  de  cuarentena  de  Tejas  tiene  la  misión  de  evitar  la  introducción  de  la  fiebre 
amarilla.  Con  respecto  á  la  peste  bubónica  tiene  poderes  semejantes;  pero  no  tiene 
facultades  en  cuanto  al  régimen  interior,  ó  por  lo  menos  no  las  ejerce  relativo  á  las  enfer- 
medades que  pudieran  prevalecer  en  las  localidades.  Bajo  este  punto  de  vista  la  organiza- 
ción sanitaria  de  Texas  pertenece  estrictamente  á  la  clase  de  agencias  de  necesidad,  y  no 
tiene  prácticamente  deberes  rutinarios  aparte  de  los  de  cuarentena  marítima,  ó  de  los 
•de  un  caso  de  urgencia.     Esta  es  la  forma  más  primitiva  de  organización  sanitaria. 

Después  viene  probablemente  la  forma  de  gobierno  que  se  limita  á  evitar  la  introducción 
de  enfermedades  exóticas,  pero  sin  que  el  gobierno  esté  investido  en  un  hombre  sólo.  El 
Estado  de  Luisiana  tiene  una  junta  de  sanidad  que  es  esencialmente  una  junta  de  cuarentena, 
es  decir,  que  no  tiene  otros  deberes  que  los  relativos  á  enfermedades  que  no  son  propias 
del  país.  No  tiene  deberes  con  respecto  á  las  enfermedades  que  prevalecen  siempre  entre 
los  habitantes  del  Estado..  Es  estrictamente  una  junta  de  cuarentena  que  sostiene  un 
extenso  y  costoso  equipo,  no  para  adquirir  pericia  en  algún  trabajo  higiénico  rutinario, 
sino  simplemente  para  impedir  la  introducción  de  enfermedades  que  no  prevalecen  nor- 
malmente en  la  población.  Varios  de  los  Estados  de  la  costa  del  Golfo  pertenecen  á  esta 
clase.  Anteriormente  Georgia,  Misisipí  y  Alabama  tenían  sus  juntas  de  sanidad  organiza- 
das bajo  un  plan  por  el  estilo.  Felizmente,  el  Estado  de  Florida  se  ha  apartado  de  esta 
condición,  y  deshaciéndose  finalmente  de  su  sistema  de  cuarentena  ha  llegado  á  constituir 
una  verdadera  junta  de  sanidad,  es  decir,  una  junta  con  ideas  modernas  que  mira  por  las 
necesidades  del  pueblo  en  las  circunstancias  ordinarias  y  en  todas  las  épocas.  Geoi'gia 
también  tiene  una  junta  de  sanidad  basada  en  principios  modernos,  y,  en  verdad,  pronto 
llegará  á  ser  un  factor  importante  en  el  progreso  de  la  higiene  en  los  Estados  Unidos.  Estos 
dos  ejemplos  demuestran  las  dos  formas  más  sencillas  de  organización  sanitaria  en  este  país. 

Sobre  éstas  está  la  forma  de  una  junta  de  sanidad  que  es,  en  realidad,  representante  del 
pueblo  del  Estado  y  que  siempre  está  ocupada  en  la  solución  de  los  problemas  que  éste  la 
presenta.  Como  ejemplo  de  esta  clase  de  junta  de  sanidad,  citaré  las  de  los  Estados  de 
Massachusetts,  Michigan  y  lowa.  Estas  juntas  se  componan  de  cinco  ó  siete  individuos, 
los  cuales  son  nombrados  por  el  gobernador  del  Estado  para  un  plazo  determinado.  Algunos 
de  ellos  son  médicos,  pero  no  todos.  Estas  juntas  no  desempeñan  funciones  ejecutivas; 
elijen  ó  nombran  á  sus  respectivos  secretarios,  los  cuales  son  sus  funcionarios  ejecutivos 
por  virtud  de  sus  nombramientos.  Con  esto  el  funcionario  ejecutivo  de  una  junta  de 
sanidad  de  este  género  queda  colocado  en  el  rango  de  jornalero  más  bien  que  en  el  de 
funcionarios  asalariados,  lo  cual  es  una  ventaja.     La  junta  no  está  obligada  á  nombrar 

■         1112a— 06 27 


418  SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL.      , 

á  un  ciudadano  del  Estado,  pasando  por  alto  las  miras  políticas,  y  no  está  restringida  por 
limitaciones  constiticionales  con  respecto  al  sueldo.  El  funcionario  ejecutivo  de  una  junta 
de  esta  clase  puede  ser  un  pciito  higienista.  Tiene  buenas  oportunidades  para  trabajar 
eficazmente  en  materia  de  saneamiento,  y  algunos  de  los  mejores  resultados  conseguidos 
en  este  país  lo  han  sido  por  medios  de  juntas  de  esta  forma,  á  pesar  de  que  son  pocas. 

Después  tenemos  la  clase  de  juntas  de  sanidad  á  la  cual  pertenece  la  gran  mayoría  de  las 
juntas  de  esta  nación.  Estas  son  las  juntas  cuya  mayoría  de  individuos  está  compuesta 
de  médicos,  y  que  son  nombrados  por  los  gobernadores  de  los  Estados  por  un  espacio  de 
tiempo  determinado,  y  las  cuales  elijen  un  secretario  6  funcionario  ejecutivo  que  es  al 
propio  tiempo  miembro  de  la  junta.  En  otras  palabras,  en  una  jimta  de  esta  forma,  el 
secretario  no  es  un  empleado  de  ella,  sino  uno  de  sus  individuos.  Generalmente  sus  fun- 
ciones están  prescritas  por  la  ley.  Como  esta  es  numéricamente  la  clase  más  grande  de 
juntas  de  sanidad,  nos  ha  dado  muchas  buenas  nuies^ras  de  sus  trabajos,  y  quizás,  jjor  era 
misma  razón,  por  ser  la  clase  más  numerosa,  también  nos  ha  demostrado  los  abusos  de 
que  es  susceptible  este  sistema.  En  esta  clase  de  juntas  no  es  posible  salirse  de  los  partidos 
políticos  para  poder  en  contrar  un  perito  higienista.  El  funcionario  ejecutivo  queda  hecho 
miembro  de  la  junta  y  debe  ser  elegido  de  entre  los  ciudadanos  del  Estado.  Mencionaré 
uno  de  los  abusos  factibles  bajo  este  sistema.  El  peor  es  que  los  miembros  de  la  junta, 
desde  la  fecha  de  sus  nombrauúentos,  pueden  convenir  en  dividir  las  utilidades,  durante 
el  desempeño  de  sus  cargos,  de  tal  manera  que  todos  reciban  partes  iguales.  En  este  país 
ninguna  de  las  juntas  de  sanidad  percibe  remuneración,  ni  tanípoco  los  funcionarios  ejecu- 
tivos, según  tengo  entendido,  en  estas  dos  clases.  De  modo  que  sucede,  como  en  una 
junta  de  sanidad  que  sé,  que  sus  miembros  se  dividen  las  utilidades  de  sus  cargos  por  el 
período  de  seis  años,  conviniendo  en  que  cada  uno  desempeñara  las  funciones  del  ejecutivo 
durante  un  año,  al  cabo  del  cual  traspasa  su  cargo  ejecutivo  al  siguiente  individuo.  De 
este  modo  la  junta  de  sanidad  que  antes  hacia  buenos  trabajos  ahora  no  los  hace,  porque 
cambia  su  secretario  y  funcionario  ejecutivo  todos  los  años.  Esta  es  la  fase  peor  que 
puede  tomar  este  sistema  nuestro,  que  comprende  el  mayor  número  de  las  juntas  de  sanidad. 

Después  de  éste,  lo  cual  es  muy  extraño,  volvemos  al  primer  sistema  de  todos,  el  cual 
tiene  la  mejor  razón  á  su  favor,  el  sistema  de  gobierno  sanitario  investido  en  un  sólo  individuo. 
Desde  que  Tejas  empezó  este  sistema,  en  donde  empieza  á  caer  en  desuso,  dos  Estados  de 
nuestra  Unión  han  vuelto  á  dar  vida  á  la  idea,  Nueva  York  y  Pennsylvania.  No  existe 
junta  de  sanidad  en  Nueva  York,  pero  si  una  extensa  y  fuerte  organización  sanitaria,  cuyo 
jefe  es  un  comisionado  de  sanidad,  nombrado  por  el  gobernador  del  Estado,  que  desempeña, 
el  cargo  por  un  espacio  de  tiempo  igual  al  de  la  duración  del  cargo  de  dicho  gobernador. 
Esto  ha  hecho  que  el  puesto  ejecutivo  de  la  organización  sanitaria  de  Nueva  York  sea 
muy  solicitado;  es  una  golosina  política;  y  la  experiencia  nos  demuestra  que  los  jefes  de 
las  juntas  de  sanidad  cambiarán  en  Nueva  York  tan  rápidamante  como  el  jefe  ejecutivo. 
La  junta  de  este  Estado  se  compone  de  un  sólo  individuo,  y  todas  las  responsabilidades 
del  gobierno  sanitario  del  Estado  se  hallan  concentradas  en  él,  con  la  facultad  de  destituir 
á  casi  todos  sus  subordinados.  Hace  un  año  que  el  Estado  de  Pennsylvania  ha  adoptado 
el  mismo  plan,  después  de  haber  tenido  por  espacio  de  veinte  y  cinco  ó  treinta  años  una  junta 
de  sanidad  nombrada,  con  facultad  para  elegir  á  su  propio  secretario.  Tal  vez  no  es  aún 
tiempo  para  decir  que  este  último  sistema  es  malo.  Es  concebible  que  un  individuo, 
como  único  arbitro  sanitario  de  los  destinos  del  Estado,  sea  bastante  poderoso  para  colocarlo 
á  una  altura  considerable ;  pero  ello  no  está  muy  de  acuerdo  con  nuestras  ideas  republicanas, 
y  yo,  personalmente,  me  inclino  á  dudar  que  haya  sido  un  paso  bien  dado.  Creo  que  es  una 
circunstancia  muy  curiosa  la  que  estos  dos  últimos  Estados  cambiaran  sus  lej^es  para 
volver  al  sistema  de  gobierno  sanitario  investido  en  un  sólo  individuo  que  entonces  única-^ 
mente  en  Tejas  se  hallaba  en  práctica,  y  estoy  bastante  seguro  de  que  Tejas  está  para 
abandonar  ese  sistema. 

He  hecho  esta  breve  descripción  de  los  métodos  de  organización  en  los  Estados  Unidos 
para  vuestra  información  simplemente.  Considero  impropio  por  mi  parte  el  que  yo  expre- 
sare mis  opiniones  personales  sobre  las  probabilidades  de  establecer  definitivamente  en 
este  país  una  organización  higiénica  de  primera  clase  bajo  uno  de  los  sistemas  expuestos, 
por  más  que  tengo  esas  opiniones,  que  por  el  presente  rae  reservo. 


EXTRACTO  DEL  INFORME  PRESENTADO  POR  EL  SEÑOR  P.  REQUE- 
NA BERMÚDEZ,  ENCARGADO  DE  NEGOCIOS  DEL  URUGUAY  EN 
WASHINGTON. 

(Si  bien  la  República  Oriental  del  Uruguay  no  firmó  el  convenio  adoptado  por  la  Confe- 
rencia, estuvo  representada  en  sus  sesiones  por  el  Señor  P.  Requena  Bermúdez,  Primer  Sec- 
retario y  Encargado  de  Negocios  de  dicha  República  en  Washington,  quien,  en  nombre  de 
su  Gobierno,  presentó  ante  la  Conferencia  una  extensa  memoria,  cuyo  extracto  es  el  siguiente.) 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL.  419 

Las  medidas  sanitarias  adoptadas  han  venido  á,  modifioar  leyes  relacionadas  con  la  sani- 
dad marítima  y  terrosti'o,  siendo  aljjunas  do  ollas  de  tal  importanr^ia  que  no  dudarnos 
presentarán  á  nuestro  país  coincí  inspirarlo  en  las  má,s  avanzadas  ideas  sol>re  el  modo  como 
debe  ostal)lecei'so  la  profilaxia  de  las  onFermíídades  exóti(;as  (\  infecto-conta'^^iosas. 

La  defensa  contra  la  iniportat-ión  4  nuestro  país  de  enfermedades  contaj^iosas  é  infecto- 
contagiosas;  lo  pertinente  á  los  ai-tí(;ulos  33  y  50  del  lirs'^lamento  de  Sanilud  Marítima; 
la  lucha  contra  la  tuberculosis,  y  la  inspección  sanita-ia  fie  la  prostitución  han  orif^inado 
nuevas  leyes  y  ordenanzas  qucí  determinan  medidas  profilácticas  rnás  en  armonía  con  el 
criterio  moderno  sobre  c-l  modo  de  propagación  y  ios  medios  para  combatir  la«  enfenne- 
dades  infecto-contagiosas. 

Todas  las  medidas  nuevas  adoptadas  por  el  Coasejo  Nacional  de  Higiene  son  de  suma 
importancia,  pero  la  que  está  destinada  á  revolucionar  totalmente  lo  existente,  la  que 
mayoies  beneficios  reportará  al  público,  al  comercio  y  á  nuestras  relaciones  internacionales, 
es  la  referente  al  modo  de  practicar  la  profilaxia  de  la  penetración  por  mai'  de  enfermedades 
exóticas  de  naturaleza  contagiosa,  como  son  la  peste  de  Oriente,  la  helare  amarilla  y  el 
cólera  asiático. 

Las  bases  de  esta  profilaxia  han  sido  adoptadas  por  la  Convención  Sanitaria  Internacional 
celebrada  en  Río  Janeiro  el  5  de  junio  de  1901  en  la  que  tomaron  parte  los  delegados  de  las 
Repúblicas  del  Uruguay,  Argentina,  Brasil  y  Pai'aguay,  bases  ({ue  fueron  i-atiíicadas  por 
los  Gobiernos  respectivos,  los  cuales  han  dictado  decretos  pertinentes  al  cumplimiento  de 
lo  establecido  en  este  convenio. 

En  materia  profilaxia  internacional  nada  existe  más  liberal  que  lo  resuelto  por  dicho 
tratado  sanitario.  Por  él  se  suprimen  las  largas  cuarentenas,  el  rechazo  de  navios  infec- 
tados y  todas  las  medidas  añejas  que  entorpecían  el  comercio,  dificultaban  las  relaciones 
con  el  extranjero  y  fastidiaban  el  viajante;  beneficios  todos  que  han  sido  obtenidos  con 
disposiciones  que  no  pueden  disminuir  en  nada  la  eficacia  de  los  medios  profilácticos  necesa- 
rios para  mantener  al  país  libre  de  enfermedades  exóticas  contagiosas.  Nuestro  país  puede 
enorgullecerse  de  haber  tomado  la  iniciativa  de  la  mencionada  convención. 

Para  la  ejecución  de  lo  acordado  en  la  convención  de  Río  Janeiro,  el  Consejo  Nacional 
de  Higiene  hará  construir  un  desinfectorio  en  uno  de  los  muelles  de  desembarco  de  pasa- 
jeros. En  ese  local  que  estará  provisto  de  estufas  y  otros  medios  de  desinfección,  se  desin- 
fectarán las  ropas  y  equipajes  de  los  pasaje¡-os.  En  tanto  que  no  se  haya  realizado  esta 
instalación  se  continuarán  utilizando  los  locales  y  estufas  de  desinfección  de  la  Isla  de 
Flores  para  el  tratamiento  de  ropas  y  equipajes. 

Los  pasajeros  irán  en  libertad  á  sus  domicilios,  donde  serán  vigilados  por  los  médicos 
inspectores  de  sanidad  terrestre  dui'ante  un  tiempo  igual  al  período  de  incubación  de  la 
enfermedad  que  se  sospecha. 

Los  buques  y  las  mercaderías  serán  desinfectadas  por  el  aparato  Clayton,  después  de 
cuya  rápida  operación  se  encontrarán  completamente  libres  para  el  comercio. 

Los  pasaj'eros  atacados  de  una  enfermedad  exótica,  y  los  pasajeros  de  tercera  clase  irán 
para  su  asistencia  ó  vigilancia  á  la  Isla  de  Flores  que  es  la  única  estación  sanitaria  que 
poseemos. 

El  Consejo  Nacional  de  Higiene  estudia  el  modo  de  trasformar  la  actual  casa  de  aisla- 
miento en  estación  sanitaria  terrestre  con  el  fin  de  poder  asistir  allí  al  pasajero  que  al  llegar 
á  nuestro  puerto  se  encuentra  atacado  de  una  enfermedad  infecto-contagiosa. 

En  el  Reglamento  de  Sanidad  Marítima  se  han  introducido  algunas  modificaciones  á  los 
artículos  33  y  50.  Los  artículos  sustitutivos  tienen  en  cuenta  el  tratamiento  correspon- 
diente á  los  lauques  infectados  por  una  de  las  enfermedades  exóticas  contagiosas;  en  ellos 
se  especifica  con  más  precisión  la  clasificación  de  buques  infectados  y  de  buques  sospechosos, 
y  se  determina  el  tra,tamiento  sanitario  de  los  buques  infectados  por  viruela,  tifus  exante- 
mático, sarampión  y  difteria. 

En  lo  relativo  á  la  sanidad  terrestre  el  consejo  ha  tomado  nuevas  medidas  con  el  fin  de 
establecer  un  tratamiento  profiláctico  más  eficaz  en  los  domicilios  de  los  tuberculosos 
menesterosos.  También  ha  estudiado  la  reglamentación  de  la  inspección  sanitaria  de  la 
prostitución. 

Las  personas  menesterosas  atacadas  de  tuberculosis,  enfermedad  que  por  su  frecuencia, 
extensión  y  graves  consecuencias  ha  llegado  á  ser  un  temible  mal  universal,  han  tomado 
en  Montevideo  un  rumbo  que  facilitará  el  llegar  más  fácilmente  al  fin  anhelado  por  las 
autoridades  sanitarias,  cual  es  la  represión  ó  disminución  de  la  diseminación  de  la  tuber- 
culosis enti-e  sus  habitantes. 

Gracias  á  los  humanitarios  servicios  prestados  por  la  Liga  contra  la  Tuberculosis,  el  tísico 
menesteroso  reúne  para  su  asistencia  á  los  dispensarios  de  esta  institución  y  los  médicos 
que  los  dirigen  se  apresm-an  á  denunciarlos.  Todos  los  casos  de  tuberculosis  que  comien- 
zan ó  son  antiguos,  que  se  asisten  en  los  dispensarios  son  denunciados.  También  lo  son 
muchos  otros  asistidos  en  sus  domicilios,  gi-acias  á  que  en  general  los  médicos  se  han  lanzado 
en  la  sana  corriente  de  denunciar  los  tuberculosos  menesterosos  á  quienes  prodigan  sus 
cuidados. 


420  SEGUNDA   CONFERENCIA    SANITARIA   INTERNACIONAL. 

De  ahí  que  las  estadísticas  recientes,  sobretodo  la  de  1904,  acusen  un  número  relativa- 
mente crecido  de  denuncias  por  tuberculosis  con  relación  á  los  años  anteriores.  En  reali- 
dad nuichos  de  esos  casos  no  son  recientes,  producidos  en  el  año,  sino  que  son  de  años 
anteriores,  que  nunca  i'ucron  denunciados  y  que  ahora,  al  concurrir  á  los  dispensarios 
"Maciel"  de  la  Liga,  solicitando  cuidados  son  declarados  á  las  autoiidades  sanitarias. 

El  Consejo  Nacional  de  Higiene,  en  diciembre  de  IDOl,  ha  dictado  varias  medidas  pro- 
filácticas que  fueron  apiobadas  por  el  Ministerio  de  Gobierno  y  que  se  p¡actican  en  los 
domicilios  de  los  tuberculosos  menesterosos  de  Montevideo. 

Entre  los  asuntos  sanitarios  que  actuahnente  ocupan  la  atención  del  consejo  figura  la 
reglamentación  de  inspección  sanitaria  de  la  prostitución. 

Hasta  el  presente  el  servicio  de  sanidad  de  la  prostitución  dependía  de  la  jefatura  de 
policía.  En  lo  adelante  será  una. dependencia  del  Consejo  Nacional  de  Higiene,  el  que 
dispondi'á  de  un  cuerpo  de  médicos  inspectores,  oficinas  de  registro,  locales  para  la  inspec- 
ción sanitaria  de  las  prostitutas,  etc. 

El  estado  sanitario  de  la  República  en  el  año  de  1901  y  lo  que  corre  del  1905  ha  sido 
satisfactorio.  Se  ha  notado  la  existencia  de  débiles  epidemias  de  viruela,  fácilmente  sofo- 
cadas por  la  vecunación  y  otras  medidas  profilácticas  comunes.  También  se  han  regis- 
trado algunos  casos  de  escarlatina,  difteria  y  fiebre  tifoidea. 

En  cuanto  á  la  fiebre  amarilla,  peste  bubónica  y  cólera  asiático  son  enfermedades 
exóticas  en  nuestro  país  y  por  lo  tanto  desconocidas. 

La  fiebre  palúdica  es  una  enfermedad  que  tampoco  existe  en  nuestro  suelo,  á  lo  menos 
en  sus  formas  típicas,  no  atreviéndonos  á  afirmar  que  no  existen  casos  lar^^ados  en  algún 
punto  de  la  campaña. 


INFORME    DEL    DELEGADO    DE    VENEZUELA,    SEÑOR    N.    VELOZ- 

GOITICOA. 

Como  delegado  de  los  Estados  Unidos  de  Venezuela  á  esta  Convención  Internacional 
tengo  el  honor  de  presentar  el  informe  prescrito  por  el  programa  científico  sobre  las  enfer- 
medades que  prevalecen  en  mi  país  y  las  leyes  de  sanidad  y  cuarentena  que  están  vigentes 
actualmente. 

Cuanto  al  primer  punto,  refiérome  al  anexo  marcado  con  la  letra  A,  que  contiene  un 
memorial  del  director  de  la  oficina  de  higiene  y  estadística  de  la  sección  occidental  del 
Distrito  Federal,  intitulado  "Informe  sanitario  demogi'áfico,"  que  comprende  toda  la 
mencionada  sección  del  referido  Distrito  y  es  un  importante  estudio  comparativo  sobre  la 
mortalidad,  natalidad,  nupcialidad  y  las  causas  de  mortalidad  y  sus  comparaciones,  é 
incluye  los  trabajos  ejecutados  por  las  inspectorías  de  aseo  urbano  y  obras  públicas  munici- 
pales. 

El  anexo  marcado  con  la  letra  B  contiene  los  cuadros  generales  de  la  estadística  de  mortaU- 
dad  relativa  al  segimdo  semestre  del  año  de  1904  en  los  Estados  de  la  Federación  Venezolana 
y  su  Distrito  Federal,  clasificada  aquella  según  el  sistema  de  BertiUón  por  enfermedades  y 
causas  de  muerte  dando  al  terminar  una  demostración  gráfica  del  por  ciento  de  la  totalidad 
de  las  defunciones.  Estos  datos  son  tomados  de  los  que  publica  la  dirección  general  de 
estadística  en  la  memoria  del  ministerio  de  fomento  de  1905. 

El  sumario  de  las  leyes  de  sanidad  y  de  cuarentena  vigentes  en  Venezuela  es  como  sigue: 

ENFERMEDADES   QUE   RECLAMAN    CUARENTENA   Y   PRECAUCIONES    SANITARIAS. 

El  cólera  asiático,  la  fiebre  amarilla,  la  peste  bubónica,  la  viruela  y  el  tifus  son  las  enfer- 
medades que  exigen  la  cuarentena  y  otras  medidas  especiales  de  salubridad. 

Los  buques  que  procedan  ó  se  sospeche  que  proceden  de  algún  puerto  infectado  de  una  de 
acjuellas  enfermedades  son  sometidos  á  cuarentena  de  observación  de  tres  días  para  las  per- 
sonas; pero  si  hay  plena  seguridad  de  que  no  ha  habido  ningún  caso  de  enfermedad  en  la 
travesía,  podrá  reducirse  la  cuarentena  de  observación  á  menor  tiempo,  después  de  un 
reconocimiento  escrupuloso. 

La  cua:  entena  de  observación  se  hace  en  lazaretos,  y,  á  falta  de  estos,  en  pontones  desti- 
nados al  efecto. 

Todo  bucpie  que,  durante  la  travesía,  ha  tenido  á  bordo  casos  de  enfermedad  de  las  men 
clonadas  se  le  someterá  á  cuarentena  de  rigor.  Esta  será  para  el  cólera  asiático  de  una  á 
dos  semanas;  para  la  fiebre  amarilla  de  tres  á  seis  días,  y  para  la  peste  bubónica  de  doce. 
Los  eníennos  serán  recluidos  en  un  lazareto,  y  las  personas  sanas  que  se  hallen  á  bordo,  junto 
con  los  equipajes,  mercancías  y  demás  objetos,  quedan  en  el  mismo  buque  ó  se  trasladan  á 
otro  lazareto  hasta  que  transcm-ra  el  tiempo  acordado  para  la  cuarentena,  procediéndose  á 
la  desinfección  del  buque  al  practicarse  el  desembarque  de  los  individuos.  Las  personas  de 
á  bordo  quedarán  sujetas  á  la  cuarentena  que  disponga  el  respectivo  médico  de  sanidad  y 
la  junta  en  vista  de  las  circimstancias  del  caso. 


SEGUNDA    GONFEKI'JNCIA    SANITARIA    INTERNACIONAL.  421 

RECONOOIMIKNTO   DE   IX)S   BUQUES   Y   CUAK ENTENA. 

Al  llegar  un  buque  sospechado  ó  infectado  á  uno  de  los  puertos  de  Venezuela,  no  se  le 
permito  en  ningíin  caso  la  comunicación  con  él  y  se  impide  el  desembarque  de  las  personas, 
equipajes,  mercaderías  y  demás  objetos. 

Los  buques  que  vichen  con  patente  limpia;  pero  que  hubieren  experimentado  en  la 
travesía  casos  do  cólera  asiático,  fiebre  amarilla,  peste  bubóniíjp,,  etc.,  serán  sometidos  á 
cuarentona  do  rigor,  la  cual  durará  el  tiempo  que  sea  designado. 

Si  el  buque  ha  tenido  comunicación  directa  con  puertos  donde  reina  epidemia,  6  si  viene 
de  algún  puerto  donde  ha  reinado  recientemente,  se  someterá  también  á  cuarentena  de 
observación. 

Todo  buque  sometido  á  cuarentena  de  observación  se  hará  anclar  á  sotavento,  se  vigilará 
atentamente  y  será  asistido  por  un  médico.  Si  durante  la  cuarentena  de  observación  se 
presenta  algún  caso  de  enfermedad  infectiva,  comenzará  desde  luego  la  cuarentena  de  rigor. 
Si  el  buque  puesto  en  cuarentena  quisiere  seguir  viaje,  al  despacharlo  debe  hacerse  constar 
en  la  patente  su  estado  de  sanidad. 

La  junta  de  sanidad  y  las  autoridades  de  policía  tomarán  todas  las  precauciones  higiénicas 
necesarias  para  impedir  el  desarrollo  de  principios  deletéreos  en  la  localidad,  destruyendo 
todo  foco  de  infección,  manteniendo  el  mayor  asco  que  sea  posible  y  esterelizando  todo 
aquello  que  pueda  alterar  la  atmósfera  ó  viciarla  de  cualquiera  manera. 

DESINFECCIÓN. 

Esta  se  verifica  delante  del  médico  de  sanidad  y  comprende  la  desinfección  de  los 
equipajes,  mercancías  y  del  buque  mismo  de  una  manera  rigurosa  y  general. 

Las  sulsstancias  animales,  como  cueros,  la  lana,  la  crin  y  las  substancias  orgánicas,  se 
desinfectan  más  cuidadosamente,  y  cuando  esto  no  pueda  hacerse  se  incineran. 

La  desinfección  se  hace  siempre  según  la  naturaleza  del  objeto,  y  es  más  estricta  respecto 
de  aquellas  substancias  susceptibles  de  conservar  el  principio  maléfico  y  menos  rigurosa 
cuanto  á  las  que  no  son,  tan  susceptibles  de  conservarlo. 

La  desinfección  se  hace  después  de  que  el  buque  esté  anclado  y  descargado,  fumigándolo 
con  cloro,  azufre  y  chorros  de  vapor. 

LAZARETOS. 

Los  lazaretos  se  escogerán  en  los  lugares  más  adecuados  á  sotavento  del  pueito, 
eligiéndose  con  preferencia  una  isla  desierta  que  tenga  buena  agua  potable. 

PATENTES   DE    SANIDAD. 

A  todo  buque  que  Uega  á  algún  puerto  de  Venezuela  se  le  exige  la  patente  de  sanidad, 
en  la  cual  debe  constar  su  punto  de  partida,  los  lugares  á  donde  se  dirige  su  verdadero 
estado  sanitario  y  las  enfermedades  que  se  hayan  sufrido  en  él  durante  la  travesía.  Si  trae 
patente  sospechosa  sera  sometido  á  cuarentena  de  observación  y  si  la  trae  sucia  á  la  de 
rigor. 

AUTORIDADES   DE   SANIDAD. 

En  cada  puerto  hay  juntas  de  sanidad  que  atienden  y  vigilan  las  necesidades  locales 
y  toman  las  precauciones  debidas  para  evitar  la  importación  de  las  enfermedades  epidé- 
micas, así  como  también  para  hacer  cumplir  las  disposiciones  del  reglamento  de  sanidad, 
especialmente  en  lo  concerniente  á  cuarentenas  y  medidas  de  salubridad. 

El  jefe  de  la  salud  es  un  médico  nombrado  al  efecto  quien  tiene  á  sus  órdenes  todos  los 
agentes  destinados  al  servicio  de  sanidad. 

Las  juntas  de  sanidad  se  compondrán  del  médico  nombrado  al  efecto  de  la  primera 
autoridad  civil  del  lugar,  del  administrador  de  la  aduana  marítima,  como  representante 
del  fisco  y  en  su  carácter  de  capitán  del  puerto,  de  dos  comerciantes  vecinos  y  de  un 
ingeniero.  Esta  junta  está  presidida  por  el  médico  de  sanidad,  y  también  forman  parte 
de  ella,  con  voz  y  voto  consultivos,  los  cónsules  extranjeros  residentes  en  el  puerto, 
para  garantía  de  los  intereses  que  tienen  que  guardar. 

Las  juntas  de  sanidad  se  reunir  cada  vez  que  lo  juzga  conveniente  el  médico  director' 
de  la  salud  y  se  ocupan  de  todo  aquello  que  se  relaciona  con  el  régimen  de  los  lazaretos  y 
pontones  establecidos  ó  que  se  establezcan,  de  su  escrupulosa  vigilancia  y  de  todo  lo  que 
contribuya  á  salubridad  de  la  localidad. 

Las  autoridades  civiles  y  militares  y  los  empleados  en  el  orden  rentístico  y  poUtico  están  en 
el  deber  de  cooperar  con  las  juntas  de  sanidad  á  este  fin  y  de  prestarles  eficaz  y  oportuna 
ayuda  en  sus  decisiones. 

Dejo,  así,  cumplido  el  encargo  de  presentar  á  la  Convención  informe  como  delegado 
de  mi  pais  sobre  las  enfermedades  que  prevalecen  en  él  y  sobre  sus  leyes  sanitarias  y  de 
cuarentena. 


422  SEGUNDA    CONFEKENCTA    SANITARIA    INTERNACIONAL. 

Anexo  A. 

Informe  sanitario-demogi-áfico  de  Caracas,  El  Valle,  Antírnano,  La  Vega,  Macarao,  El 
Recreo,  La  Guaira,  Maiquetía,  Macuto,  Caraballeda,  Naiguatá  Carayaca,  Caruao,  Los  Teques, 
Miquilén,  Carrizal,  San  Pedro,  San  Antonio,  San  Diego,  Tacata,  Paracotos,  Petare, 
Baruta,  Él  Hatillo  y  Chacao  en  el  afío  de  190i. 

• 

INFORME     PRESENTADO     AL     OIÜÍJADANO     GOBERNADOR     POR     EL     DR.    A.    HERRERA    VEGAS, 

DnttlCfrOR  DE  LA  OFICINA.         ,  t 

Ciudadano  Gobernador  de  la  Sección  Occidental  del  Distrito  Federal,  Caracas: 

Cábeme  hoy  la  muy  legítima  satisfacción  deponer  en  sus  manos  el  informe  sanitario  y 
demogi'áfico  del  vasto  territorio  de  su  jurisdicción  en  el  año  de  1904.  Es  este  el  cuarto  que  me 
toca  subscribir,  pues  aunque  la  oficina  de  higiene  y  estadística  á  mi  cargo,  sólo  cufenta  dos 
años  de  establecida,  desde  tiempo  antes  dediquéme  á  esta  clase  de  estudios  y  solicitando 
datos  y  materias,  hube  de  conseguir  formar  el  expediente  sanitario  de  Caracas  y  sus 
pueblos  circunvecinos  en  los  años  de  1901  y  1902. 

En  la  actualidad,  asistida  la  oficina  de  higiene  y  estadística,  poi  las  autoridades  civiles 
y  administrativas,  su  labor  ha  sido,  si  no  fácil,  al  menos  más  hacedera,  y  puedo  por  tanto 
presentar  á  Vd.  un  estudio  particular  y  comparativo  del  movimiento  de  población  y  de  las 
condiciones  sanitarias  de  Caracas,  El  Valle,  Antimano,  La  Vega,  Macarao  y  El  Recreo, 
que  forman  el  Departamento  de  Libertador;  de  La  Guiara,  Maiquetía,  Macuto,  Caraballeda, 
Naiguatá,  Carayaca  y  Caruao,  parroquias  del  Departamento  de  Vargas;  de  Los  Teques, 
Miquilén,  Carrizal,  San  Pedro,  San  Axitonio,  San  Diego,  Tacata  y  Paracotos,  componentes 
del  Departamento  de  Guaicaipuro,  y  finalmente  de  Petare,  Baruta,  Hatillo  y  Chacao,  partes 
del  Departamento  de  Sucre.  En  total  veinte  y  cinco  poblaciones  con  un  número  de 
184,500  almas,  repartidas  así:  Caracas,  85,000  almas;  parroquias  foráneas,  18,500;  Departa- 
mento de  Vargas,  32,000;  Departamento  de  Guaicaipuro,  30,000,  y  Departamento  de 
Sucre,  19,000. 

La  vastísima  extensión  territorial,  su  numerosa  población  y  los  múltiples  intereses 
que  se  encierran  en  esta  sección  de  Venezuela  hace  que  ha3^a  deber  de  fijar  seriamente  la 
atención  en  todos  los  pormenoi-es  que  se  desprenden  del  estudio  de  este  informe,  que  me 
permito  recomendar  muy  encarecidamente  á  Vd. 

Sumario. 

labor  de  la  oficina  de  higiene  en  el  año  de  1904. 

Caracas. — Estudio  comparativo  de  su  mortalidad,  natalidad,  nupcialidad  y  movimiento 
de  población  en  1904.  Causas  de  mortalidad,  edad  de  los  fallecidos,  nacionalidad,  enfer- 
medades dominantes  en  el  año,  fiebre  tifoidea,  tuberculosis,  enfermedades  del  aparato 
digestivo,  clima  de  Caracas,  paralelo  entre  los  fallecimientos  y  las  estaciones  del  año, 
coeficiente  de  mortalidad,  natalidad  general  y  comparada,  hijos  legítimos  é  ilegítimos, 
variaciones  anuales  de  natalidad  desde  1900.  Nupcialidad:  Total  de  matrimonios,  edad 
de  los  contrayentes,  matrimonios  por  mes  y  por  parroquias.  Nupcialidad  comparada  y 
coeficiente  de  nupcialidad.  Conclusiones.  Departamento  de  Vargas,  Departamento 
de  Guaicaipuro  y  Departamento  de  Sucre:  Estudio  de  su  población. 

LABOR   DE    LA    SECCIÓN    DE    HIGIENE   EN    EL  ^AÑO   DE    1904. 

Antes  de  entrar  en  el  estudio  sanitario  y  demográfico  de  la  sección,  séame  permitido 
mostraF  á  Vd.  el  informe  detallado  del  gran  número  de  trabajos  ejecutados  por  la  oficina 
de  higiene  y  por  las  inspecLorías  de  aseo  urbano  y  obras  públicas  municipales,  que  si  bien 
estas  últimas  no  dependen  de  aquella,  sus  labores  redundan  directamente  en  pro  de  la 
salubridad  general  y  es  por  ésto  que  las  incluyo. 

Nada  se  había  hecho  en  Caracas  semejante  á  lo  que  dejo  espuesto  en  este  informe; 
algo  se  está  haciendo,  pero  mucho,  muchísimo  falta  por  hacerse,  para  que  la  higiene  y  la 
salubridad  por  consecuencia,  de  nuestra  capital,  alcance  el  debido  desarrollo. 

Con  sobra  de  bien  fundadas  esperanzas  creo,  y  junto  conmigo  todo  Caracas,  que  este 
ha  de  marcarse  con  letras  de  oro  en  los  anales  de  la  historia  de  Venezuela  por  su  progreso, 
y  no  es  dudable  que  el  Gobierno  Nacional,  presidido  por  un  patriota  tan  ardiente  como 
el  General  Castro,  tenderá  mano  providente  á  la  yá  empezada  obra  de  la  higienización  de 
la  República. 

Á  Vd.  como  fiel  intérprete  de  los  elevados  setimientos  de  aquél,  corresponderá  la  gloriosa 
tarea,  secundado  por  sus  subalternos,  de  arrancar  á  la  muerte  el  crecido  tributo  que  hoy 
le  pagamos,  debido  á  lo  insuficiente  de  nuestros  medios  de  defensa  contra  ella. 


SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAT..  423 

RELACIÓN  DE  LOS  TKABAJOS  EJECUTADOS  POR  LA  OFICINA  DE  IHOIENE  EN  EL  ARO  DE     1904. 

Sección  de  aseo  urbano. 

Aseo  diario  del  mercado,  matadero,  plazas,  Ijulevares  y  gran  número  de  calles.     Repa- 
ración constaiile  de  cloacas  y  pavimento  de  calles.     (Inspectorías  del  ramo.) 

Número. 

Focos  de  infeccidn  denunciados 378 

Inspecciones  verificadas 412 

Órdenes  de  aseo 215 

Total  de  asuntos 1,014 

Sección  de  hromatología. 

Ni'iinero. 

Denuncios  de  alimentos  de  mala  calidad 257 

Muestras  de  alimentos  recibidas 137 

Solicitud  de  análisis 35 

Inspecciones  en  mercado 26 

Inspecciones  en  matadero 18 

Inspecciones  en  vaquerías 89 

Inspecciones  en  hortalizas 28 

Inspecciones  en  pesas  de  carne 56 

Inspecciones  en  establecimientos  de  víveres. 178 

Total  de  asuntos 824 

Alimentos  decomisados  por  la  oficina  de  higiene  y  por  la  regiduría  del  mercado : 


Libras. 

Peteado  ft'esco 4,  967 

Pescado  salado 2,  706 

Carne  fresca 443 

Carne  salada 573 

Caráotas 4, 701 

Garbanzos 882 

Papas 4,  048 

Otras  verduras 325 


Libras. 

Queso 180 

Morcilla 214 

Mantequilla 139 

Jamón 173 

Pastas  italianas 190 


Total 19,  541 

Conservas  alimenticias potes. .         261 


Sección  de  profilaxia  de  enfermedades  contagiosos. 

Número. 

Denuncios  recibidos 32 

Inspecciones 32 

Solicitud  'de  desinfecciones ." 26 

Desinfecciones  verificadas  en  26  locales 152 

Total 242 

Sección  de  vacunación. 

Número. 

Inoculaciones  de  vacuna 212 

Certificados  expedidos 37 

Total 249 

Sección  de  estadística  demográfica. 

Se  expidieron  datos  pedidos  por  los  DD.  L.  Razetti  y  Ayala  y  Bachilleres  Clemente, 
Smith,  De  Armas,  y  ponzález  Montano  y  por  la  oficina  de  higiene  de  Sao  Paulo,  Brasil. 

Se  publicó  mensualmente  el  informe  de  la  sección  occidental  del  Distrito  Federal. 

Corresponde  por  todos  respectos  el  sitio  de  preferencia  á  Caracas  y  por  tanto  por  ella 
daré  comienzo. 

El  año  de  1904  puede  calificarse  como  el  más  favorable  para  nuestra  capital,  considerado 
desde  el  punto  de  vista  sanitario  demogi'áfico,  como  se  vé  con  perfecta  claridad  en  el  cuadro 
marcado  con  el  número  1. 


424 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 


Comparado  con  el  correspondiente  al  de  1903,  la  mejora  es  resaltante  y  atenidos  á  las 
cift'as  de  los  años  anteriores  resulta  aún  más,  como  se  demuestra  aquí: 

Mortalidad  de  Caracas. 


Año. 

Número  de 
muertes. 

Coeficiente 
anual. 

1901                          - : 

2,838 
3,233 
3,199 
2,516 

33.00 

190''                                         

38.03 

1903                               

37.99 

1904                                                

29.06 

estadística  de  mortalidad. 


Defunciones  por  causas,  edades,  sexos  y  nacionalidades  ocurridas  en  Caracas  durante 

de  190  Jt. 

[Población  de  Caracas,  85,000  habitantes.] 


Enfermedades  epidémicas: 

Fiebre  tifoidea 86 

Erisipela 2 

Sarapión 1 

Difteria 4 

Tos  ferina '.  -  -  4 

Gripe 7 

Otras  enfermedades  epidémicas. .  5 

Total 109 


Enfermedades  generales: 

Tuberculosis  pulmonar 

Tuberculosis  meníngea 

Tuberculosis  de  otros  órganos. 

Tuberculosis  generalizada 

EscrofuHsmo 

Mal  de  Pott 

SífiHs 

Alcoholismo 

Cáncer  y  otros  tumores 

Septicemia 

Anemia  y  clorosis 

Fiebres  palúdicas 

Reumatismo 

Intoxicaciones  profesionales. . 

Total 


415 
13 
80 
13 
11 

2 

8 
21 
56 

1 
21 
31 

1 


675 


Enfermedades  del  sistema  nervioso  y  de  los 
órganos  de  los  sentidos: 

Encefalitis 16 

Meningitis  simple 44 

Ataxia  locomotriz 3 

Reblandecimiento  cerebral 13 

Congestión  cerebral 12 

Hemon-agia  cerebral 23 

Epilepsia 2 

Pai'álisis  general 11 

Eclampsia  no  puerperal 26 

Tétanos  infantil 46 

Otras  enfermedades  del  cerebro. .  23 

Otras  enfermedades  de  la  médula  10 

Tétanos 17 


Total. 


246 


Aparato  circulatorio : 

Endocarditis .' 

Pericarditis 

Enfermedades  orgánicas  del  co- 
razón  

Angina  de  pecho 

Afecciones,  valvulares 

Afecciones  arteriales 

Aneurismas 

Embolias 

Otras  enfermedades 


10 
2 


16 
84 
60 
67 
2 
14 


Total. 


335 


Aparato  respiratorio: 

Enfermedades  de  la  laringe. 

Bronquitis  aguda 

Bi'onquitis  crónica 

Nemnonía 

Pleuresía 

Congestión  pulmonar 

Hemorragia 

Gangrena 

Asma 

Bronconeumonía 

Otras  enfermedades 


2 
25 

3 
59 
18 
12 
11 

1 

3 
41 
22 


Total. 


194 


Aparato  digestivo: 

Faringe  y  exófago 

Úlcera  del  estómago 

Otras    enfermedades    del 


estó- 


mago  

Diarrea  en  menores  de  dos  años. 

Enteritis - 

Hernias  y  obstrucciones  intesti- 
nales  

Parásitos  intestinales 

Otras  enfermedades  del  intestino 

Disentería 

Cirrosis 

Icteria  grave 

Abcesos  hepáticos 

Cálculos  hepáticos 

Peritonitis  simples 


2 
9 

34 
133 
159 

11 

17 

& 

181 

23 

11 

40 

6 

2& 


SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAL. 


425 


JJef^nciones  por  causas,  edades,  sexos  y  nacionalidades  ocurridas  en  Caracas  durante  eZ  afity 

de  lOOJt. — Continúa. 


Aparato  digostivo^ — Continúa. 

Apcndicitis 

Otras  enfermedades 

Cólera  infantil , 


7 
13 
16 


Total. 


694 


Aparato  génito-urinai'io : 

Nefritis  atíuda 25 

Mal  do  Bright 19 

Cálculos  vesicales 1 

Enfermedades  de  la  vejiga 6 

Enl'ermcdades  de  la  próstata  ...  2 

Hemorragia  uterina 5 

Hemorragia  de  los  anexos 5 

Qistes  y  otros  tumeres  del  útero 

y  de  los  anexps 11 

Total 74 


Afecciones  puerperales: 
Eclampsia 

Otros  accidentes 

Septicenaia  puerperal. 

Total 


1 
1 

18 

20 


Piel  y  tejido  celular: 

Ántrax 

Otras  enfermedades. 

Total 


Edades  extremas: 

Debilidad  congenita. 
Debilidad  senil 


89 

27 


Total. 


116 


Muertes  violentas: 

Por  armas  do  fiiego 

Fracturas 

Quemaduras 

Suicidios 

PJnvenenamiento 

Otras  muertes  violentas. 
Muertes  súbitas 


12 
3 
7 
1 
4 
8 
2 


37 


Total 

Enfermedades  mal  definidas. . . 

EESUMEN  GENERAL. 


Sistema  nervioso 246 

Sistema  circulatorio : 335 

Sistema  respiratorio 1 97 

Sistema  digestivo 694 

Sistema  génito-urinario 74 

Enfermedades  epidémicas 109 

...  675 
20 
89 
27 
37 
9 
4 


Enfermedades  generales. 

Afecciones  puerperales 

Debelidad  congenita 

Debelidad  senil 

Muertes  violentas 

Piel  y  {ejido  celular 

Enfermedades  mal  definidas. 


Total  general 2,  516 


Veamos  ahora  fel  cuadi'o  comparativo  de  las  causas  de  mortalidad  en  1903  y  1904: 


Sistema  nervioso. 

Sistema  circulatorio 

Sistema  respiratorio 

Sistema  digestivo 

Sisteraa  genito-urinario . . . 
Enfermedades  epidémicas . 
Enfermedades  generales . . . 

Afecciones  puerperales 

Debilidad  congenita 

Debilidad  senil 

Muertes  violentas 

Piel  tejido  celular 

Mal  de  Pott 

Desconocidas 


283 

446 

153 

8.55 

71 

172 

869 

15 

52 

23 

41 

14 

6S 

15 


Diferen- 
cia fa- 
vorable 
á  1904. 


246  37 

335  111 

197    

694  161 

74    

109  63 

675  194 

20    

89    

27  ¡ 

37  4 

9  5 

•  4  64 
10 


Total. 


3,199 


,516 


El  cuadro  (3)  pone  de  manifiesto  la  marcha  de  la  mortalidad  en  cada  uno  de  los  meses 
del  año,  siendo  de  notar  el  descenso  de  ella  de  enero  á  diciembre,  conservando  siempre  el 
tipo  de  baja,  la  que  persiste  en  los  meses  corridos  de  este  año.  Sigúese  también  eñ  este 
cuadro  el  movimiento  de  los  fallecimientos  en  las  ocho  parroquias,  notándose  que  la  más 


426 


SEGUNDA   CONFERENCIA    SANITARIA   INTERNACIONAL. 


saludable  es  Santa  Rosalía,  y  la  menos  San  José.  Aquella  con  una  población  de  1(3,000 
habitantes,  y  ésta  con  6,000;  viene  luego  como  saludable  Santa  Teresa,  con  9,000  almas  y 
224  de  mortalidad;  en  seguida  L.a  Pastora,  con  6,000  habitantes  y  241  fallecimientos,  y 
finalmente  Candelaria,  San  Juan,  xMtagracia  y  Catedral,  con  una  mortalidad  suficiente- 
mente representada  para  sus  poblaciones. 

En  el  mismo  cuadio  se  puede  estudiar  el  movimiento  de  mortahdad  comparativo  con  el 
de  1903: 

Mortalidad  por  meses  en  1904- 


ó 
o 
C 

ó 

1 

o 

o 

2 

'3 

3 

ó 

ó 
o 

2 

3 
O 

o 

.SiP 

■z, 

s  . 
b 

Total. 

1903. 

34 
34 
22 
27 
35 
24 
12 
50 

29 
31 
22 
24 
19 
22 
22 
40 

25 
34 
21 
25 
23 
19 
20 
56 

30 
31 
23 
28 
31 
11 
15 
31 

21 
25 
19 
39 
29 
18 
19 
46 

31 
20 
24 
27 
34 
21 
25 
56 

24 
21 
11 
28 
29 
14 
20 
43 

28 
32 
23 
31 
18 
18 
19 
54 

20 
23 
17 
19 
34 
22 
14 
36 

23 
37 
25 
28 
15 
19 
34 
30 

27 
34 
16 
25 
23 
13 
,  11 
44 

23 
38 
18 
33 
17 
12 
13 
36 

315 
360 
241 
334 
307 
213 
224 
522 

330 

Altagracia  .  . 

423 

344 

386 

Candelaria . ._ 

424 
276 

Santa  Teresa 

258 

San  José 

758 

Total 

238 

209 

223 

200 

216 

238 

190 

223 

185 

211 

193 

190 

2,516 

3,191 

Aún  es  susceptible  el  cuadi'o  anterior  de  mayor  análisis  y  de  más  favorables  deducciones 
al  comparar  las  cifras  de  las  enfermedades  que  siempre  han  causado  más  hondos  quebrantos 
en  la  salubridad  de  nuestra  capital.     Comencemos  por  la  tuberculosis. 

TUBERCULOSIS. 

En  el  año  de  1903  esta  terrible  pl?,ga  social  produjo  un  total  de  563  víctimas  escogidas 
en  todas  las  edades  de  la  vida,  muy  en  especial  entre  los  15  y  40  años  para  ambos  seibos. 
En  1904  aquella  cifra  se  redujo  á  521,  aún  altísima,  cifra  que  clama  muy  alto  nuestra  decidla. 
Cuantas  veces  he  intentado  hasta  hoy  la  creación  de  la  Liga  venezolana  contra  la  tubercu- 
losis, he  fracasado  lastimosamente,  pero  aún  no  estoy  vencido,  todavía  me  siento  con 
fuerzas  para  la  lucha  y  con  entusiasmo  para  el  trabajo.  Nunca  será  tarde  si  conseguimos 
el  objeto  que  perseguimos. 

Otro  de  los  capítulos  que  merecen  seria  atención  es  el  de  la  fiebre  tifoidea. 

Mucho,  muchísimo,  pero  no  bastante  háse  hablado  y  escrito  en  estos  primeros  meses 
de  1905  y  en  los  últimos  de  1904  sobre  esta  enfermedad  que  nos  invade  cada  día  más  y 
que  nos  amenaza  con  sentar  sus  reales  para  siempre  entre  nosotros. 

Como  las  causas  productoras,  conservadoras  y  repartidoras  de  la  enfermedad  aún  sub- 
sisten á  saber :  Cloacas  deficientes  por  su  primitiva  construcción,  las  que  afortunadamente 
serán  muy  en  breve  modificadas,  pues  el  señor  gobernador,  tan  celoso  de  la  salubridad  de 
Caracas,  ha  destinado  el  producto  de  la  patente  que  por  su  contrato  pagará  el  Señor  Felipe 
Cavallini,  para  la  instalación  de  la  nueva  red  que  realizará  una  mejora  sanitaria  de  primer 
orden;  y  entre  tanto,  las  reparaciones  de  las  existentes  se  verifican  con  una  constancia 
que  es  prenda  segura  del  buen  deseo  de  velar  por  la  vida  de  los  habitantes  do  Caracas; 
servicio  de  aguas  en  las  casas  de  habitación  defectuoso,  descuido  de  las  prácticas  higiénicas 
en  lo  referente  á  ella,  es  claro  que  ha  continuado  su  nefasta  obra,  no  llegando  por  fortuna 
á  tomar  el  carácter  de  epidemia,  pero  sí  á  producir  un  número  de  defunciones  que  nos 
obliga  á  tomar  contra  ella  todas  las  precauciones  que  la  ciencia  prescribe  y  que  la  experiencia 
aconseja.- 

En  1903  la  enfermedad  produjo  88  defunciones  y  en  este  año  86. 

APARATO   DIGESTIVO. 

Toca  su  turno  á  las  desoladoras  enfermedades  del  aparato  digestivo,  muy  disminuidas 
relativamente  en  este  año,  pero  siempre  acusando  un  coeficiente  tan  alto,  que  las  hace 
justiciables  de  un  serio  análisis. 

En  el  año  que  estudiamos  aquella  clase  de  enfermedades  produjeron  694  defunciones, 
contra  855  en  el  que  nos  sirve  de  comparación,  resultando  un  saldo  favorable  para  1904 
de  161. 

Ya  lo  he  dicho  más  veces  de  las  indispensables  para  ser  bien  entendido,  pero  una  más 
no  huelga.  El  agua  en  primer  término,  no  el  agua  de  Macarao,  sino  el  agua  de  Caracas, 
productora  de  disenterías,  enteritis,  vehículo  de  parásitos  intestinales,  es  la  causa  más 
inmediata  como  causa  del  gran  número  de  las  enfermedades  aludidas.  Opinión  que 
sostendré  en  tanto  no  se  me  pruebe  lo  contrario. 


SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL. 


427 


A  posar  de  lo.s  coníinuados  y  muy  liicn  diiifridos  eHfut'.i-zo.s  dol  muy  compr-tení/C  regidor 
del  mercado  de  esta  ciudad,  ()u¡en  d¡ariam(!nt,e  vÍH¡(,a  los  fii versos  Deparfainíínlos  del 
•edificio  y  decomisa  ciianl.o  íif)  llena  las  condicioríos  de  salubiidad  ner/isarias,  y  de  las 
pesquizas  de  la  oficina  de  liigiene,  la  cantidad  de  alimentos  d<s  mala  calidad  que  se  expen- 
den on  osla  ciudad  os  tal,  quo  bastan  paia  producir  los  malos  efectos  que  diariamente 
presenciamos. 

A  Vd.,  ciudadano  gobernador,  bago  pr(!sonte  la  urgentísima  necesidad  de  dolar  la 
oficina  de  higiene  con  loa  servicios  do  un  laboratoi'io  da  química  para  verificar  el  análisis 
de  todas  aquellas  substancias  que  íí  juicio  del  director  de  la  oficina  no  llenen  las  W)ndiciones 
requeridas.  Esto  tiene  una  ventaja  inmediata,  cual  es  pod(!r  conocer  el  pií)ducto  á  ciencia 
cierta  y  castigar  al  comerciante  infiel  que  á  truoc|uo  de  unas  cuantas  monedas,  no  duda 
eu  intoxicar  toda  una  población,  y  otra  ventaja  i'emota;  el  escarmiento  de  \(m  demás 
industriales,  quienes  al  ver  inhabilitado  un  colega  para  el  ejercicio  de  su  industria,  mucho 
Jo  pensarán  antes  do  dar  al  público  un  producto  alterado  6  adulterado. 

Caracas  agradecida  batirá  á  Vd.  palmas. 

Mucho  podría  extenderme  sobre  materia  tan  interesante  y  tan  llena  de  enseñanzas,  pero 
por  una  parte  lo  ya  dicho  en  años  anteriores  en  informes  y  en  la  7)rensa  diaria,  y  por  otra, 
la  grande  extensión  que  necesariamente  debe  alcanzar  el  presente  trabajo,  me  impiden 
seguir  adelante. 

El  cuadro  (4)  nos  pone  de  bulto  un  trascendental  problema  social,  cual  es  la  edad  de  los 
fallecidos.  De  O  á  10  años  murieron  en  Caracas  729  inviduos,  algo  menos  de  la  tercera 
parte  del  total  2,516. 

Muchos  son  los  llamados  á  vivir  y  pocos  los  escogidos  para  seguir  viviendo.  Hechos 
de  esta  naturaleza  desgraciadamente  no  son  patrimonio  nuestro  exclusivo;  otro  tanto 
acontece  en  toda  Europa,  en  América,  en  fin  en  todo  el  mundo,  pero  en  otras  naciones 
no  se  conforman  con  señalar  el  mal,  lo  remedian,  formando  ligas  protectoras  de  la  infancia 
sociedades  de  "La  Gota  de  Leche,"  ligas  contra  el  tétano  infantil,  etc. 

Aquí  la  alimentación  defectuosa,  el  tétano  infantil  y  pocas  veces  las  enfermedades 
epidémicas  diezman  la  población  tierna.  Me  permito  indicar  á  Vd.  el  establecimiento 
de  los  paquetes  higiénicos  contra  el  tétano  infantil  como  una  de  las  obras  más  fáciles  de 
ejecutar,  tanto  por  lo  exiguo  de  su  costo  como  por  la  manera  de  hacerlos  llegar  á  su  destino. 
Sírvase  dictar  sus  órdenes  pues  yo  poseo  todos  los  datos  para  llevar  á  buen  término  el 
asunto. 

De  20  á  50  años,  es  decir,  en  la  edad  del  vigor  sexual,  en  la  época  de  la  procreación  en 
ambos  sexos,  desaparecieron  1,259  personas,  víctimas  en  su  mayor  parte  de  la  tubercu- 
losis, pues  bien  sabido  es  que  esta  es  la  edad  escogida  por  ella  para  sus  mayores  destrozos. 
Véase  por  esta  cuan  importante  es  establecer  cuanto  antes  la  lucha  contra  aquella 
enfermedad. 

De  50  á  100  años  murieron  528,  cifra  muy  poco  halagadora  en  cuanto  á  duración  de  la 
vida  se  refiere,  entre  nosotros. 


CuADO  Número  4. — Edades. 


0  á  1  año... 

1  á  10  años. 
11  á  20  años. 
21  á  30  años. 
31  á  40  años. 
41  á  50  años. 


413 
316 
241 
447 
349 
222 


51  á  60  años. . . 
61  á  70  años... 
71  á  80  años. . . 
81  y  más  años. 


185 

169 

102 

72 


Total 2,516 


Respecto  al  estado  civil  y  á  la  nacionalidad,  poco  notables  son  las  cantidades  que  acusa 
la  estadística  de  1904.     Al  efecto  consúltese  el  cuadro: 


Solteros 1,  940 

Casados 386 

Viudos : 190 


Total 2,  516 

La  nacionalidad  sólo  nos  hace  presente  el   escaso  número   de   extranjeros  que   nos 
acompañan: 


Venezolanos 2, 346 

Españoles 107 

Italianos 20 

Franceses 10 

Alemanes 9 


Otras  naciones. 
Desconocidos. . 


20 

4 


Total 2,516 


428 


SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 


NATALIDAD. 

Asunto  de  primera  magnidad  en  los  destinos  de  un  país!  Grave  problema  para  una 
nación,  sobre  todo  para  la  quo  como  Venezuela  ha  sufrido  sangrías  tan  considerables 
desde  épocas  remotas! 

Cifras  casi  idénticas  regístranse  en  el  capítulo  de  la  natalidad  de  Caracas  en  los  a  os  de 
1903  y  1904,  2,382  y  2,387,  cuyas  cifras  representan  coeficientes  de  28  muy  halagadores 
por  cierto." 

Ahora  bien,  si  nuestra  mortalidad  no  fuera  tan  elevada,  la  población  aumentaría  rápi- 
damente, pero  es  lo  contrario,  de  tal  modo,  que  el  déficit  es  casi  de  Ic}^.  En  1903  fué 
de  817  y  en  1901  también  lo  hubo  pero  mucho-  más  bajo,  apenas  alcanzando  á  129 
Diferencia  favorable  á  este  año  688. 

Penoso  en  extremo  sería  repetir  los  argumentos  que  pueden  considerarse  como  la  expre- 
sión de  la  verdad  para  explicar  el  déficit  de  población,  no  como  ya  queda  dicho,  por  la 
escasez  de  nacimientos,  sino  por  el  exceso  de  muertes. 

Siempre  he  atribuido  al  gran  número  de  hijos  ilegítimos  el  crecido  coeficiente  de  mortalidad 
infantil  y  con  sobra  de  razón  lo  repito  hoy. 

Me  permito  hacer  ver  á  usted,  ciudadano  Gobernador,  el  cuadro  demostrativo  de  los 
nacimientos  en  las  ocho  parroquias  que  componen  nuestra  capital  y  finahnente  el  resumen 
de  legítimos  é  ilegítimos  en  los  años  de  1903  y  1904. 

El  número  de  varones  y  de  hembras  hié  sensiblemente  el  mismo,  1,207  y  1,183,  factor 
éste  de  bastante  importancia  desde  el  punto  de  vista  social,  si  reflexionamos  que  al  fin  del 
año  mueren  muchos  más  varones  que  hembras  y  que  por  tanto  es  preciso  que  nazcan  más 
de  aquéllos  que  de  éstas  para  restablecer  el  equilibrio  que  influye  de  manera  tan  directa 
en  la  constitución  de  las  fuerzas  vivas  de  im  país  para  su  defensa  y  su  vitahdad. 

Cuadro  Número  5. — Natalidad  de  Caracas  en  1904  por  parroquias  y  por  meses. 


Urbanas. 

6 

a 

ó 

s 

ó 

o 
>, 

o 

g 

6 

3 

d 

1 

< 

á 

3 
o 
O 

é 

i 

> 

o 

ú 

fi 

.Si 
o 

5 

m 

o 

Catedral 

29 
27 
21 
27 
23 
19 
16 
15 

28 
24 
16 
21 
17 
14 
15 
11 

26 
34 
19 
23 
39 
13 
14 
21 

43 
26 
30 
29 
35 
24 
17 
27 

» 

39 
30 
16 
36 
32 
12 
11 
26 

41 
25 
29 
23 
28 
23 
19 
26 

37 
25 
18 
39 
11 
10 
21 
18 

21 
21 
22 
■      38 
31 
30 
15 
28 

27 
41 
19 
21 
33 
13 
14 
22 

35 
36 
20 
43 
10 
19 
23 
20 

28 
30 
23 
34 
20 
16 
15 
18 

43 
33 
35 
34 
25 
26 
28 
39 

397 

35? 

La  Pastora 

268 

San  Juan 

368 

304 

Santa  Teresa 

Santa  Rosalía 

219 
208 
271 

Totales 

177 

146 

189 

231 

202 

214 

179 

206 

190 

206 

184 

263 

2,387 

Varones  legítimos 626 

Hembras  legítimas: 603 

Total 1,229 


Varones  ilegítimos 581 

Hembras  ilegítimas,  i 577 

Total 1,158 


NUPCIALIDAD. 


Efectuáronse  en  la  ciudad  de  Caracas,  en  el  año  de  1904,  405  matrimonios.  Calculando 
esta  cifra  como  exacta,  puesto  que  emana  del  Registro  Civil  y  atribuyéndose  á  la  capital  una 
población  de  85,000  habitantes,  nos  resultará  un  coeficiente  de  nupcialidad  que  alcanza  á 
4.70  por  mil  habitantes,  bastante  lisongero  en  sí  y  mucho  más  comparativamente  al  de  1903, 
que  fué  de  3.60. 

Mejorada  en  algo  la  situación  financiera  de  nuestra  patria  en  el  año  que  acaba  de  trans- 
currir, gran  número  de  individuos  aptos  para  contraer  el  hasta  ayer  indisoluble  lazo,  ha 
encontrado  medios  de  satisfacer  sus  legítimos  anhelos  y  de  aquí  que  de  un  año  á  otro  el 
número  de  matrimonios  haya  acrecido  de  300  á  405.  En  el  año  que  corre  es  indudable  que 
veremos  este  número  llegar  hasta  una  cifra  igual  á  las  de  los  buenos  tiempos  de  Caracas,  á 
la  sombra  de  la  paz  alcanzada  en  los  campos  de  batalla  por  la  siempre  victoriosa  espada  de 
nuestro  Primer  Magistrado  y  consolidada  por  las  prácticas  que  se  vienen  observando  luego 
en  el  campo  sereno  del  trabajo. 

Si  el  actual  Soberano  Congreso  Nacional  sedignara  estudiar  una  ley  que  facilitara  al  más 
humilde  ciudadano  contraer  matrimonio  sin  la  serie  de  trabas  y  requisitos  que  los  aleja  de  la 
saludable  práctica  y  que  los  obliga  hasta  cierto  punto  á  vivir  al  natural,  haría  una  de  las 
más  provechosas  obras  que  repercutiría  en  pocos  años  sobre  el  aumento  de  la  población. 


SEGUNDA    CONFERENCIA    SANITARIA   INTERNACIONAL. 


429 


El  cuadro  número  6  nos  indica  el  número  de  matrimonios  por  parrofjuiaH  y  por  rnesfjs, 
ocurridos  en  Caracas;  y  el  número  7  el  estado  anterior  de  los  contrayentes,  su  grado  de 
instrucción  y  su  nacionalidad. 

De  las  parroquias  (|uo  componen  Caracas  sobresale  La  Pastora  por  su  elevado  coeficiente 
de  nupcialidad,  dada  su  polVÍacidn  mucho  más  pequeña  que  las  otras,  en  que  82  matri- 
monios se  voriíicafon ;  viene  luego  Altagracia  con  G8  y  en  escala  descendiente  llegamos  Iia.sta 
la  de  San  José  en  la  (|uo  sólo  hulx)  28. 

Del  estado  anterioi'  de  los  contrayentes  deducimos  que  382  solteros  y  23  viudos  contra- 
jeron matrimonio  con  390  .solteras  y  15  viudas  con  20  hijos  en  su  totalidad. 

De  la  nacionalidad  tenemos  <|uc  los  españoles  son  los  que  más  forman  alianza  con  nuestras 
mujeres,  pues  44  contrajeron  inatrimonio,  luego  vienen  los  italianos,  franceses,  ingleses  y 
otras  naciones. 


Cuadro  Número  6. — Matrimonios  verificados  en  Caracas  en  190 Jf. 


fí 

i 

i. 

Urbanas. 

ó 

g 

ó 

^ 

d 

ó 

0 

4^ 

.0 

1 

1 

•b 

to 

s 

.Q 

03 

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n 

d 

g 

feo 

+j 

0 

0 

ü 

0 

w 

(i 

S 

-15 

S 

i-í 

«i< 

«5 

0 

'-A 

Q 

E-- 

Catedral  .         .  .  . 

4 
5 
3 
5 
3 
6 

3 
9 
3 
6 
4 
1 

5 

8 

■"■"4' 
1 
6 

3 
5 
(i 
0 
3 
4 

5 

4 

1 
1 
9 
5 

1 
1 
7 
3 
4 
3 

2 

4 
9 
5 
1 
3 

3 

5 

1 

7 
1 

3 

6 
6 
.5 
4 

1 

5 
5 
13 

6 
2 
3 

2 
6 
15 

í 
4 

6 
10 
15 

8 

11 

3 

42 

68 

82 

San  Juan 

61 

52 

Santa  Rosalía 

.39 

Santa  Teresa 

4 

5 

1 

4 

2 

4 

2 

2 

6 

1 

2 

33 

5 

1 

3 

2 

1 

6 

2 

4 

5 

28 

Totales 

34 

32 

28 

31 

29 

24' 

31 

32 

25 

40 

39 

60 

405 

Cuadro  Número  7. — Datos  relativos  á  los  contrayentes. 


El  contrayente : 

Número  de  matrimonios 405 

Solteros 382 

Viudos ■----.--. 23 

Sabían  leer  y  escribir 382 

Tenían  parentesco 4 

Tenían  hijos 91 

Nacionalidad : 

Venezolanos 342 

Españoles 44 

Itahanos 8 

Ingleses 2 

Franceses 2 

Otros 7 


La  contrayente: 

Solteras 390 

Viudas 1.5 

Sabían  leer  y  escribir 377 

Tenían  parentesco ^     4 

Tenían  hijos 90. 

Nacionalidad : 

Venezolanas 378 

Españolas 16 

Italianas 3 

Francesas 1 

Otras  naciones 7 


NACIDOS   MUERTOS. 

Se  designa  con  el  nombre  de  morti-natalidad,  la  relación  existente  entre  el  total  de  los 
nacidos  niuertos  y  el  de  nacimientos  y  defimciones  ocurridos  en  un  plazo  determinado. 

En  Caracas  este  número  fué  de  109  en  1904  contra  142  en  1903,  clasificados  aquellos  en 
64  varones  y  45  hembras,  hecho  casi  constante  en  todo  el  mundo  y  que  viene  en  esta  ocasión 
á  corroborar  lo  dicho  por  Bertillon  quien  autoridad  en  la  materia  asegura  que  la  morti- 
natalidad masculina  es  siempre  superior  á  la  femenina. 

Es  este  un  asunto  que  merece  mucha  atención  pero  los  datos  que  hasta  la  fecha  poseo, 
me  impiden  conocer  la  legitimidad  ó  ilegitimidad,  la  nacionalidad  de  los  padres  y  muchas 
veces  hasta  el  sexo:  en  el  registro  civil  no  está  muy,en  claro. 

Me  propongo,  contando  de  antemano  con  su  reconocida  benevolencia,  ocuparme  de  hacer 
■que  estos  datos  lleguen  á  esta  Oficina  con  más  detalles  y  más  precisos. 

Terminada  esta  larga  reseña  de  Caracas,  corresponde  su  turno  á  las  parroquias  foráneas, 
algunas  de  ellas  suburbios  de  la  capital  y  lugares  de  recreo  para  sus  moradores.     . 


430 


SEGUNDA    CONFEIIENCIA    SANITARIA    INTERNACIONAL. 


Nada  notable  nos  muestran  sus  cuadros  parciales  como  no  sea  la  manera  saludable  como 
en  ellas  se  vive  y  la  casi  ausencia  de  enfermedades  contagiosas  y  epidémicas. 
En  todas  aumentó  su  población  y  se  verificaron  75  matrimonios. 

DEPARTAMENTO   VARGAS. 

Con  el  objeto  de  que  cada  una  de  las  porciones  de  territorio  denominados  Departamentos 
figuren  en  el  presente  informe  con  su  fisionomía  propia,  he  creido  conveniente  hacer  un 
estudio  suficientemente  detallado  de  todas  sus  poblaciones.  Al  efecto  en  seguida  se  verá 
una  demonstración  del  movimiento  de  población  y  las  causas  de  mortalidad  de  La  Guaira, 
Maiquetia,  Macuto,  Caraballeda,  Naiguatá,  Carayaca  y  Cai^uao. 

Del  estudio  de  estos  cuadros  deducimos  que:  en  La  Guaira  predominaron  en  el  año  de 
1904  la  tuberculosis  47  defunciones,  el  paludismo  16  y  las  afecciones  del  aparato  gastro- 
intestinal 45. 

En  jíaiquet  a  la  tuberculosis  en  mayor  escala,  53  y  las  enfermedades  del  tubo  digestivo 
en  proporción  aun  mayor  que  en  La  Guaira,  62,  para  una  mortalidad  menor. 

En  Macuto,  las  enfermedades  de  los  niños,  tétanos  infantil,  eclampsia,  parásitos  intes- 
tinales y  uno  que  otro  caso  de  fiebre  paludosa  y  tifoidea  indudablemente  importada  esta 
última. 

En  Caraballeda  la  disentería  causó  daños.  En  36  defunciones,  11  lo  fueron  por  esta 
causa;  la  tuberculosis  y  el  paludismo  junto  con  el  tétanos  produjeron  el  resto. 

Naiguatá  nada  notable  nos  acusa  como  no  sea  varios  casos  de  muerte  por  envenena- 
miento ofidiano. 

Carayaca,  población  de  5,000  habitantes,  incorporado  al  Departamento  Vargas  á  mediados 
del  año,  su  estadística  es  de  sólo  un  semestre.  Sus  defunciones  fueron  61.  Por  paludismo 
11  y  9  por  tétanos  infantil. 

Finalmente  Caniao  con  30  defunciones:  13  por  tos  ferina,  cifra  suficientemente  alannante 
para  pensar  en  un  correctivo  si  se  repitiere. 

En  resumen:  el  movimiento  sanitario-demográfico  del  Departamento  Vargas  en  1904  fué 
el  siguiente: 

ESTADÍSTICA   DE   MORTALIDAD. 

Defunciones  por  causas,  edades,  sexos  y  nacionalicíades  ocurridas  en  el  Departamento  Vargas 

el  año  de  1904- 


[Población  del  Departamento  Vargas,  32,000.] 


Enfermedades  epidémicas: 

Fiebre  tifoidea 13 

Erisipela 1 

Difteria 1 

Tos  ferina 16 

Grippe 2 

Escarlatina 1 

Otras  enfermedades  epidémicas. .  2 

Total 36 

Enfermedades  generales: 

Tuberculosis  pulmonar 122 

Mal  de  Pott 3 

Sífilis 5 

Alcoholismo 2 

Cáncer  y  otros  tumores 10 

Fiebres  palúdicas 42 

Reumatismo 1 

Intoxicaciones  profesionales 2 


Total. 


187 


Enfermedades  del  sistema  nervioso  y 
de  los  órganos  de  los  sentidos: 

Meningitis  simple 13 

Congestión  cerebral 11 

Hemorragia  cerebral 5 

Epilepsia 1 

Paráhsis  general 5 


Enfermedades  del  sistema   nervioso  y 
de  los  órganos  de  los  sentidos — Con. 

Eclampsia  no  puerperal 16 

Tétanos  infantil 40 

Otras  enfermedades  de  la  médula.  3 

Tétanos 8 


Total. 


102 


Aparato  circulatorio: 

Enfermedades    orgánicas    del    co- 
razón   31 

Afecciones  valvulares 20 

Afecciones  arteriales .' 2 

Aneurismas 18 

Total 71 

Aparato  respiratorio: 

Bronquitis  crónica 5 

Neumonía 33 

Pleuresía 2 

Hemorragia 2 

Asma 1 

Total 43 

Aparato  digestivo; 

Enteritis 69 

Parásitos  intestinales 11 

Disentería 60 


SEGUNDA    CONFERENCIA   SANITARIA    INTERNACIONAL. 


481 


Defunciones  por  causas,  edades,  sexos  y  nacionalidades  ocurridas  en  d  Departamento  Vargas 

el  año  de  l'JOJ^ — Continúa. 

Aparato  digestivo — Continúa. 

Cirrosis 8 

Ictcria  gravo 1 

Abocaos  lippáticos 4 

Peritonitis  simple 1 

Apondicitis 1 

Cólera  infantil 2 


Total. 


157 


Aparato  génito-urinario: 

Nefritis  aguda 4 

Mal  do  Bright 3 

Enfermedades  de  la  vegiga 2 


Total. 


Ai eociones  puerperales : 

Septicemia  puerperal 4 

Piel  y  tejido  celular: 

Gangrena 5 


Edades  extremas: 

Debilidad  congenita 6 

Debilidad  senil 3 


Total. 


9 


Muertes  violentas: 

Por  armas  de  fuego 

Quemaduras 

Suicidios 

Oti-as  muertes  violentas. 
Muertes  súbitas 


Total. 


1 
2 
3 
5 

4 

15 


Enfermedades  mal  definidas 50 

Causas  desconocidas 2 


Total. 


52 


RESUMEN    GENERAL. 


Sistema  nervioso 102 

Sistema  circulatorio 71 

Sistema,  respiratorio 43 

Sistema  digestivo 157 

Sistema  génito-urinario 9 

Enfermedades  epidémicas 36 

Enfermedades  generales 187 

Afecciones  puerperales. 5 

Debilidad  congenita 6 

Debilidad  senil 3 

Muertes  violentas 15 

Piel  y  tejido  celular 5 

Enfermedades  mal  definidas 50 

Causas  desconocidas 2 


Total. 


691 


Edades. 


De  o  á  4  año 144 

De  1  á  4  años 88 


Edades. 


De  5  á  19  años 75 

De  20  á  39  años 131 

De  40  á  59  años 136 

De  60  en  adelante 117 

Total 691 

Nacionalidad. 

Venezolanos 622 

Españoles 52 


Italianos. 

Franceses 

Alemanes 

Otras  naciones. 


Total 691 


Estado  civil  de  los  fallecidos. 

Solteros 532 

Casados 99 

Viudos 60 


Total. 


691 


Nacimientos. 


Varones  legítimos 213 

Hembras  legítimas 210 


Varones  ilegítimos. . .  .* 236 

Hembras  ilegitimas 190 


Total 849 

Defunciones 691 

Matrimonios 81 

El  Departamento  Guaicaipuro,  compuesto  de  Los  Teques,  Miquilén,  Carrizal,  San  Pedro, 
San  Antonio,  San  Diego,  Tacata  y  Paracotos,  constituyen  lo  que  entre  nosotros  se  llama 


432 


SEGUNDA   CONFERENCIA   SANITAEIA   INTERNACIONAL. 


*'  Los  Altos  "  y  dotados  de  hermoso  clima  y  ricas  haciendas  hacen  una  magnífica  porción  de 
la  patria. 

Los  Tequcs,  ameno  sitio  de  recreo  por  su  admirable  topografía  y  saludable  clima  con  una 
población  de  4,000  habitantes,  acusó  en  el  segundo  semestre  de  190-1  (en  mayo  fué  anexada  al 
Distrito  Federal)  una  mortalidad  de  63  le  que  multiplicada  por  2  para  tener  la  del  año  nos 
da  un  coeficiente  por  mil  de  15.74  igual  ó  mejor  que  el  de  nuichas  poblaciones  europeas. 

La  disentería  y  la  anemia,  enfermedades  endémicas  y  muy  mortíferas  en  aquella  región 
de  Venezuela,  como  so  verá  en  el  curso  de  este  informe,  produjeron  el  mayor  nvlmero  de 
bajas,  correspondiendo  uTi  sitio  importante  á  las  enfermedades  del  aparato  respiratorio; 
tuberculosis  pulmonar,  bronquitis,  etc.  .      ■ 

MiquiUn,  extenso  barrio  del  pueblo  de  Los  Teques,  también  con  4,000  habitantes — 60 
defunciones.  Hubo  10  por  tuberculosis;  la  sexta  parte.  Estose  explica  por  sjr  aquel  pueblo 
el  escogido  por  los  enfi'rmos  do  esta  clase  de  dolencias  para  restablecer  su  salud  y  allí  mueren. 
Se  registra  un  gran  número  de  enfermedades  mal  definidas  (hidropesía  en  su  mayor  parte) 
y  muchas  por  causas  desconocidas.  A  unas  y  otras  atribuyo  como  causa  la  anemia,  que 
como  3^a  queda  dicho  es  endémica  allí.  Esta  suposición  está  lejos  de  ser  caprichosa,  está 
basada .  en  un  informe  que  poseo  firmado  por  mi  estimable  colega  Dr.  Perdomo  Hurtado 
quien  ejerce  con  tino  en  aquella  localidad  su  profesión. 

En  Carrizal,  San  Pedro,  San  Antonio  y  San  Diego,  la  tuberculosis  y  la  anemia  causaron 
estragos  y  en  Tacata  y  Paracotos  la  disentería,  el  paludismo  y  la  anemia  por  ankilostomasia. 

ESTADÍSTICA   DE   MORTALIDAD. 


Defunciones    -por    causas,  edades,    sexos,  y   nacionalidades  ocurridas    en   d  Departamento 
Guaicaipuro  en  el  segundo  semestre  de  190 Jt. 


Población  del  Departamento  Guaicaipuro,  8,000.^ 


Enfermedades  epidémicas: 

Fiebre  tifoidea 

Difteria 

Tos  ferina 


Total. 


Enfermedades  generales : 

Tuberculosis  pulmonar 31 

Sífilis 1 

Cáncer  y  otros  tumores 5 

Anemia  y  clorosis 31 

Fiebres  palúdicas 19 

Reumatismo 1 


Total. 


98 


Enfermedades  del  sistema  nervioso  y  de 
los  órganos  de  los  sentidos: 

Congestión  cerebral 5 

Hemorragia  cerebral 1 

Epilepsia 1 

Parálisis  general 2 

Eclampsia  no  puerperal 16 

Tétanos  infantil 18 

Télanos 3 


Total 

Aparato  circulatorio: 

Pericarditis 

Enfermadades    orgánicas    del    co- 
razón  ^ 

Afecciones  valvulares 

Afecciones  arteriales 

Aneurismas 


46 


Total -     14 

Aparato  respiratorio: 

Pnemnonía 7 


Aparato  respiratorio — Continúa. 

Pleuresía 2 

Congestión  pulmonar 1 

Bronco  pnemnonía 5 


Total. 


15 


Aparato  digestivo: 

Enteritis _. _.  10 

Hernias    y    obstrucciones    intesti- 
nales   1 

Parásitos  intestinales 18 

Disentería 26 

Cirrosis. 6 

Abcesos  hepáticos 2 

Peritonitis  simple 3 


Total. 


66 


Aparto  genito-urinario: 

Nefritis  aguda 2 

Afecciones  puerperales : 

Otros  accidentes 1 

Piel  y  tegido  celular: 

Gangrena 1 

Edades  extremas: 

Debilidad  congenita 18 

DebiHdad  senil 4 


Total. 


22 


Muertes  violentas: 

Por  armas  de  fuego 1 

Quemaduras 2 

Suicidios .  - 1 

Envenenamientos 3 

Otras  muertes  violentas. 3 


Total. 


10 


SEGUNDA    CONFERENCIA   SANITAIíTA    INTERNACIONAL. 


433 


Defunciones  for  causas,   edades,  sexos,  y   nacionalidades   ocurridas  en   el  Dcpa/rUimento 
Quaicaijmro  en  el  segundo  semestre  de  ^.90^^— Continúa. 


RESUMEN    GliNERAL. 


Sistema  ni/rvioso 46 

Sistema  circulatorio 14 

Sistema  respiratorio 15 

Sistcinu  digestivo 66 

Sistcniíi  <í6nitü  urinario 2 

Knreniicdadcs  ei)i(léinicas 5 

Enrermedadcs  gciici-ales 98 

Afecciones  puerperales 1 


Debilidad  congenita 18 

Del)¡lidad  sínil 4 

Muí^rtes  violentas 10 

Pi(  I  y  t(  gido  celular 1 

Enfermedad'  s  mal  definidas 45 

Causas  desconocidas 16 


Total 341 


Estado  civil. 


Solteros 283 

Casados 31 

Viudos 27 


Total. 


341 


Edades  de  los  fallecidos. 


De  O  á  11  meses 65 

De  1  á  10  años.. 73 

De  11  á  20  años 26 

De  21  á  30  años 47 

De  31  á  40  años , 34 

De  41  á  50  años ' 39 


De  51  á  60  años 27 

De  61  á  70  años 15 

De  71  á  80  años 9 

De  81  y  más 6 

Total 341 


Nacionxilidad. 

Venezolanos 339 

Españoles 2 

Total ., 341 

Nacimientos. 

Hembras  ilegítimas. 175 

Total 580 

Matrimonios 14 


Varones  legítimos 105 

Hembras  legítimas 104 

Varones  ilegítimos 196 


DEPARTAMENTO   SUCRE. 

Incorporado  jmito  con  Guaicaipuro  en  mayo  del  año  próximo  pasado  á  la  Sección  Occi- 
dental del  Distrito  Federal,  el  Departamento  Sucre  comentó  á  figurar  en  la  estadística  en 
julio  de  ese  año. 

Sus  componentes:  Petare,  Baruta,  Hatillo  y  Chacao,  forman  un  total  como  de  20,000 
almas,  repartidas  en  inumerables  aldeas  y  caseríos. 

La  tuberculosis,  la  disentería,  tétanos  infantil  y  el  paludismo  constituyen  las  notas  salientes 
de  las  causas  de  mortalidad  de  este  Departamento. 

La  anemia  lo  mismo  que  en  Guaicaipuro  no  es  extraña  allí  por  lo  que  seía  juicioso  y  alta- 
mente benéfico,  extender  hasta  allí  la  gira  científica  que  suplico  para  aquel  Departamento. 

Aún  á  riesgo,  Ciudadano  Gobernador,  de  hacer  este  informe  más  extenso  de  lo  permitido, 
voy  á  tomarme  la  libertad  de  manifestar  á  usted  el  imperioso  anhelo  que  siento  en  que  usted 
se  apersone  del  importantísimo  asunto  de  la  anemia  por  ankilostomasia,  terrible  enfermedad 
que  ataca  á  la  parte  más  útil,  más  sana  y  más  laboriosa  de  los  pobladores  de  los  terrenos 
agrícolas  denominados  "Los  Altos."  Creo  que  si  su  ilustrado  gobierno  nombra  una  comi- 
sión compuesta  del  bachiller  Rangel  tan  inteligente  cuanto  modesto,  del  Dr.  Perdomo 
Hurtado,  médico  en  ejercicio  en  Los  Teques  y  por  tanto  conoceder  del  país  y  de  la  enferme- 
dad, y  del  suscrito  que  no  aportaría  más  capital  científico  que  su  amor  á  la  medicina  y  muy 
especial  á  la  higiene,  comisión  que  estudiaría  la  enfermedad,  sus  causas  y  su  manera  de 
evitarla,  jamás  se  había  invertido  mejor  el  poco  dinero  que  aquello  costara,  dado  el  nume- 
roso beneficio  que  reportaría  en  no  lejano  porvenir. 

El  cuadro  (lO)  dará  una  idea  más  clara  de  cuanto  dejo  dicho  y  hará  comprender  el  movi- 
miento de  población  con  todos  sus  detalles  en  el  año  de  1904. 


1112a— 06- 


-28 


434 


SEGUNDA    CONFERENCIA    SANITARIA    INTEENACIONAL. 


estadística  de  mohtalidad. 


Defunciones  por  causas,  edades,  sexos  y  nacionalidades  ocurridas  en  el  Departamento  Sucre 

durante  el  ario  de  190 Jf. 


[Población  del  Departimento  Suero,  20,000.] 


Enfermedades  epidémicas : 

Difteria. . .  . , 

Tos  ferina 

Grippe 


Aparato  i-cspiratorio : 

4  Bronquitis  aguda 5 

6  Pneumonía 5 

1  


Total. 


Enfermedades  generales : 
Tuberculosis  pulmonar. . 
Sífilis 

Cáncer  y  otros  tumores. 

Anemia  y  Clorosis 

Fiebres  palúdicas 


11 


29 

2 

2 

15 

14 


Total - 62 

Enfermedades  del  sistema  nervioso  y  de 
los  órganos  de  los  sentidos: 

Me  ningitis  simple 7 

Hemorragia  cerebral 3 

Parálisis  general 1 

Eclampsia  no  puerperal 14 

Tétanos  infantil 20 

Tétanos 1 

Total 46 


Aparato  circulatorio : 

Endocarditis , 

Enfermedades    orgánicas 

razón .• 

Afecciones  arteriales 

Aneurismas 

Embolias 


del 


Total. 


9 
3 
5 
2 

24 


Total 10 

Aparato  digestivo: 

Eeteritis 22 

Disent'  ría 19 

Cirrosis 6 

Peritonitis  simple 1 

Api  ndicitis 3 

Cólera  infantil 2 

Total 53 

Aparato  génito-urinario : 

Neiritis  ainada 2 

Mal  de  Bright. 3 

Enfermedades  de  la  vegiga 1 


Total. 


6 


Afecciones  puerperales: 

Eclampsia 4 

Otros  accidentes 6 


Total. 


10 


Piel  y  tegido  celular: 

Gangrena 1 

Edadí  s  extremas: 

D.  bilidad  congenita. 6 

Muert'  s  vioLntas: 

Poi'  armas  de  fuego 3 

Enfermedades  mal  definidas 18 


RESUMEN   general. 


Sistema  nervioso 46 

Sistema  circulatorio 24 

Sistema  n  spiratorio 10 

Sistema  dig'  stivo 53 

Sistema  génito-urinario 6 

Enfermedades  epidémicas 11 

Enfermedades  generales 62 


Afecciones  puerperales 11 

D.' bilidad  congenita 6 

Muertes  vioL  ntas 3 

Piel  y  tegido  cí  lular 1 

Enfermedades  mal  definidas 17 


Total 250 


Edades. 


De  O  á  1 1  meses 69 

De  1  á  10  años 32 

De  11  á  20  años 30 

De  21  á30  años 40 

De  31  á  40  años 27 

De  41  á  50  años ' 13 


De  51  á  60  años 14 

De  61  á  70  años .- 13 

De  71  áSO  años 2 

De  81  y  más 10 

Total 250 


Nacionalidad. 

Venezolanos 246 

Españoles 4 


Total 250 


íáEGUNDA    CONFERENCIA    .SANITARIA    INTERNACIONAL.  435 

Estado  civil  de  los  fallecidos. 

Solteros ^06 

Casados 28 

Viudos 16 

Total 250 

Matrimonios 50 

Nacimientos. 

Varones  legítimos 60  I  Hembras  ilegítimas 94 

Hembras  legítimas 67  ^  .  

Varones  ili-gítimos 99  |  Total 320 

Ciudadano  Gobernador:  Por  todo  lo  expuesto  en  minucioso  detalle,  en  lo  que  si  algo  falta 
cúlpese,  no  mi  negligencia,  sino  á  mi  escasez  intelectual,  se  encuentra  cuanto  en  materia 
sanitaria  y  demográfica  ha  ocurrido  en  el  vasto  territorio  encomendado  por  el  ciudadano 
Presidente  Provisional  de  Ja  República  á  su  patriotismo  y  decisión  partidaria.  Las  necesi- 
dades son  uu'iltiples,  las  conosco,  el  tiempo  que  el  país  disfruta  de  paz  ( s  corto,  el  buen  deseo 
de  remediarlas  basta  para  que  se  realicen.  Concédanos  Dios  tranquilidad,  y  el  milagro  de 
ver  primero  á  Caracas  y  luego  á  las  otras  poblaciones  gozando  de  inmejorables  condicionen 
de  salubridad  se  hará  en  breve  plazo. 

Me  consideraré  feliz  si  mereciere  la  aprobación  de  usted  para  el  presente  informe. 

A.  Herrera  Vegas, 
Directo?'  de  Higiene  y  Estadística. 


Anexo  B. 

morbUjIdad  nacional. 

ESTADÍSTICA   DE    ENFERMEDADES. 

lat-Van  á  continuación  los  cuadros  generales  de  la  Estadística  de  mortalidad  ocurrida  en  el 
2°  semestre  de  1904,  en  los  Estados  de  la.  República  y  el  Distrito  Federal,  clasificada  por 
enfermedades  3'  causas  de  muerte. 

Adoptada  la  clasificación  de  M.  Bertillón  en  la  Oficina  de  Estadística  de  Venezuela,  estos 
cuadros  son  el'resumen  del  trabajo  de  clasificación  del  semestre. 

Sólo  dos  Estados  no  enviaron  sus  datos — Guárico  y  Táchira,  pero  seguramente,  en  el 
nuevo  año  contaremos  con  los  datos  de  estas  dos  entidades;  por  la  ausencia  de  dichos  dos 
Estados  y  por  no  aparecer  clasificadas  muchas  enfermedades,  no  resulta  el  cómputo  general 
de  mortahdad  aquí  igual  á  la  mortalidad  que  arroja  el  estudio  demográfico. 

El  total  de  muertes  clasificadas  llega  á  23,  603,  de  las  cuales  las  que  más  muertes  causaron 
fueron  las  cuatro  siguientes,  que  dieron  ellas  solas  39  por  ciento  del  total  general: 

Paludismo  (todas  sus  manifestaciones) 4,  1 32 

Tuberculosis 2,  116 

Disentería 1,  630 

Tétanos 1,  445 

Luego  siguen  en  orden  de  magnitud: 

Convulsiones  de  los  niños  (eclampsia  etc.)  463.,  neimionía  (416),  enfermedades 
orgánicas  del  corazón  (432),  anemia,  clorosis  (416),  tos  ferina  (379),  diarrea  y  enteritis  en 
niños  de  2  años  y  mayores  (33S),  eclampsia  no  puerperal  (318),  diarrea  y  enteritis  en  niños 
menores  de  2  años  (299),  parásitos  intestinales  (293),  etc. 

Las  cuatro  enfermedades  principales  han  producido,  del  total  de  defunciones,  los  por 
cientos  siguientes,  en  números  redondos. 

Por  ciento. 

Paludismo 18 

Tuberculosis 8 

Disentería 6 

Tétanos 6 


436 


SEGUNDA    CONFERENCIA   SANITARIA    INTERNACIONAL. 


MORBILIDAD  NACIONAL. 

ESTADÍSTICA    DE   DEFUNCIONES. 


Cuadro  general  de  las  defunciones  ocurridas  en  la  República  duianle  el  segundo  semestre 
de  1904,  clasificadas  por  eiil'crniedades  y  causas  de  nuieite. 


Nomenclatura  de  enfermedades  ó 
causas  de  muerte. 


I.  Enfermedades  generales. 

Fiebre  tifoidea.  (Tifo  abdominal) . 
Paludismo: 

Tifo  exantemático 

Fiebre  recurrente 

Fiebre  intermitente  y  caquexia 

palustra 

(bis)  Caquexia  palustre 

Viruela 

Sarampión 

Escarlatina 

Tos  ferina 

Difteria  y  crup 

Difteria 

Gripa 


Cólera  nostras 

Disentería 

(bis)  Disentería  epidémica 

Verminosis 

Fiebre  amarilla 

Lepra 

Erisipela 

Otras  afecciones-  epidémicas 

Infección  purulenta  septicemia 

Muermo  y  Farcin  ó  Lamparón 

Pústula  maligna  y  carbón 

Rabia 

Actimomicosis,  trequinosis,  etc 

Pelagra 

Tubercolosis  de  la  laringe 

Tuberculosis  de  los  pulmones 

Tuberculosis  de  las  meninges 

Tuberculosis  abdominal 

Mal  de  Pott 

Abceso  frío  ó  por  congestión 

Tumores  blancos 

Tuberculosis  de  otros  órganos 

Tuberculosis  generalizada 

Escr<^fula 

Síñlis 

Blenorragia  del  adulto 

Afecciones  gonocócicas  del  niño 

Cáncer  y  otros  tumores  malignos. 

de  la  cavidad  bucal 

del  esto  mago,  del  hígado 

del  peritoneo,  de  los  intestinos  y  del 

recto ? 

de  los  órganos  genitales  de  la  mujer . 

del  seno 

de  la  piel 

de  otros  órganos  y  de  órganos  no 

especificados 

Otros  tumores  (exceptuando  los 

tumores  de  los  órganos  genitales 

de  la:  mujer) 

Reumatismo  articular  agudo 

Reumatismo  crónico  y  gota 

Escorbuto 

Diabetes 

Bocio  exoftálmico 

Enfermedad  bronceada  de  Addison. 

Leucemia 

Anemia,  clorosis 

Otras  enfermedades  generales 

Alcoholismo  agudo  ó  crónico 

Saturnismo 

Otras  intoxicaciones  profesionales 

crónicas , 

Otros  envenenamientos  crónicos  .. . 


47. 
48. 
49. 
50. 
51. 
52. 
53. 
54. 
55. 
56. 
57. 
58. 

59. 

II.   Enfermedades  del  sistema  nervioso 
y  de  los  órganos  de  los  sentidos. 

60.  Enícefalitis • 

61.  Meningitis 

61.  (bis)  Meningitis  cerebro-espinal  epi- 
démica   


58 


Nomenclatura  de  enfermedades  6 
causas  de  muerte. 


Total 
general. 


II.  Enfermedades  del  sistema  nervioso  • 
y  de  los  órganos  de  los  sentidos— Con. 

62.  Ataxia  locomotriz  progresiva 

63.  Otras  enfermedades  de  la  médula 

espinal 

64.  Congestión  j'  hemorragias    cere- 

brales   

65.  Reblandecimiento  cerebral i 

66.  Parálisis  sin  causa  indicada i 

67.  Parálisis  general ' 

68.  Otras  formas  de  enagenación  men-  ! 

tal i 

69.  Epilepsia '. 

70.  Eclampsia  (no  puerperal) 

71.  Convulsiones  de  los  niños  (eclam- 

psia)   ' 

72.  Tétanos 

73.  Corea i 

74.  Otras  enfermedades  del  sistema  i 

nervioso 

75.  Enfermedades  de  los  ojos  y  sus  j 

anexos : 

76.  Enfermedades  de  los  oí  dos i 

III.  Enfermedades  del  aparato  circula- 

torio. 

77.  Pericarditis 

78.  Endocarditis  aguda 

79.  Enfermedades  orgánicas  del  cora- 

zón   

80.  Angina  de  pecho 

81.  Afecciones    de    las  arterias,  ate- 

roma 

81a.  Aneurisma,  etc 

82.  Emljolia  y  i  rombosis 

83.  Afecciones  de  las  venas  (varices, 

hemorroides,  flebitis,  etc.) 

84.  Afecciones   del   sistema  linfático 

[linlangitis,  etc.) 

85.  Hemorragias 

85a.  Afecciones  valvulares 

86.  Otras  afecciones  del  aparato  circu- 

latorio  


99. 


Enfermedades    del    aparáis    res- 
piratorio. 

Enfermedades  de  las  fosas  nasales . 

Afecciones  de  la  laringe 

Afecciones  del  cuerpo  tiroide 

Bronquitis  aguda 

Bronquitis  crónica 

B  ronco-neumonía 

Neumonía 

Pleuresía 

Congestión  y  apoplegía  pulmonar. 

Gangrena  del  pulmón 

Asma 

Enfisema  pulmonar 

Otras  enfermedades  del  aparato 
respiratorio  (excepto  la  tisis) . . . 


V.    Enfermedades   del  aparato  diges- 
tivo. 

100.  Afecciones  de  la  boca  y  sus  anexos.. 

101.  Afecciones  de  la  laringe 

102.  Afecciones  del  esófago 

103.  Ulcera  del  estómago 

104.  Otras  afecciones  del  estómago  (ex- 

cepto cáncer) 

105.  Diarrea  y  enteritis  (en  menores 

de  dos  años) 

105  bis.  Enteritis  crónica 

106.  Diarrea  y  enteritis  (en  niños  de  2 

años  y  mayores) 

107.  Parásitos  intestinales 

108.  Hernias,    obstrucciones     intesti- 

nales   


259 
21 
72 

124 

11 

66 
318 

463 
1,445 


68 


43 
21 

432 
157 

82 
141 

7 


17 
102 
92 

28 


11 
22 
2 
219 
97 
71 
436 
185 
157 
97 
66 
81 

49 


3 

18 
36 

45 

299 
200 

338 
293 


SEGUNDA-  COJSTFERIíNOrA    SANITARIA    TNTERNACTONAT.. 


437 


Nomenclatura  de  eníerinedades  6 
causas  de  muerte. 


V.  Enfermedades  del  aparato  diges- 
tivo— Continúa. 

109.  Otras  afecciones  del  intestino 

110.  Icteria  grave 

111.  Tuniorcs  hidíitic^os  del  hígado 

112.  Cirrosis  del  hígado 

113.  Cálculos  biliares 

11.3a.  Abscesos  liepáticos 

114.  Otras  afeceioiios  del  Mgado 

115.  AícEcionos  del  byzo 

116.  Peritonitis    simple    (excepto    la 

puerperal) 

117.  Otras  afecciones  del  aparato  diges- 

tivo (excepto  cáncer  y  tubercu- 
losis)   

118.  Apendicitis  y  flegmón  de  la  fosa 

ilíaca 

118a.  Cólera  infantil 

VI. 

119. 
120. 
121. 

122. 
123. 
124. 

125. 
126. 

127. 
128. 

129. 
130. 
131. 
132. 

133. 


Total 
general. 


67 
24 
36 
04 
33 
89 
114 
56 


Enfermedades  del  aparato  genito- 
urinario y  sus  anexos. 

Nefritis  aguda 

Mal  de  Bright 

Otras  enfermedades  de  los  riñones 
y  sus  anexos 

Cálculo  de  las  vías  urinarias 

Enfermedades  de  la  vejiga 

Otras  enfermedades  de  la  uretra, 
abscesos  uriuosos 

Enfermedades  de  la  próstata 

Enfermedades  no  venéreas  de  los 
órganos  genitales  del  hombre 

Metritis 

Hemorragias  del  útero,  no  puer- 
perales   

Tumores  del  útero,  no  cancerosos. . 

Otras  enfermedades  del  útero 

Quistes  y  otros  tumores  del  ovario. 

Qtras  enfermedades  de  los  órganos 
genitales  de  la  mujer 

Enfermedades  no  puerperales  del 
seno  ó  mama  (excepto  cáncer)  . . . 

VII.  Estado  puerperal. 

Accidentes  del  embarazo 

Hemorragia  puerperal 

Otros  accidentes  del  parto 

Septicemia  puerperal 

Albuminuria  y  eclampsia  puer- 
peral   

Phlegmasia  alba  dolens puerperal . 
Otros  accidentes  puerperales 

Muerte  súbita. 

141.  Enfermedades     puerperales     del 
seno  ó  glándula  mamaria 


134. 
135. 
136. 
137. 
138. 

139. 
140. 


VIII.  Enfermedades  de  la  piel  y  del 
tegido  celular. 

142.  Gangrena 

143.  Ántrax  ó  divieso 

144.  Flegmón,  absceso  caliente 

145.  Otras  enfermedades  de  la  piel  y 

sus  anexos 


IX.  Enfermedades  de  los  árganos  de  la 
locomoción. 

146.  Abscesos  de  los  huesos  (excepto 

tuberculosis) 

147.  Enfermedades    de    las    articula- 

ciones (excepto  tuberculosis  y 
reumatismo) 


39 


Nomenclatura  do  eníonriodadcK  ó 
causas  de  muerte. 


IX.  Enfermedaden  de  los  órganos  de  la 
locomoción— Continúa. 

148.  Amputnción i 

149.  Otras  enf(ni:edadc8  de  los  órganos  i 

de  la  locojuoeióD I 

X.   Vicios  de  conformación.         ¡ 

150.  Vicios  de  conformación  congtínitos  I 

(no    comprender    los    nacidos  i 
muertos) 

XI.  Primera  infancia. 

151.  debilidad  congdnita,  Ictericia  y 

escleroma 

1.52.  Otras  enícnnedadcs  especiales  ala 
I^rimera  infancia 

153.  Falta  de  cuidado 

XII.    Vejez. 

154.  Debilidad  senil 


'J'otal 
general. 


XIII.  Afecciones      producidas      por 
causas  exteriores. 

A.  Suicidio. 

155.  Suicidio  por  el  veneno 

156.  Suicidio  por  asfixia 

157.  Suicidio  por  suspensión  ó  extran- 

gulación 

158.  Suicidio  por  submersion 

159.  Suicidio  por  armas  de  fuego 

160.  Suicidio  por  armas  cortantes 

161.  Suicidio  por  precipitación  de  un 

lugar  elevado 

162.  Suicidio  por  machacamiento 

163.  Suicidio  por  otros  medios 

B.  Homicidio. 

163a. 
163b, 
163c. 
163d. 
163e. 
16.3f. 
163g. 


Homicidio  por  arma  blanca 

Homicidio  por  arma  de  fuego 

Homicidio  por  fractura 

Homicidio  por  envenenamiento. . 

Homicidio  por  asfixia 

Homicidio  por  submersion 

Homicidio  por  precipitación  de 
un  lugar  elevado 

C.  Otras  causas  exteriores. 

164.  Fracturas 

165.  Lujaciones 

166.  Otros  traumatismos  accidentales. . 

167.  Quemaduras  por  el  fuego 

168.  Quemaduras  por   sustancias   co- 

rrosivas   

169.  Insolación 

170 

171.  Comoción  eléctrica 

172.  Submersion  accidental 

173.  Inanición 

174.  Absorción  de  gases  deletéreos 

175.  Otros  envenenamientos  agudos. . . 

176.  Otras  violencias  exteriores 

176a.  Mordeduras    de   animales  pon- 
zoñosos   


XIV.  Enfermedades  mal  definidas. 

177.  Hidropesía 

178.  Muerte  súbita  ó  repentina 

179.  Causas  de  muerte  no  especificadas 

ó  mal  definidas 


Total. 


118 


222 
63 


101 


1.285 
131 

2,676 


23,603 


Total  de  las  defunciones  ocurridas  en  el  segundo  semestre  de  1904,  clasificadas  por  enfer- 
medades y  causas  de  muerte : 

Por  ciento. 

Tétanos 6 

Disentería 6 

Tuberculosis  en  general 8 

Paludismo  (diversas  manifestaciones) 18 

Varias  enfermedades  y  causas  de  muerte 62 


438  SEGUNDA   CONFERENCIA   SANITARIA    INTERNACIONAL. 

OBSERVACIONES  SOBRE  LA  DISTRIBUCIÓN  DEL  MOSQUITO  DE  LA 
FIEBRE  AMARILLA  Y  OTROS  PUNTOS  RELACIONADOS  CON  ESTE 
INSECTO,  POR  EL  DR.  L.  O.  HOWARD,  JEFE  DE  LA  OFICINA 
DE  ENTOMOLOGÍA  DEL  DEPARTAMENTO  DE  AGRICULTURA 
DE  LOS  ESTADOS  UNIDOS,  Y  ENTOMÓLOGO  CONSULTOR  DEL 
SERVICIO  DE  SANIDAD  PÚBLICA  Y  HOSPITALES  MARÍTIMOS. 

El  Doctor  Howard  expresó  el  placer  que  sentía  por  el  alto  honor  que  se  le  confirió  al  con- 
cedérsele las  prerrogativas  de  la  Convención  y  al  ser  invitado  para  que  hablara  sobre  su 
reciente  trabajo  relativo  al  Stegomyia  fascíata.  Manifestó  que  había  leído  en  los  periódicos 
que  el  Presidente,  Ciiiijano  General  Wyman,  había  repartido  entre  los  miembros  del  Congreso 
la  última  revisión  del  folleto  titulado  "  Distribución  Geográfica  del  Mosquito  de  la  Fiebre 
Amarilla,"  publicado  originalmente  en  noviembre  de  1903  y  revisado  en  septiembre  de  1905. 

El  orador  dijo  que  los  delegados  de  las  Repúblicas  de  Centro  y  Sur  América  le  harían 
un  gran  favor  leyendo  con  algún  cuidado  las  generalizaciones  hechas  en  las  páginas  7  y  8  del 
documento  en  cuestión,  y  que  esperaba  que  aplicarían  la  ley  de  temperatura,  formulada  en 
dichas  páginas,  á  las  regiones  de  sus  respectivos  países  en  donde  existe  el  Stegomyia  ó  en  las 
que  se  tema  su  introducción. 

Toda  piiieba  que  confirme  la  exactitud  de  dicha  ley,  especialmente  las  que  provengan  del 
hemisferio  sur,  será  de  mucha  importancia.  También  rogó  á  los  delegados  de  las  Repúb- 
licas Latino-Americanas  que  enviaran  al  Museo  Nacional  délos  Estados  Unidos  ejemplares  de 
los  mosquitos  de  sus  respectivos  países.  Las  personas  que  se  dedican  en  esos  países  al 
estudio  de  los  mosquitos  recibirán,  si  así  lo  desean,  la  cooperación  del  personal  de  auxiliares 
del  Doctor  Howard,  y  éste  tendría  sumo  placer  en  cambiar  ejemplares  clasificados  por  los  no 
clasificados. 

Antes  de  que  los  Doctores  Reed,  Carroll  y  Lazear  fueran  á  Cuba  la  primera  vez,  estuvieron 
en  el  Departamento  de  Agricultura  para  hacer  estudios  preliminares  sobre  los  mosquitos  en 
las  colecciones  que  están  á  cargo  del  orador.  Estudiaron  con  especial  cuidado  las  pecu- 
liaridades anatómicas  de  los  mosquitos,  las  cuales  son  de  importancia  para  determinar  las 
especies,  por  lo  que  fueron  á  Cuba  conociendo  perfectamente  el  asunto  que  les  llevaba,  y 
una  vez  allí  hicieron  los  experimentos  que  tan  notable  resultado  han  dado. 

El  Doctor  Howard  vio  desde  un  principio,  en  cuanto  se  comprobó  la  relación  que  tiene  el 
Stegomyia  con  la  fiebre  amarilla,  que  la  distribución  geogi-áfica  de  esta  especie  es  de  suma 
importancia  como  base  para  el  establecimiento  de  medidas  preventivas  eficaces,  por  lo  que 
inmediatamente  comenzó  á  estudiar  este  importante  asunto  con  los  medios  limitados  que 
tenía  á  mano. 

Los  resultados  preliminares  fueron  publicados  en  la  primera  edición  del  documento  que 
nos  ocupa,  que  vio  la  luz  en  noviembre  de  1903.  Sin  embargo,  en  1904,  después  de  haber 
hecho  sus  generalizaciones  y  de  haberse  convencido  de  que  el  Stegomyia  fasciata,  para  todos 
los  fines  prácticos,  es  una  especie  de  los  trópicos  y  de  las  bajas  regiones  australes,  trató  de 
determinar  la  línea  de  la  distribución  norte  de  esta  especie  en  los  Estados  Unidos.  En 
junio  envió  un  auxiliar  á  Texas  que  siguió  la  línea  norte  imaginaria  de  distribución  hasta 
Tennessee,  en  donde  fué  sustituido  por  otro  auxiliar  que  continuó  la  investigación  hasta  la 
costa  del  Atlántico.  Los  resultados  de  este  trabajo  fueion  de  grande  importancia,  según 
se  ha  indicado  en  la  segunda  edición  del  folleto  de  referencia.  El  Ciiiijano  General  Wyman 
ha  tenido  la  amabilidad  de  decirme  que  los  hechos  demostrados  en  esta  investigación  han 
servido  de  valiosa  ayuda  al  Servicio  de  Sanidad  Pública  y  Hospitales  Marítimos  durante 
la  epidemia  de  fiebre  amarilla  de  este  año. 

Sucedió  que,  mientras  era  necesario  publicar  este  trabajo  lo  más  pronto  posible,  dos 
importantes  clases  de  investigaciones  so  estaban  llevando  á  cabo  en  Centro  América  y  en  las 
Anti]las._  Nmguno  de  los  investigadores  de  estas  regiones  había  \'ue]to  á  Washington  en  lo 
fecha  en  que  se  escribió  el  documento  y  ninguno  de  ellos  había  mandado  infomies  completos. 
Hace  pocos  días  que  ambos  funcionarios  han  vuelto  á  Washington  y  han  persentado  sus 
infomes  verbales,  por  lo  que  el  orador  puede,  afortunadamente,  dar  en  la  presente  ocasión, 
muy  brevemente,  los  hechos  adicionales  que  han  averiguado  estos  investigadores. 

Mr.  Frederick  Knab  salió  de  Veracruz  en  junio,  dirigiéndose  á  Córdoba  (México)  al  sur  del 
Ferrocarril  de  Tehuantepec  y  cruzó  el  Istmo  desde  Santa  Lucrecia  hasta  Salina  Cruz, 
deteniéndose  en  Rincón  Antonio  y  en  Tehuantepec.  Después  visitó  algunos  puntos  de 
Guatemala,  Costa  Rica  y  San  Salvador.  Los  puntos  en  donde  encontró  el  Stegomyia 
fascíata  y  que  no  constan  en  el  documento  distribuido  en  esta  conferencia  son  los  siguientes: 


Rincón  Antonio  (Oaxaca),  México. 

Tehuantepec  (Oaxaca),  México. 

Sahna  Cruz  (Oaxaca),  México. 

Acapulco,  México. 

Champerico,  Guatc^mala. 

San  José,  Guatemala.  .  |  Puerto  Limón,  Costa  Rica. 

San  Salvador,  Salvador. 


Sonsonatp,  Salvador. 
Corinto,  Nicaragua. 
Puntarcnas,  Costa  Rica. 
Esparta,  Costa  Rica. 
San  José,  Costa  Rica. 


SEGUNDA    CONFERENCIA   SANITARIA   INTERNACIONAL.  439 

El  otro  investigador,  Mr.  A.  Busck,  salií)  de  Trinidud  y  se  dii'igió  hacia  el  iiortc  atrave- 
sando las  Antillas  hasta  vSanto  Domingo  y  volviendo  ú.  Washington  desde  este  nunto.  Los 
puntos  en  qu(t  Mr.  Buscík  encontró  el  tSlegomyia  fascial  a.  y  que  no  aparecen  en  el  documento 
mencionado  son  los  siguientes: 

Trinidad:  Cedros  (al  extremo  sur  de  la  isla),  Maj-tinica,  Pu(!rto  de  Francia,  poro  nó  Monte 

Pitch  Lake,  Puerto  de  España,  Monserrat,  P.  lado. 

Arima  (en  el  centro  d(>.  la  isla).  Dominica. 
Isla  Tobago.                                                         i  Guadalupe:  Tierra  Baja. 

Granada.  Santo  Tomás. 

San  Vincfnte.  Pui  rto  Kico:  Pence  y  Mayagüez. 

Barbados.  Santo  Domingo:  San  Cristóbal  (2,000  pies 

Santa  Lucía.  de  elevación),  Sanchi  z  y  Puerto  Plata. 

Las  observaciones  de  estos  funcionarios  demostraron  algunos  hechos  interesantes.  Por 
ejemplo,  Mr.  Knab  encontró  que  en  San  José.  Costa  liica,  una  ciudad  que  está  á  una  altura 
de  unos  3,000  pies,  el  mosquito  de  la  fiebre  amarilla  no  es  abundante,  y,  según  se  le  ha 
informado  hasta  ahora  no  se  ha  registrado  ninguna  epidemia  de  fiebre  amarilla  en  ese  sitio;  la 
verdad  es  que  los  convalecientes  de  la  costa  son  traídos  á  San  José  en  ferrocarril.  Al  orador 
le  parece  que  este  es  un  caso  comparable  con  las  regiones  extralimitales  de  los  Estados 
Unidos,  en  las  que  el  mosquito  de  la  fiebre  amarilla  es  introducido  durante  el  verano  por 
los  ferrocarriles  ó  los  barcos  y  en  las  que  se  multiplica  por  una  ó  más  generaciones  ha.sta  el 
fia  de  la  estatüóii.  Estas  no  son  regiones  en  donde  existe  permanentemente  el  Síegomyia, 
sino  regiones  en  donde  esta  especie  se  encuentra  hacia  el  ñnal  del  verano  algunos  años, 
quizás  cada  año. 

Mr.  Busck  ha  observado  que  apenas  hay  mosquitos  de  la  fiebre  amarilla  en  la  ciudad  de 
Santo  Domingo,  y  en  cambio  abundan  en  San  Cristóbal,  que  es  una  población  que  se  halla 
á  una  altura  de  20,000  pies  y  que  está  en  el  interior  á  20  millas  de  distancia  de  la  costa. 
Este  es  un  hecho  curioso  que  parece  inexplicable.  Según  la  distribución  geográfica  de  este 
mosquito,  las  ciudades  costaneras  de  otras  partes  del  mundo  son  las  que  están  más  infes- 
tadas de  este  insecto;  en  ellas  son  numerosos  los  mosquitos,  y,  naturalmente,  la  enfer- 
medad prevalece  en  alto  grado.  Mr.  Busck  fué  informado  de  que  en  la  ciudad  de  Santo 
Domingo  nunca  ha  habido  una  epidemia  de  fiebre  amariUa.  Ni  él  ni  yo  hemos  consultado 
los  archivos  para  averiguar  la  exactitud  de  esta  noticia. 

El  punto  más  elevado  del  Ferrocarril  de  Tehuantepec  es  Rincón  Antonio.  El  médico  del 
ferrocarril  en  este  pueblo.  Doctor  Athey,  estaba  haciendo  una  fuerte  guerra  á  los  mosquitos, 
pero  no  estaba  seguro  si  allí  existía  el  Stegomyia.  Mr.  Knab  encontró  que  esta  especie 
abundaba  en  las  casas  de  obreros,  y  descubrió  que  se  estaba  haciendo  mucho  trabajo  en 
balde  y  gastándose  mucho  petróleo  inútilmente,  porque  se  aplicaba  el  remedio  á  los  pozos 
y  grandes  albercas  en  donde  no  se  criaban  mosquitos  de  ningún  género,  en  tanto  que  los 
pequeños  receptáculos  y  otros  criaderos,  como  las  huellas  de  ganado  en  terrenos  mojados, 
se  pasaban  por  alto.  También  encontró  Mr.  Knab  un  gran  barril  de  agua  en  el  que  había 
cientos  de  larvas  y  que  no  había  sido  notado. 

Hasta  aquí  lo  referente  á  la  distribución.  Estos  dos  funcionarios  hicieron  otras  muchas 
observaciones  en  regiones  tropicales,  que  son  más  ó  menos  interesantes.  Mr.  Knab  encontró 
el  Stegomyia  en  un  vapor  fuera  de  Kingston,  Jamaica.  En  un  viaje  anterior,  Mr.  Busck 
encontró  el  Stegomyia  en  un  vapor  de  la  Ward  Line  al  llegar  á  Nueva  York  procedente  de 
Cuba. 

Con  respecto  á  los  criaderos,  ambos  investigadores  estaban  interesados  en  el  hecho  de 
que  el  Stegomyia  crece  siempre  en  agua  clara,  y  rara  vez,  ó  nunca,  en  agua  sucia  y  siempre 
en  receptáculos  artificiales,  excepto  en  un  caso  que  observó  Mi".  Knab,  en  el  que  esta  especie 
se  criaba  en  un  canalón  de  una  calle.  La  cría  casi  universal  en  el  agua  clara  que  han  obser- 
vado estos  dos  funcionarios  es  de, interés  especial  en  comparación  con  el  hecho  notado  por 
Carroll,  Dupree  y  otros  observadores,  que  el  desarrollo  de  la  larva  del  Stegomyia  se  pre- 
cipita en  el  laboratorio  poniendo  en  el  agua  una  pequeña  cantidad  de  excremento  humano. 
La  casa  del  consul  americano  en  San  Salvador  estaba  especialmente  infestada  de  Síegomyia. 
En  una  iglesia  de  Granada,  Mr.  Busck  encontró  gran  canitdad  de  larvas  de  Stegomyia  en  el 
pila  del  agua  bendita,  y  también  en  otras  iglesias  de  varios  puntos  de  las  Indias  Occiden- 
tales. Los  mosquitos  adultos  abundaban  en  estas  iglesias.  Cuando  j\Ii\  Busck  me  dijo 
esto,  llamé  por  teléfono  al  Rev.  Dr.  Stafl'ord,  de  esta  ciudad,  con  el  fin  de  averiguar  qué 
se  usaba  en  las  pilas  de  agua  bendita,  y  me  contestó  que  tenían  la  costumbre  de  echar 
sal  en  las  pilas  ordinarias.  Actualmente  se  usa  la  sal  en  Nueva  Orleans  como  sustancia 
destructora  del  mosquito,  echándola  en  los  pozos  j  alcantarillas,  por  lo  que  me  parece  que 
si  los  sacerdotes  usaran  más  sal  en  las  pilas  de  agua  bendita,  nó  un  poquito,  sino  lo  bastante 
para  que  dé  un  resultado  apreciable,  se  conseguirían  buenos  efectos;  porque  no  solamente 
encontró  Mr.  Busck  larvas  del  Stegomyia  en  las  pilas  de  agua  bendita,  sino  que  también 
vio  mosquitos  en  las  iglesias  que  picaban  á  las  personas  en  ellas  presentes. 


4-10  SEGUNDA   CONFEEENCIA   SANITAKIA   INTEENACIONAL. 

En  Ti-inidad  rió  que  en  algunos  jardines  se  usaban  botellas  para  adornarlos.  Los  cuellos 
de  las  botellas  estaban  enterredos  en  el  suelo  y  las  bases  cóncavas  de  las  mismas  (vueltas 
hacia  arriba)  habían  acumulado  agua,  criándose  en  ellas  el  Sterioirn/ia.  En  los  bordes  de 
la  pared  que  rodea  la  cárcel  había  botellas  rotas  en  cuyas  concavidades  se  había  acuminado 
el  agua  y  se  criaba  el  Ste(/omyia. 

Eu  Acapulco  encontró  Mr.  Knab  mosquitos  en  abundancia  en  el  patio  de  un  hotel,  en 
el  cual  había  preciosas  plantas  protejidas  contra  las  hormigas  por  depósitos  de  agua  alre- 
dedor de  las  bases  de  sus  troncos.     En  este  agua  se  criaba  el  Stegomyía  en  abundancia. 

Muchas  de  las-  observaciones  hechas  por  ambos  señores  vienen  á  comprobar  el  hecho  de 
que  el  Siegomyia  ha  llegado  á  ser  prácticamente  una  especie  domesticada,  ó,  de  todos  modos, 
una  especie  doméstica.  La  costujnbre  de  esconderse  que  tiene  el  adulto,  su  aire  general 
de  familiaridad  con  el  hombre,  su  hábito  de  acercarse  por  detrás  en  vez  de  hacerlo  por 
delante,  su  costumbre  de  esconderse  en  los  pliegues  de  los  vestidos  y  de  subirse  por  debajo 
de  los  vestidos  para  picar  las  piernas  en  vez  de  hacerlo  en  las  partes  del  cuerpo  que  están 
expuestas,  son  signos  de  familiaridad  con  el  género  humano  desde  hace  muchísimas  gene- 
raciones. Mr.  Knab  indica  que  el  hecho  de  que  esta  especie  no  produzca  zumbido  alguno 
es  el  resultado  de  la  ley  de  supervivencia  de  los  más  aptos.  Es  interesante  notar  que 
Goeldi,  del  Brasil,  ha  establecido  la  teoría  de  que  esta  especie  pica  con  más  frecuencia 
durante  las  horas  más  calurosas  del  día  porque  es  atraída  por  el  olor  del  sudor,  y  ^ír.  Knab, 
por  las  observaciones  que  ha  hecho  durante  este  verano,  se  inclina  á  creer  que  el  Stegomyia 
pica  con  más  frecuencia  durante  la  tarde.  Mr.  Busck,  según  las  observaciones  que  ha 
hecho  en  las  Antillas,  se  inclina  á  creer  cjue  las  picadm-as  son  más  frecuentes  cuando  la 
tarde  está  avanzada. 

Todavía  queda  mucho  por  estudiar  sobre  este  insecto,  tanto  como  lo  que  ya  se  ha  estu- 
diado en  varios  países.  Los  informes  contradictorios  sobre  sus  costumbres  indican  que 
hay  mucha  variación  en  éstas,  ó  bien  que  algunos  de  esos  informes  son  erróneos.  Agra- 
monte  dice  que  el  Stegomyia  en  Cuba  apenas  puede  ser  inducido  á  que  muerda  sino  tiene 
cuatro  días  de  edad.  Mr.  Busck,  que  representó  la  Oficina  de  Entomolagía  del  Departa- 
mento de  Agricultura  de  los  Estados  Unidos  en  la  Exposición  de  San  Luis  y  que  ha  necho 
estudios  sobre  el  crecimiento  de  mosquitos  de  esta  especie  durante  los  meses  del  otoño, 
dice  que  mosquitos  que  se  han  desarrollado  durante  la  mañana  pueden  picar  por  la  tarde. 
Dupree  dice  que  en  Luisiana  este  mosquito  puede  picar  sin  que  se  le  instigue  á  las  veinti- 
cuatro horas. 

Otro  punto  interesante  es  la  opinión  del  Doctor  Souchon,  presidente  de  la  Junta  de 
Sanidad  del  Estado  de  Luisiana,  sobre  la  improbabilidad  de  que  el  Stegomyia,  que  viaja 
en  los  buques  fruteros  que  Uegan  á  Nueva  Orleans  procedentes  de  la  América  Central, 
quede  infectado  antes  del  arribo  del  buque  á  la  estación  de  cuarentena.  Basa  esta  opinión 
en  la  teoría,  originada  de  Cuba  probablemente,  de  que  la  hembra  tiene  que  estar  preñada 
antes  de  que  pueda  picar,  y  que  tienen  cjue  transcurrir  de  cinco  á  siete  días  entre  la  primera 
y  la  segunda  picadura.  Las  citadas  observaciones  de  Air.  Busck  demuestran  que  no  es 
necesario  que  la  hembra  esté  preñada  antes  de  poder  picar,  y  que  las  hembras  criadas 
artificialmente  pueden  picar  por  la  segunda  vez  después  que  han  transcurrido  cuarenta  y 
ocho  horas  desde  la  primera  picadura.  El  Doctor  Dupree,  de  Baton  Rouge,  ha  observado 
que  las  hembras  aisladas  en  estado  de  crisálida  y  criadas  aparte  de  los  machos  "pican  en 
seguida  y  con  ft-ecuencia."  Es  posible  que  la  confianza  en  esa  opinión  aparentemente 
errónea  sea  la  causa  de  la  presente  epidemia  de  Nueva  Orleans? 

Otra  cuestión  que  merece  más  amplio  estudio  es  la  de  la  distancia  que  el  Stegomyia  infec- 
tado puede  volar  en  lo  que  respecta  la  distancia  en  que  deben  anclar  los  lauques  en  los 
puertos  infectados.  El  Dr.  A.  H.  H.  Russell,  de  la  Alarina  de  los  Estados  Unidos,  ha  hecho 
algunas  interesantes  observaciones,  aun  cuando  indetermmadas,  sobre  este  particular,  las 
cuales  todavía  no  se  han  publicado.  Refiriéndose  á  esta  cuestión  el  Mr.  Busck  dice  que  en 
L'Abrea,  Trinidad,  hay  un  embarcadero  construido  por  la  compañía  del  asfalto,  al  extremo 
del  cual"  el  superintendente  construyó  su  casa  con  el  fin  de  no  ser  molestado  por  los 
mosquitos.  El  experimento  le  dio  resultados  iJuenos  hasta  que  otro  empleado  de  la  misma 
compañía  edificó,  su  casa,  con  el  mismo  fin,  en  medio  del  embarcadero.  Esto,  al  parecer, 
ocasionó  el  intermedio  exacto  para  que  el  Stegomyia  volara  desde  la  oriha  hasta  la  casa 
que  estaba  en  el  medio  y  desde  ésta  hasta  la  que  estaba  en  el  extremo,  quedando  infes- 
tadas ambas.     La  longitud  total  del  embarcadero  era  de  unos  cuatrocientos  pies. 

Éstos  son  unos  cuantos  de  los  muchos  puntos  que  todavía  requieren  la  atención  de  los 
entomólogos  y  de  los  médicos. 

Por  la  razón  de  que  ya  se  han  publicado  muchas  pruebas  acerca  del  hecho  de  cjue  el 
Stegomyia.  es  un  mosquito  casero,  es  casi  innecesario  añadir  que  nunca  se  le  encuentra  en 
los  campos,  pero  con  todo  sería  de  importancia  hacer  relucir  este  punto,  porque  tanto 
Mr.  Busck  como  Mr.  Knab  son  entomólogos  expertos  cuya  especialidad  es  el  estudio  del 
mosquito.  Cualquiera  otro  que  dijera  que  el  Stegomyia  no  se  encuentra  en  los  campos  no 
recibiría  tanto  crédito  como  estos  dos  funcionarios. 


SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL.  441 

OBSERVACIONES  DEL  DR.  H.  L.  E.  JOHNSON,  DE  WASHINGTON, 
D.  C,  MIEMBRO  DE  LA  JUNTA  DE  FIDEICOMISARIOS  DE  LA 
ASOCIACIÓN   MÉDICA  AMERICANA. 

SEfSOR  Presidente,  Señores  Delegados,  Señores  Invitados:  El  título  de  este  docu- 
mento es  "Influirá  on  la  opinión  pública  la  calificación  etiológica  de  las  enfermedades?" 
En  la  actualidad  el  objeto  principal  do  la  ciencia  y  el  estudio  médico  é  higiénico  es  la  pre- 
vención y  la  limitación  de  enlermedadcs. 

Las  invostigaciorica  patológicas,  biológicas  y  químicas  de  laboratorio  han  hecho  valiosos 
progresos  en  determinar  la  causa  y  el  origen  de  la  trasmisión,  la  confirmación  científica,  la 
modificación  y  la  supresión  de  muchos  de  las  afecciones  mórbidas  del  hombre  y  de  los  ani- 
males de  la  clase  inferior. 

Se  ha  conseguido  hacer  mucho  bien  y  se  conseguirán  más  beneficios  con  los  trabajos  del 
porvenir,  pero  antes  do  que  se  consiga  una  aceptación  universal  y  de  que  sea  posible  la 
aplicación  práctica  y  eficaz  de  los  hechos  demostrados  en  el  laboratoi-io,  es  conveniente  que  el 
vulgo  sea  instruido  y  quede  convencido. 

Generahuonte  el  vulgo  es  escéptico  con  respecto  á  los  nuevos  hechos  y  descubrimientos 
módicos,  y  antes  que  aprecie  el  valor  y  la  importancia  de  las  medidas  higiénicas,  curativas 
y  preventivas,  pondrá  en  ridículo  nuestros  principios  y  pondiá  obstáculos  á  nuestros  mito- 
dos.  Los  legisladores  hacen  causa  c(jmún  con  el  público  y  la  prensa,  y  por  consiguiente 
raras  veces  se  votan  cantidades  suficientes  para  el  adecuado  mantenimiento  de  las  condi- 
ciones higiénicas,  ya  sean  los  de  un  estado,  ya  los  de  una  nación.  Hablando  en  términos 
generales,  la  creencia  del  público  en  nuestras  teorías  sobre  las  causas  de  las  enfermedades 
y  las  precauciones  contra  ellas,  es  esencial  para  nuestras  luchas  en  pro  de  la  salud,  y  con  este 
fin  las  materias  de  higiene  deben  hacerse  parte  de  los  estudios  de  una  escuela  ordinaria  de 
instrucción,  y  deberían  ser  propagadas  mediante  conferencias  sistemáticas  en  términos  que 
todos  puedan  comprender.     Los  baños  dieron  á  Roma  su  salud  y  su  fuerza. 

Se  ha  demostrado  que  la  mosca  es  un  agente  de  infección  de  la  fiebre  tifoidea  y  la  de 
tuberculosis,  así  como  también  el  papel  que  desempeña  el  mosquito  en  la  fiebre  palúdica  y 
en  la  amarilla,  pero  el  vulgo  y  la  prensa,  á  pesar  de  que  la  opinón  médica  es  unánime  en  el 
particular,  no  han  sancionado  del  todo  nuestras  esfuezas  para  vencer  estes  males. 

Debemos  demostrar  al  público  la  causa  y  el  efecto  de  cada  enfermedad,  y  deberíamos  dar 
un  nombre  relacionado  con  su  etiología,  ó  que  la  indique,  á  las  enfermedades  cuya  propa- 
gación depende  de  un  agente  intermedio,  como  la  fiebre  amarilla  y  la  palúdica;  verbi- 
gracia, la  fiebre  palúdica  debería  llamarse  "fiebre  anopheles,"  infección  ó  envenenamiento; 
la  fiebre  amarilla, "  fiebre  stegoymia,''  infección  ó  envenenamiento.  Con  estos  calificativos  se 
indicaría  su  origen  y  la  necesidad  del  exterminio  de  los  insectos  las  respectivas  enfermeda- 
des, cuya  naturaleza  se  sugiere  forzosamente. 

El  fomento  de  la  higiene  y  la  eliminación  de  las  enfermedades  dependen  del  público 
tanto  como  de  la  profesión  médica,  y  la  cooperación  en  estos  asuntos  depende  mucho  de  la 
educación  del  vulgo  en  materias  de  higiene. 


MEMORIA  SOBRE  LA  FIEBRE  AMARILLA  EN  CUBA  POR  EL  DR. 
JUAN  GUITERAS,  DELEGADO  DE  CUBA. 

La  observancia  de  las  medidas  profilácticas  contra  la  fiebre  amarilla,  inventadas  por  el" 
Dr.  C.  J.  Finlay  é  instituidas  por  el  Gobierno  Americano  de  Intervención,  han  dado  los 
resultados  siguientes: 

Primero,  la  continua  inmunidad  contra  la  fiebre  en  todo  nuestro  territorio,  y 

Segundo,  la  prueba  terminante  de  que  la  picadura  de  un  mosquito  contaminado  es  el 
único  medio  natural  para  la  trasmisión  de  la  fiebre  amarilla. 

Al  presentar  este  resimien  de  lo  que  se  ha  conseguido  durante  los  tres  últimos  años,  desarro- 
llaré un  argmuento  en  apoyo  de  la  segundo  proposición. 

Lo  hago  porque  en  algunas  de  nuestras  hermanas  repúblicas  hay  todavía  algima  vacila- 
ción en  admitir  y  observar  todas  las  conclusiones  lógicas  de  esta  doctrina.  No  se  ha  ense- 
ñado á  los  habitantes  de  estos  países  á  comprender  completamente  esta  teoría,  y  de  aquí 
el  que  prevalezca  entre  algunos  el  mal  y  que  invada  á  otros. 

Repetiré  lo  que  declaré  en  la  última  conferencia,  que  no  es  posible  llevar  á  cabo  con  éxito 
las  medias  profilácticas  contra  la  fiebre  amarilla  sin  la  cooperación  del  pueblo.  Una  comu- 
nidad en  la  que  el  aviso  del  acaeciniiento  de  un  caso  de  fiebre  amarilla  causa  una  consterna- 
ción irrefrenable,  no  puede  dejar  que  sus  autoridades  sanitarias  hagan  tal  aviso  ó  que 
rodeen  al  enfermo  con  todas  las  precauciones  posibles.  Es  segm-o  que  un  aviso  de  esta 
naturaleza  produzca  una  grave  paralización  en  los  negocios,  restricciones  comerciales  y 
violentas  cuarentenas.     Se  ha  establecido  de  hecho  un  cm-ioso  círculo  vicioso,  el  cual  puede 


■4-12  SEGUNDA   CONFERENCIA   SANITARIA   INTERNACIONAL. 

ser  expresado  concisamente  en  esta  forma:  El  aviso  do  que  ha  ocurrido  un  caso  de  fiebre 
amarilla  produce  una  gran  consternación  y  gi-aves  desordenes,  porque  todos  temen — fre- 
cuentemente con  razón — que  han  ocurrido  otros  casos  (jue  se  han  encubierto;  y,  en  segimdo 
lugar,  que  se  ocultan  casos  por  temor  de  causar  una  consternación  perjudicial. 

La  confianza  cjue  existe  en  la  Habana  está  basada  en  la  aceptación  de  la  doctrina  que 
nos  ocupa  por  el  pueblo,  y  en  la  convicción  de  que  las  autoridades  sanitarias  obrarán  sin  pér- 

En  el  hospital  de  Las  Anijnas,  de  la  Habana,  para  la  fiebre  amarilla,  vemos  pertuamente 
dida  de  tiempo  y  abiertamente  en  cuanto  se  presente  cualquier  caso  sospechoso, 
presentes  y  en  operación  activa  las  causas  que,  de  acuerdo  con  la  antigua  doctrina,  podrían 
ocasionar  espontáneamente  la  propagación  del  mal  que  nos  ocupa.  Hace  más  de  cuatro 
años  que  los  adictos  de  la  antigua  escuela  están  acechando  en  vano  estas  causas,  que, 
según  opinan  todavía,  están  escondidas  en  el  suelo,  para  renovar  su  actividad  y  hacer 
revivir  los  horrores  del  antiguo  mal  endémico  del  Mar  Caribe. 

Los  últimos  días  de  la  fiebre  amarilla  en  Cuba  han  sido  relatados  en  un  trabajo  leído  ante 
la  Sociedad  de  Estudios  Clínicos  de  la  Habana  por  el  Dr.  J.  Le  Roy,  en  abril  de  lf;02,  bajo  el 
título  de  "Estadísticas  de  la  fiebre  amarilla  y  la  desaparición  del  mal  de  la  Habana  según 
se  demuestra  en  los  datos  de  dichas  estadísticas." 

La  agonía  del  gran  mal  endémico  duró  siete  meses,  á  saber,  desde  el  16  de  febrero  hasta  el 
18  de  septiembre  de  1901,  fecha  del  último  caso  autóctono  ocurrido  en  la  Habana. 

Conviene  recordar  que  cuando  empezó  la  campaña  contra  el  mosquito  en  febrero  de 
1901  había  habido  desde  1898  una  anuencia  de  42,000  inmigrantes,  no  faltando,  por  lo 
tanto,  campo  nuevo  para  la  infección. 

No  repetiré  una  vez  más  los  detalles  del  nuevo  método  empleado  para  combatir  la  fiebre 
amarilla.  Este  método  ha  sido  aceptado,  por  lo  menos  teóricamente,  como  el  único  proce- 
dimiento para  el  exterminio  del  mal.  Baste  decir  que  consiste  en  protejer  todo  caso  de 
fiebre  amarilla,  contra  las  picaduras  de  mosquitos,  y  en  extenninar  todos  los  mosquitos 
que  hayan  podido  picar  á  los  atacados  de  la  fiebre,  es  decir,  todos  los  insectos  que  se  encuen- 
tren ai  rededor  del  enfenno.  Esto  fué  lo  que  se  hizo  con  nuestros  casos  autóctonos,  y  la 
vigilancia  de  nuestra  Cuarentena  Marítima  y  nuestra  Oficina  de  Inmigración  nos  permi- 
tieron obrar  del  mismo  modo  con  los  casos  hnportados. 

El  efecto  de  estas  medidas  puede  ser  comprobado  en  las  estadísticas   de  1901. 

En  enero  tuvimos  27  casos. 

En  febrero  10.  En  este  mes  se  empezó  la  campaña,  el  período  en  que  el  estado  mórbido 
de  la  fiebre  amarilla  llagaba  á  su  mínimvmi.  El  éxito  obtenido  en  la  Habana,  así  como 
otras  consideraciones  teóricas,  nos  hacen  creer  que  ésta  es  la  mejor  época  para  iniciar  la 
campaña  contra  este  enemigo  endémico. 

En  marzo  tuvimos  2  casos,  y  uno  importado. 

En  abril,  2. 

En  mayo  tuvimos  5  y  uno  importado;  esto  demuestra  que  la  epidemia  anual  de  cos- 
tmnbre  empezaba  á  afirmarse. 

En  junio  tuvimos  un  caso  y  otro  importado. 

En  julio  tuvimos  6  y  otros  6  importados  de  un  pueblo  vecino. 

En  agosto  tuvimos  7,  4  de  los  cuales  fueron  importados. 

En  septiembre  tuvimos  9  casos.  Dos  de  estos  cayeron  enfermos  en  el  2°,  siendo  los 
últimos  que  se  originaron  en  la  ciudad  de  La  Habana. 

Presento  este  resumen  estadístico  porque  los  últimos  casos  de  la  agonizante  endemia  son 
de  especial  interés  en  relación  con  los  casos  experimentales  inoculados  en  el  Hospital  de  Las 
Ánimas.  Éstos  fueron,  hablando  generalmente,  los  más  graves  que  se  habían  producido 
■mediante  la  apHcación  de  mosquitos  de  laboratorio,  y  tienen  mucha  importancia  como 
prueba  de  la  trasmisión  de  la  fiebre  por  el  mosquito,  porque  en  dos  de  ellos  se  demostraron 
las  lesiones  post  mortem  características  de  la  fiebre  amarilla. 

Sin  embargo,  algunos  autores  que  han  intentado  argüir  contra  la  aceptación  de  esta  forma 
de  trasmisión  del  mal,  han  rechazado  la  prueba  de  todos  los  casos  experimentales.  Recha- 
zaron los  casos  leves  porque  los  síntomas  no  estaban  suficientemente  desarrollados,  y  los 
casos  graves  porque,  según  ellos,  no  se  contrajo  la  enfermedad  por  medio  de  la  inoculación 
del  mosquito,  sino  mediante  la  exposición  ordinaria  á  la  causa  desconocida. 

Así  es  que  el  Profesor  Zanai'elli  y  algunos  de  nuestros  colegas  brazileños  han  sostenido 
que  los  casos  experimentales  del  Hospital  de  Las  Animas  no  tienen  valor  alguno  desde  el 
momento  que  han  ocurrido  en  un  hospital  de  fiebre  amarilla  y  en  una  ciudad  en  donde 
entonces  prevalecía  una  epidemia  del  mal  en  cuestión.  Nuestros  cologas  están  equivocados. 
Hemos  visto,  de  hecho,  según  las  estadísticas  que  acabo  de  mencionar,  que  lo  que  hubo  no 
fué  una  epidemia  sino  únicamente  las  últimas  manifestaciones  de  la  agonía  de  la  gran 
endemia,  en  forma  de  unos  cuantos  casos  esporádicos. 

Nada  más  fácil  que  demostrar  que  el  Hospital  de  Las  Animas  no  estaba  contaminado 
cuando  se  hfcieion  los  experimentos.  Los  casos  inoculados  de  que  se  trata  se  m?nifestaron 
en  los  días  11,  12,  14,  17,  18  y  20  de  agosto.  Veamos  ahora  la  marcha  de  los  otros  casos  en 
dicho  hospital  durante  esos  días  y  durante  los  meses  anteriores  de  1901,  en  lo  siguiente: 


SEGUNDA    CONFERENCIA   SANITARIA    INTERNACIONAL.  443 

Cuadro  demostrativo  de  los  casos  de  fiebre  amarilla  en  el  Tlosjñtal  de  Las  Ardmas  durante  el  año 
de  1901  hasta  el  lo  de  septiembre,  clasificados  de  acuerdo  con  los  orígenes  respectivos. 


Mosps. 


Enero                                         

1 
1 
1 

1 

0 
0 
ü 

2 

1  1 

1 

0  1 

1 

0 

0 

1 

0 

1 

0 

Abril 

0 

0 

0 

Julio                                                          i 

0 

6 

Se  verá  que  los  casos  curados  en  el  liospital  fueron  gradualmente  disminuyendo  hasta 
desaparecer  por  completo  durante  junio  y  julio,  que  es  el  período  en  que  un  edificio  con- 
taminado debe  haber  empezado  á  producir  su  coscclia  de  infecciones.  Y  no  se  puede  decir 
que  esta  inmunidad  era  debida  á  la  ausencia  de  individuos  susceptibles  en  el  hospital, 
porque  en  él  teníamos,  desde  el  22  de  febrero  de  ISOl,  además  de  los  casos  ordinarios  de 
otras  fiebres,  casi  todos  los  cuales  no  eran  inmunes,  cierto  número  de  inmigrantes  jóvenes, 
recién  Uegados,  que  habían  sido  llevados  de  la  estación  de  inmigración  de  Tricornia  para 
nuestros  experimentos  de  inoculación.  Durante  el  mes  de  agosto  había  12  de  estos  jóvenes 
españoles  en  los  edificios  del  hospital.  El  número  de  las  personas  no  inmunes  que  había 
en  él  aparece  en  lo  siguiente: 

üuadro  demostrativo  de  los  residentes  no  inrmines  del  Hospital  de  Las  Animas  durante  él  mes 

de  agosto  de  1901. 

Casos  de  fiebre  tifoidea 3 

Casos  de  orquitis 1 

Casos  de  uncinariasis 4 

Casos  de  febrícula 2 

Total  de  enfermos  no  inmunes 10 

Enfermeras  y  sirvientes 5 

inmigrantes  jóvenes 12 

Total  general  de  personas  no  inmunes 27 

De  estos  27  individuos  no  inmunes  solamente  6  fueron  atacados  por  la  fiebre,  y  fueron 
precisamente  los  6  en  quienes  se  expeiimentó  la  inoculación  por  medio  de  las  picaduras 
de  mosquitos  infectados  ad  hoc  en  un  caso  grave  de  fiebre  amarilla. 

Aún  nos  queda  por  estudiar  el  caso  que  aparece  en  la  columna  de  importados  durante  el 
mes  de  agosto  en  nuestro  primer  cuadro.  Veamos  si  el  enfermo  pudo  ser  la  causa  de  la 
pequeña  epidemia  de  seis  casos  durante  el  mes  de  agosto  en  el  Hospital  de  Las  Animas. 
Ingresó  el  6  de  agosto  procedente  del  vapor  Monterrey,  de  Méjico.  Según  nuestro  conoci- 
miento de  la  etiología  de  la  fiebre  amarilla,  este  caso  importado  no  pudo  haber  producido  la 
pequeña  epidemia  en  cuestión.  El  paciente  fué  admitido  el  6  de  agosto,  y  la  epidemia 
empezó  solamente  cinco  días  después,  el  11.  El  período  del  desarrollo  del  parásito  de  la 
fiebre  amarilla  es  de  diez  días,  por  lo  menos,  en  el  mosquito  y  dos  en  el  hombre,  haciendo  un 
total  de  doce  días.  No  se  diga  que  este  período  de  incubación  etiológica  se  observa  solamente 
en  las  inoculaciones  experimentales,  porque  sabemos  que  algún  tiempo  antes  de  las  demos- 
traciones terminantes  de  la  Comisión  del  Ejc'rcito  de  los  Estados  Unidos  el  Doctor  Carter 
había  ya  llamado  la  atención  al  hecho  de  que  debe  pasar  un  período  de  doce  días  ó  más  antes 
de  la  introducción  de  un  caso  de  fiebre  amarilla  y  del  desarrollo  de  los  casos  subsiguientes. 

Es  evidente,  por  lo  tanto,  que  la  iníección  en  el  Hospital  de  Las  Animas  estaba  contenida 
en  el  jarro  cubierto  de  gaza  en  que  estaban  encerrados  los  mosquitos  contaminados.  Cuando 
se  suspendió  la  aplicación  de  estos  insectos  á  los  no  inmunes,  cesó  también  la  pequeña 
epidemia  en  el  hospital.  Algunas  semanas  más  tarde  fué  necesario  produch-  vm  nuevo 
caso  para  demostrar  la  falsedad  de  cierto  virus,  y  con  este  fin  se  extrajo  un  mosquito  del 
jarro  y  se  le  aplicó  á  un  individuo  susceptible,  produciéndose  la  fiebre  amarilla. 

Más  tarde  el  Doctor  Carroll  necesitó  otro  caso  para  hacer  experimentos  con  suero  filtrado, 
y  se  produjo  con  el  mismo  procedimiento.  La  epidemia  local  en  el  Hospital  de  Las  Animas 
fué,  por  lo  tanto,  hecha  ó  deshecha  con  sólo  abrir  ó  cerrar  el  jarro  que  contenía  los  mosquitos 
contaminados. 


444  SEGUNDA   CONFERENCIA    SANITARIA   INTERNACIONAL. 

Desde  entonces  sólo  hemos  tenido  en  Las  Animas  casos  importados,  á  saber: 

De  septiembre  á  diciembre  de  1901 2 

En  1902 7 

En  1903 r 10 

En  1904 2 

En  Enero  de  1905 3 

Total. . ., 24 

No  cabe,  pues,  la  menor  duda  que  el  sistema  de  profilaxis  empleado  en  el  mencionado 
hospital  ha  tenido  éxito,  porque  durante  el  tiempo  en  que  se  trataron  esos  24  casos, 
teníamos  en  las  salas  otros  muchos  enfermos  de  distintos  males,  y  la  mayoría  de  ellos  era 
no  inmune.  Y,  con  todo,  sin  más  aislamiento  que  la  sepai'ación  por  medio  de  canceles  de 
tela  metálica,  la  enfermedad  no  pudo  propagarse  nunca. 

Según  las  antiguas  teorías  este  hospital  debía  ser  un  pestilente  foco  de  infección  de  la 
fiebre  amarilla.  Nunca  se  empleó  en  él  desinfección  alguna,  en  el  sentido  ordinario  de  la 
palabra,  contra  el  mal  que  nos  ocupa:  y  con  bastante  íreciiencia  los  parientes  no  inmunes 
de  los  enfennos  de  fiebre  amarilla  se  quedaban  con  ellos  en  sus  mismos  cuartos  durante  el 
ataque.  Médicos  americanos  y  europeos  que  no  son  inmunes  van  con  frecuencia  á  visitar 
las  salas  y  los  enfermos  del  hospital.  Un  número  de  congresistas,  miembros  de  la  AsociaT 
ción  Americana  de  Sanidad  Pública,  que  asistieron  á  la  conferencia  que  se  celebró  en  La 
Habana  en  enero  último,  visitaron  los  3  casos  que  entonces  teníamos  en  el  hospital 
importados  de  Colón.  En  el  laboratorio  de  esta  institución  se  examinan  la  sangre  y  el 
excremento — nunca  desinfectados — de  los  casos  de  fiebre  amarilla;  el  practicante  que  hace 
esta  operación  y  que  se  acerca  á  los  enfermos  para  sacar  esas  sustancias,  no  es  inmune.  Las 
autopsias  se  hacen  en  el  mismo  laboratorio  y  con  la  ayuda  del  mismo  practicante.  Las 
dos  últimas  necropsias  se  hicieron  á  presencia  de  siete  miembros  de  la  Asociación  Americana 
de  Sanidad  PúbUca,  los  cuales  no  eran  imnunes. 

En  el  mismo  laboratorio  todavía  uso,  para  tapar  los  jarros  en  dojide  criamos  los  mosqui- 
tos, las  mismas  fundas  de  gaza  que  se  emplearon  con  el  mismo  fin  durante  la  epidemia  de 
1900.  Estas  fundas  han  pasado  por  las  manos  de  muchos  pacientes  de  fiebre  amarilla. 
Nunca  las  he  mandado  lavar,  sino  que,  por  el  contrario,  las  he  conservado  sucias  para  que 
sirvan  como  ejemplares  de  fomes. 

Así,  pues.  ¿No  podemos  afirmar,  sin  temor  á  contradecirnos,  que  en  el  antiguo  hogar  de 
la  fiebre  amarilla  se  dan  toda  clase  de  facilidades,  con  excepción  del  mosquito  infectado, 
para  la  propagación  de  la  enfermedad? 

No  necesito  repetir  aquí  los  detalles  del  sistema  preventivo  establecido  en  La  Habana. 
Pueden  verse  en  los  trabajos  de  nuestra  última  conferencia. 

El  mismo  sistema  de  defensa  se  ha  establecido  en  otros  puertos  de  la  Kepública,  y  en 
donde  quiei'a  que  se  observa  una  rotura  amenazante  en  las  defensas,  todos  los  medios  de  la 
Junta  Superior  de  Sanidad  y  de  la  Cuarentena  Marítima  se  concentran  en  el  punto  débil. 
Hace  poco  se  ha  dado  ejemplo  de  ello  en  Santiago,  en  donde  por  la  primera  vez  desde  1901 
la  fiebre  amarilla  consiguió  romper  nuestras  defensas,  ocasionando  dos  casos.  El  primero 
fué  el  de  S.  A.  Fuller,  natural  de  los  Estados  Unidos,  que  c&j6  enfermo  el  18  de  octubre 
del  año  pasado  en  Punta  de  Sal,  en  la  Bahía  de  Santiago.  Hacía  veinticuatro  días  que  Mr. 
Fuller  estaba  en  la  isla  cuando  so  enfermó.  Por  lo  tanto  tuvimos  que  iiacer  la  deducción 
que  se  había  contaminado  en  Santiago  ó  en  Punta  de  Sal,  los  únicos  sitios  que  había  visitado 
durante  los  cinco  días  anteriores  al  en  que  cayó  enfermo.  Mi  Gobierno  me  ordenó  que 
investigara  este  gi-avisímo  caso,  y  deduje  la  consecuencia  de  que  el  foco  de  infección  debía 
estar  en  Punta  de  Sal,  porque  las  fechas  de  las  visitas  de  Mr.  Fuller  eran  muy  próximas  ó 
muy  lejanas  á  de  su  ataque  para  caer  dentro  de  los  límites  del  período  de  la  incubación. 
Afortunadamente  encontré  que  las  condiciones  en  Punta  de  Sal  eran  favorables  para  el 
aislamiento  del  enfermo  y  para  la  observación  de  todos  aquellos  que  pudieran  habei  estado 
expuestos  á  la  infección.  El  sitio  en  cuestión  está  á  unas  3  millas  de  distancia  de  San- 
tiago por  mar.  Fué,  por  lo  tanto,  fácil  detener  á  los  no  inmunes  é  impedir  que  fueran  á 
nuevos  focos  de  infección.  Los  individuos  así  detenidos  pudieron  ser  protejidos  contra  la 
contaminación  mediante  el  rápido  exteiTninio  de  todos  los  mosquitos  que  había  en  los 
hogares.  Lmiediatamente  se  fumigaron  todos  los  edificios  y  conseguimos  limitar  la  propa- 
gación á  un  caso  secundario.  El  enfenno  fué  trasladado  al  Hospital  de  Aislamiento,  que 
está  situado  en  una  de  las  islas  de  la  Bahía,  y  se  le  rodeó  de  canceles  tan  pronto  como  se 
hizo  el  diagnóstico.  En  el  hospital  el  paciente  estaba  rodeado  de  personas  no  inmunes. 
No  sabemos  cómo  se  introdujo  la  infección.  Claro  está  que  no  puede  haber  más  que  dos 
medios,  á  saber,  que  se  introdujo  en  Punta  de  Sal  un  caso  sin  diagnosticar,  ó  que  un 
mosquito  contamiíado  llegara  en  un  vapor  procedente  de  un  puerto  infectado.  En  el 
primer  ejemplo,  debemos  suponer  que  fué  un  caso  sumamente  leve  que  pasó  desapercibido: 
pero  contra  esta  suposición  existe  la  objeción  de  que  si  el  paciente  no  fué  reconocido  tuvo 
que  ser  tratado  sin  ningunas  precauciones  y  por  lo  tanto  debiera  haber  infectado  un  número 


SEGUI'JDA    CONFERENCIA    tíANlTAKIA    INTEKNACJONAJ.,  445 

-considorablo  do  mosíjuitos,  y  ol  resultado  hubiera  nido  la  aparición  siuiiiltánea  de  varifw  casos 
al  misino  tiempo  que  el  de  Fuller.  Así  pues,  irio  iii(;l¡no  á  aceptai'  la  segunda  suposición, 
es  decir,  la  importación,  cu  un  bucjuo,  de  un  nio.sfiuito  iiilcctado,  y  si  fueron  má-s  de  uno, 
no  serían  muchos,  porque  todos  parecieron  sin  pi'oducir  más  que  un  caso,  el  de  Fuller.»  Se 
diagnosticó  este  caso  al  tercer  día  después  del  ata(|ue.  Fué  por  lo  tanto  necesario  extermi- 
nar los  mosquitos  que  durante  estos  tres  días  picaron  á  Mr.  Fuller,  cuyos  tres  días  consti- 
tuyeron el  período  del  peligro.  AfoitunadameJíte  teníamos  todavía  ocho  ó  nueve  días  para 
llevar  á  cabo  el  exterminio  antes  de  (jue  los  mosquitos  j)udieran  empezar  á  ti-nsrnitir  la 
infección.  Tan  bien  se  aprovechó  este  tiempo  que  sólo  ocurrió  un  caso  secundario,  e!  de 
Mr.  Salter,  que  cayó  enfermo  el  1.°  de  novitimbre.  Con  ésto  se  extinguió  el  pequeíio  conato 
de  epidemia.  Ya  se.  habían  destruido  todos  los  mosquitos  que  había  en  el  Hospital  de 
Aislamiento  do  Key  Duan,  cuando  Mr.  Fuller  y  Mr.  Saltei-  fueron  dados  de  alta. 

Aún  hubo  otro  serio  conato  de  invasión  do  la  fiebre  amarilla,  en  cuya  ocasión,  como  en 
la  que  acabo  do  relatar,  las  medidas  que  so  pusieron  en  práctica  fnei'on  una  prueba  más 
de  la  verdad  de  los  principios  en  que  se  basa  nuesti'o  sistema  de  defensa.  En  julio  de  1903, 
un  pasajero  del  vapor  Vigilancia,  procedente  de  México,  valiéndose  de  un  falso  certificado 
de  inmunidad,  consiguió  evadir  imestra  inspección  de  cuarentena  en  La  Habana.  Este 
individuo  se  alojó  en  el  No.  29  de  la  Calle  Inquisidor,  en  donde  paso  las  primeras  48  horas 
de  su  ataque,  y  en  cuya  casa  había  un  gran  número  de  huéspedes  no  inmunes.  Entonces 
pidió  que  se  le  trasladara  á  un  hospital  y  al  ingresar  en  el  de  Las  Mercedes  enseguida  cono- 
cieron la  naturaleza  de  su  enfermedad,  enviándosclo  entonces  inmediatamente  al  de  Las 
Animas.  Las  medidas  profilácticas  que  se  tomaron  en  este  caso  consistieron  en  el  extermi- 
nio, por  medio  de  la  fiunigación  con  polvos  do  piretrina,  de  todos  los  mosquitos  que  había 
alrededor  de  la  casa  de  la  Calle  Inquisidor  y  del  Hospital  Mercedes.  Se  hizo  una  lista  de 
todas  las  personas  no  imnunes  que  residían  entonces  en  estos  locales:  se  les  tomaba  la 
temperatura  dos  veces  al  día  con  el  fin  de  descubrir  los  primeros  síntomas  de  una  raanisfesta- 
ción  secundaria.  Gracias  á  las  diligentes  medidas  que  se  tomaron,  el  mal  no  pudo  propa- 
garse. 

Para  terminar,  Señores  Delegados,  les  ruego  una  vez  más  que  contemplen  por  un  momento 
el  cuadro  representado  en  la  primera  parte  de  este  documento;  la  agonía  de  una  gran 
enfermedad  epidémica.  ¡  Que'satisfacción  tan  grande  es  el  haber  sido  testigo  de  los  últimos 
momentos  de  tan  temido  mal;  el  haber  presenciado  los  resultados  de  la  obra  de  Reed, 
Lazear,  Carroll  y  Agramonte!  Esta  es  la  primera  vez  que  en  la  historia  de  la  medicina  se 
registra  un  suceso  tan  importante  como  el  que  estamos  viendo:  la  agonía  y  la  extinción 
para  siempre  de  una  plaga  que  tanto  se  había  extendido  y  que  había  echado  raíces  tan  pro- 
fundas. 

Si  nuestra  satisfacción  al  comtemplar  este  hecho  es  tan  grande,  jcuánto  más  grande  será 
la  del  hombre  que,  mediante  un  esfuerzo  de  inteligencia,  que  no  tiene  igual  en  la  historia 
del  pensamiento  humano,  hizo  posible  todos  estos  hechos  y  este  gran  beneficio? 


INDICACIONES  SUGERIDAS  POR  EL  DR.  A.  H.  DOTY,  FUNCIONARIO 
DE  SANIDAD  DEL  PUERTO  DE  NUEVA  YORi^:. 

[Carta  de  remisión.] 

"Estado  de  Nueva  York, 
"Departamento  del  Funcionario  de  Sanidad, 
"Cuarentina,  Long  Island,  9  de  Octubre  de  1905. 
"Querido  Doctok  Wyman:  Por  ahora  no  puedo  decirle  cuándo  llegaré  á  Washington, 
lo  cual  siento  en  el  alma.     Diariamente  llegan  vapores  procedentes  de  distritos  infectados 
de  fiebre  amarilla  y  peste  bubónica,  y  por  varias  razones  deseo  estar  piesente  cuando 
llegan.     Con  ésta  le  envío  algunas  indicaciones  relativas  á  inspección  de  cuarentena,  etc., 
los  cuales  desearía  que  presente  Vd.  á  la  Convención,  si  Vd.  lo  cree  conveniente.     He  hecho 
este  documento  todo  lo  breve  posible,  y  espero  que  recibirá  su  aprobación. 
"Afectuosamente, 

(firmado)         "A.  H.  Doty." 

(1)  Los  métodos  de  inspección  comunmente  empleados  en  las  estaciones  de  cuarentena 
de  en  todo  el  mundo  son  inadecuados  para  descubrir  la  existencia  de  casos  benignos,  ambu- 

a  Desde  entonces  he  visto  prueba  de  la  existencia  de  un  solo  mosquito  infectado  á  bordo 
de  un  buque.  Los  individuos  de  la  tripulación,  del  barco  á  q'ue  pie  refiero  fueron  enfer- 
mándose uno  tras  otro  en  intervalos  de  tres  ó  cuatro  días,  que  es  el  espacio  de  tiempo  que 
necesita  el  mosquito  para  digerir  su  alimento  de  sangre  y  disponerse  para  volver  á  picar. 
Si  hubiera  habido  más  de  un  mosquito  los  casos  hubieran  sido  simultáneos  ó  hubieran 
ocurrido  á  intervalos  más  breves. 


446  SEGUNDA    CONFERENCIA    SANITARIA    INTERNACIONAL. 

lantes  6  do  reconocidos  de  enfermedades  contagiosas,  las  que  en  lo  relativo  á  la  salud 
pública  constituyen  uno  de  los  enemigos  más  peligrosos  con  que  tenemos  que  combatir. 

(2)  Se  depende  demasiado  en  la  expiración  del  período  de  incubación  de  la  fiebre  amarilla 
para  determinar  el  plazo  en  que  deben  estar  detenidos  los  pasajeros  que  1  egan  de  puertos 
contaminados. 

(3)  La  falta  do  apreciación  de  la  necesidad  de  descubrir  casos  benignos  6  ambulantes  y  la 
frecuencia  con  que  esos  casos  son  causa  de  aitaques  del  mal,  cuyo  origen  es  desconocido,  han 
contribuido  grandemente  al  apoyo  de  la  teoría  de  que  los  cargamentos  de  buques  son  con 
frecuencia  vehículos  de  infección,  lo  cual  no  es  cierto. 

(4)  La  propagación  de  la  fiebre  amarilla  j  la  peste  bubónica,  asi  como  de  otras  enferme- 
dades contagiosas,  es  comvmmente  debida  á  la  costumbre  de  algunos  funcionarios  de  sanidad 
pública  de  ocultar  y  no  dar  aviso  de  los  primeros  casos  que  caen  bajo  su  observación. 
Esta  costumbre,  no  solamente  es  causa  frecuente  de  pérdidas  innecesarias  de  vidas,  sino  que 
también  está  en  pugna  con  la  higiene  moderna,  la  cual  exige  que  se  ponga  en  conocimiento 
del  público  toda  irrupción  de  enfermedad  infecciosa,  particularmente  las  de  carácter 
formidable.  De  esta  manera  se  obtiene  la  confianza  y  la  cooperación  públicas,  las  cuales  sir- 
ven de  mucho  para  contrarrestar  esas  irrupciones. 

Las  conclusiones  que  anteceden,  las  presento  como  el  resultado  de  mi  experiencia  como 
funcionario  de  sanidad  pública,  y  creo,  como  3'a  he  dicho,  que  los  métodos  de  inspección  de 
cuarentena  que  comunmente  se  emplean  ahora,  por  general  no  son  lo  suficientemente  ade- 
cuados para  descubrir  la  presencia  de  casos  benignos,  ambulantes  ó  no  reconocidos — 
cuestión  de  suma  importancia.  La  circunstancia  de  que  un  buque  procedente  de  un  puerto 
infectado  de  fiebre  amarilla  ha  empleado  en-  el  viaje  cinco  días,  y  que  los  que  están  á  su 
bordo  pueden  comparecer  ante  el  inspector  médico  y  decir  que  están  bien,  presentando  una 
apariencia  que  tiende  á  corroborar  sus  declaraciones,  no  es  en  manera  algima  prueba  con- 
cluyente  de  que  alguno  de  los  pasajeros  no  está  afectado  del  mal.  Esta  misma  teoría  es 
aplicable  al  examen  de  los  que  llegan  de  un  puerto  infectado  de  peste  bubónica.  Por  más 
que  deseo  creer  que  cinco  días  es  en  la  mayoria  de  los  casos  el  periodo  máximo  de  incubación 
de  la  fiebre  amarilla,  tengo  la  convicción  de  que  en  muchos  casos  la  enfermedad  puede  pa- 
sarse desapercibida  durante  el  período  de  invasión,  ó  después  ó  durante  la  enfermedad,  si  el 
caso  es  benigno.  Y  además,  si  una  persona  no  presenta  síntomas  del  iiial  hasta  después 
del  sexto  ó  séptimo  día  después  de  la  fecha  de  su  salida  de  un  puerto  contaminado  con  fiebre 
amarilla,  no  quiere  decir  que  ha  sido  infectado  por  mosquitos  á  bordo,  porque  puede  haber 
estado  sufriendo  del  mal  dos  ó  tres  días  antes  de  que  se  hubiera  descubierto.  Desgraciada- 
mente se  admiten  en  los  puertos  casos  benignos  ó  ambulantes  de  peste  bubónica,  y  ello  es 
debido  mayormente  al  hecho  de  que  solamente  los  casos  graves  y  típicos  son  vigilados, 
pasando  desapercibidos  los  benignos.  Más  de  las  dos  terceras  partes  de  los  casos  de  peste 
bubónica  que  han  llegado  á  la  estación  de  cuarentena  de  Nueva  York  han  sido  de  carácter 
benigno  y  hubieran  pasado  desapercibidos  ante  el  examen  visual  ordinario.  Solamente  se 
descubrieron  después  de  un  examen  de  las  glándulas  superficiales  del  cuerpo  y  de  tomarse  la 
temperatura  de  los  que  estaban  en  observación. 

De  los  6  casos  de  fiebre  amarilla  que  durante  el  presente  año  han  llegado  á  esta  estación, 
3  pudieron  presentarse  para  la  inspección  y  hubieran  pasado  desapercibidos  Se  descubrió 
su  estado  por  el  uso  del  termómetro  principalmente.  Además  los  buques  en  que  vinieron 
estos  casos  habían  empleado  seis  días  en  el  viaje.  Puedo  añadir  que  después  que  las  personas 
á  que  me  refiero  fueron  trasladadas  al  hospital,  admitieron  francamente  que  sentían  calo- 
fríos, ó  que  habí  an  estado  enfermas  dos  ó  tres  días  antes  de  su  llegada.  No  hay  duda  que  el 
desapercibimiento  de  los  casos  benignos  ó  no  reconocidos  ha  sido  causa  de  muchas  irrupcio- 
nes de  enfermedades  contagiosas,  cuyo  origen  se  atribuye  á  otras  fuentes.  Casos  benignos 
de  peste  bubónica  que  han  pasado  desapercibidos  en  un  puerto  puede  llevar  la  infección  á 
otro,  y  este  hecho  ha  apoyado  en  grande  escala  la  teoría  de  que  las  ratas  son  comunmente  el 
vehículo  de  infección  de  este  mal.  Por  más  que  no  hay  duda  que  este  roedor  trasmite  la 
peste  bubónica,  yo  creo  que  se  exagera  la  frecuencia  con  que  ésto  sucede,  y  que  tarde  ó  tem- 
prano nos  convenceremos  de  que  tal  es  el  caso.  Además,  no  se  dá  suficiente  atención  á  la 
aparición  de  casos  irregulares  á  bordo  de  buques,  particularmente  de  los  que  vienen  de 
puertos  infectados.  Se  dice,  de  buena  tinta,  que  el  primer  caso  que  hace  poco  apareció  en 
Hamburgo  fué  admitido  en  el  hospital  como  un  ca,so  de  puhnonía,  no  averiguándose 
verdadero  carácter  de  la  enfermedad  hasta  algún  tiempo  después.  También  pueden  ocurrir 
complicaciones  que  pueden  despistar  ó  encubrir  la  presencia  de  una  enfermedad  contagiosa. 
Casos  de  esta  naturaleza  han  caído  con  frecuencia  bajo  mi  observación. 

Creo  que  si  el  termómetro  íaiera  cuidadosa  y  científicamente  usado  sería  uno  de  los  medios 
más  valiosos  para  descubrir  la  existencia  de  casos  benignos  ó  no  reconocidos. 

A  mi  juicio  es  de  suma  iniportancia  el  que  esta  Convención  tome  un  acuerdo  para  que  las 
distintas  naciones  hagan  lui  convenio  en  el  que  se  estipule  la  notificación  inmediata  de  las 
irrupciones  de  enfermedades  contagiosas.  Ello  constituiría  uno  de  los  medios  más  eficaces 
para  impedir  la  trasmisión  de  enfermedades  infecciosas  y  sería  una  valiosa  ayuda  para  la 
conservación  de  la  salud  pública. 


SEGUNDA    CONFERENCIA    HANITAIIIA   INTERNACIONAL.  447 

AliOCUCldN  aUE  PRONUNCIÓ  EL  PRESIDENTE  ROOSEVELT  EN 
LA  OFICINA  EJECUTIVA  CUANDO  LOS  MIEMBROS  DE  LA 
SEGUNDA  CONVENCIÓN  SANITARIA  INTERNACIONAL  FUERON 
A  VISITARLE  EN  EL  12  DE  OCTUBRE  DE   1905. 

De.  Wyman,  Señores  y  SeSoras  de  la  Convención:  Saludóles  y  dóykn  la  bienvenida 
con  especial  placer,  tanto  por  la  piolesitín  que  representáis  como  porque  venís  de  nuestras 
hermanas  llepúblicas  de  la  Amdrica. 

Creo  que  nosotros,  los  de  este  Hemisferio,  vamos  á  demostrar  al  mundo  entero  que 
nacionas  separadas  pueden  unirse  para  trabajar  en  perfecta  armonía  y  en  un  csiucrzo  común, 
como  están  Vds.  unidos  ahora,  para  el  mejoramiento  de  las  condiciones  que  afectan  á  todas 
ellas.        ' 

El  mundo  exterior  está  empezando  solamente  á  apreciar  el  asombroso  progreso  hecho  por 
las  Repíiplicas  do  Centro  y  Sur  América,  no  sólo  social  é  industrialmente,  sino  también  en  las 
ciencias,  artos  y  literatura.  En  asuntos  médicos,  industriales,  científicos,  sociales  ó  artísticos, 
cada  uno  de  nuestros  paises  tiene  algo  nuevo  que  aprender  de  los  otros;  y  les  doy  la  bien- 
venida como  colegas  y  maestros. 

Claro  está  que  no  puedo  exagerar  la  suprema  importancia  de  la  profesión  médica  en  la  vida 
moderna  y,  como  la  que  está  empezando  á  adquirir,  en  la  internacional.  En  los  tiempos  de 
antaño,  cuando  una  epidemia  azotaba  un  país  se  consideraba  que  solamente  afectaba  á  ese 

f)ais,  hasta  que  se  propagaba  á  algún  otro  indefenso  contra  ella.     Ahora  reconocemos  que 
a  extirpación  de  enfermedades,  la  guerra  contra  las  condiciones  antihigiénicas,  debe  hacerse 
por  el  esfuerzo  organizado  de  la  profesión  médica  de  todas  las  naciones  unidas. 


lí^DEX 


Address  of:  Page. 

Doctor  Gatewood 93 

Doctor  Geddings,  at  closing  of  convention 92 

Doctor  Guiteras,  at  close  of  convention 91 

«   Doctor  McCaw,  at  closing  of  convention 92 

Doctor  Medina,  at  closing  of  convention 95 

Doctor  Moore,  at  close  of  convention 90 

Doctor  Stiles 96 

Doctor  Ulloa,  at  close  of  convention 90 

Doctor  Wyman — 

At  closing  of  convention 97 

Opening  remarks 7 

Hon.  Gonzalo  de  Quesada,  minister  of  Cuba 12 

Hon.  Horace  A.  Taylor,  Assistant  Secretary  of  the  Treasury 10 

Hon.  Williams  C.  Fox,  Director  of  the  Bureau  of  the  American  Republics 14 

President  Roosevelt 228 

Secretary  Root 9 

Doctor  Joubert,  at  closing  of  convention 191 

Advisory  council: 

Committee  on  organization  continued  as 22 

Nomination  of  vice-presidents  referred  to 22 

{See  also  Committee  on  organization.) 

.ffitiologic  naming  of  diseases,  remarks  on,  by  Doctor  Johnson 271 

Alcivar,  Dr.  Miguel  H.: 

Delegate  of  Ecuador '. 13 

Report  from 154 

Anderson,  Dr.  J.  F.,  privileges  of  the  floor  extended  to 24 

Appendix 101 

Ai'my  Medical  School,  president  of,  privileges  of  the  floor  extended  to 15 

Army  of  the  United  States,  Surgeon-General  of: 

Privileges  of  the  floor  extended  to 15 

Vote  of  thanks  to 63 

Bailhache,  surgeon,  Preston  H.,  privileges  of  the  floor  extended  to 15 

Bankers'  Association  of  the  District  of  Columbia,  vote  of  thanks  to 88 

Barnet,  Dr.  Emñque  B.: 

Delegate  of  Cuba 14 

Report  ft'om 117 

Carroll,  Dr.  James: 

Letter  from 29 

Privileges  of  the  floor  extended  to 23 

Remarks  of,  at  closing  of  convention 96 

ChUe: 

Report  from  Doctor  Moore 115 

Representation  of,  in  convention 13 

Committee  on  organization: 

Advisory  council 22 

Members  of 15, 24 

{See  also  Advisory  council.) 

1112a— 06 -29  449 


450  INDEX. 

fSlgQ. 

Convention  concluded  at  the  conference.     (See  Sanitary  convention  of  1905.) 

Convocation  of  the  convention 5 

Cosmos  Club,  vote  of  thanks  to 88 

Costa  Rica: 

Report  from  Doctor  UUoa 116 

Representation  of,  in  convention 13 

Cuba: 

Sanitary  ordinances  of 117 

Report  ft'om  Doctor  Barnet 117 

Report  from  Doctor  Gaiteras  on  yellow  fever  in 2n7 

Representation  of,  in  convention 13 

Resolution  extending  congratulations  of  convention  to 85 

Delegates,  list  of 13 

Disinfection  of  vessels  and  baggage,  regulations  governing,  in  Ecuador 155 

Dominican  Republic: 

Report  from  Señor  Joubert 191 

Representation  of,  in  convention 13 

Doty,  Dr.  A.  H.,  health  officer  of  the  port  of  New  York,  suggestions  by 221 

Ecuador: 

Regulations  for  the  disinfection  of  vessels  and  baggage 155 

Regulations  governing  the  sanitary  station  at  Puna 156 

Report  from  the  delegates  of 154 

Representation  of,  in  convention 13 

Epidemics,  resolution  recommending  management  of,  by  national  health  authorities.  85 

Fox,  Hon.  Williams  C,  Director  of  the  Bureau  of  the  American  Republics: 

Remarles  by,  at  opening 14 

Remarks  by,  at  closing  of  convention 97 

Vote  of  thanks  to 88 

Fulton,  Dr.  John  S.: 

Delegate  of  the  United  States 13 

Report  from. 193 

Gatewood,  Dr.  J.  D.: 

Delegate  of  the  United  States 13 

Member  of  committee  on  organization 24 

Remarks  by,  at  closing  of  convention 93 

Geddings,  Dr.  H.  D.: 

Delegate  of  the  United  States 13 

Member,  committee  on  organization 15 

Remarks  at  closing  of  convention 92 

Report  from 192 

Statement  regarding  the  International  Sanitaiy  Convention  of  Paris 19 

Goode,.  Dr.  Rhett,  letter  from 26 

Guatemala: 

Report  from  Doctor  Yela 158 

Representation  of,  in  convention 13 

Guiteras,  Dr.  Juan: 

Delegate  of  Cuba 13 

Addi'ess  at  close 91 

Member,  committee  on  organization 15 

Report  by,  on  the  yellow  fever  in  Cuba 217 

Resohitions  presented  by 85 

Howard,  Dr.  L.  O.: 

Privileges  of  the  floor  extended  to 23 

Remarks  by,  on  the  distribution  of  the  yellow-fever  mosquito 214 


INDEX.  451 

Page. 

Hunt,  Dr.  Eeid,  privileges  of  the  iioor  extended  to 16 

International  Sanitary  Bureau,  continued  as  constituted 43 

International  Sanitary  Conference  of  Paris,  outline  of,  by  Doctor  Geddings 19 

International  Sanitary  Convention: 

Third,  to  be  held,  when 16 

To  be  hold  every  two  yoai's lo 

{See  also  Sanitary  convention  of  1905.) 

Johnson,  Dr.  H.  L.  E.: 

Delegate  of  the  United  States 13 

Remarks  by,  at  closing  of  convention 93 

Romacks  by,  on  the  ietiologic  naming  of  diseases 217 

Joubert,  Señor  Don  Emilio  C: 

Delegate  of  Santo  Domingo 13 

Remarks  by,  at  closing  of  convention 192 

Report  from 191 

Kennedy,  Dr.  J.  F.: 

Delegate  of  the  United  States 13 

Letter  ft'om 29 

Kober,  Dr.  George  M.,  privilege  of  floor  extended  to f 14 

Lavoreria,  Dr.  Eduardo: 

Delegate  of  Peru 13 

Report  ft'om 175 

Licéaga,  Dr.  Eduardo: 

Delegate  of  Mexico - 13 

Member,  committee  on  organization 15 

Paper  read  by,  in  accordance  with  the  scientific  programme Ill 

President  of  Third  International  Sanitary  Convention,  nomination 16 

Report  from 160 

List  of  delegates. 13 

List  of  officers  of  the  convention 3 

Marchoux  and  Simon,  discussions  regarding  statement  made  by 72-77 

McCaw,  Dr.  Walter  D.: 

Delegate  of  the  United  States 13 

Member,  committee  on  organization 15 

Remarks  by,  at  closing  of  convention 92 

Medina,  Dr.  J.  L.: 

Delegate  of  Nicaragua 13 

Remarks  of,  at  closing  of  convention 95 

Report  from 174 

Resolution  presented  by 72 

Mexico: 

Paper  read  by  Doctor  Licéaga  in  accordance  with  the  programme Ill 

Report  from  Doctor  Licéaga 160 

Representation  of,  in  convention 13 

Resolution  extending  congratulations  of  convention  to 85 

Moore,  Dr.  Eduardo: 

Delegate  of  Chile 13 

Addi'ess  at  close .' . .  90 

Member,  committee  on  organization 15 

Report  from 115 

Navy  Medical  School,  president  of,  privileges  of  the  floor  extended  to 15 

Navy  of  the  United  States,  Surgeon-General  of,  privileges  of  the  floor  extended  to  .  15 

Nicaragua: 

Report  ft'om  Doctor  Medina 175 

Representation  of,  in  convention 13 


452  INDEX. 

i'age 

OEBcers  of  the  convention,  list  of 3 

Ordinances,  sanitary,  of  Cuba 117 

Panama  Canal  Zone,  resolution  extending  congratulations  of  convention  to 85 

Paris,  International  Sanitar}^  Conference  of,  outline  of,  by  Doctor  Geddings 19 

Paris,  Sanitary  Convention  of.     {See  Sanitary  Convention  of  Paris.) 
Peru: 

Report  ñoñi  Doctor  Lavoreria 175 

Representation  of,  in  convention 13 

PharmacopcEia  of  the  United  States,  resolution  regarding 30 

Press  of  the  city  of  Washington,  vote  of  thanks  to 88 

Programme  of  the  convention 6 

Public  Health  and  Marine-Hospital  Service,  resolution  extending  congratulations  of 

convention  to '. 85 

Quarantine,  maritime,  resolution  recommending  management  of,  by  national  health 

authorities 85 

Quesada,  Hon.  Gonzalo  de,  minister  of  Cuba: 

Remarks  by 12 

Vote  of  thanks  to 88 

Regulations  governing  disinfection  of  vessels  and  baggage  in  Ecuador. '. 155 

Reports  from  the  delegates,  reading  of 23,  25 

{See  also  the  appendix,  page  101.) 

Requena  Bermudez,  Señor  P.,  report  from 195 

Resolutions  adopted  by  the  convention 16, 30, 72,  85, 87,  88 

Roosevelt,  Hon.  Theodore,  President  of  the  United  States: 

Remarks  of,  to  members  of  convention 228 

Vote  of  thanks  to 88 

Root,  Hon.  Elihu,  Secretary  of  State: 

Address  of  welcome  by 9 

Vote  of  thanks  to 88 

Sanitary  Convention  of  1905: 

Adoption  of 84 

Discussion  of  additional  articles 77-84 

Discussions  on 33-64, 66 

Signing  of 89 

Text  of 103 

Sanitary  Convention  of  Paris  of  1903,  discussions  on  the  adoption  of 33-68 

Sanitary  station  at  Puna,  Ecuador,  regulations  governing 156 

Stegomyia  fasciata.     {See  Yellow  fever.) 

Sternberg,  Surgeon-General  George  M.,  U.  S.  Army  (retired),  privileges  of  the  floor 

extended  to 15 

StUes,  Dr.  Ch.  Wardell: 

Address  by,  at  closing  of  convention 96 

Privileges  of  the  floor  extended  to 15 

Subjects  to  be  discussed  at  the  convention.     {See  Progi'amme  of  convention.) 

Surgeon-General,  U.  S.  Army: 

Privileges  of  the  floor  extended  to 15 

Vote  of  thanks  to 63 

Surgeon-General,  U.  S.  Navy,  privileges  of  the  floor  extended  to 15 

Suzuki,  Surgeon-General,  privileges  of  the  floor  extended  to 15 

Taylor,  Horace  A.,  Assistant  Secretary  of  the  Treasmy: 

Address  by 10 

Vote  of  thanks  to 88 

Ulloa,  Dr.  Juan  J.: 

Delegate  of  Costa  Rica 13 

Address  at  close - 90 


INDEX.  453 

)'llK<i. 

Ulloa,  Dr.  Juan  J. — Continued. 

Permanent  secretary  of  the  convention 16 

Report  from 116 

Resolutions  presented  by 88 

Secretary  of  the  convention 15 

Temporary  secretary  of  tlie  convention 13 

Vote  of  thanks 87, 88 

United  States : 

Delegates  of,  vote  of  thanks  to,  by  delegates  of  Spanish-American  Republics 88 

Remarks  by  Doctor  Johnson  on  the  tetiologic  naming  of  diseases 217 

Report  from  Doctor  Fulton 193 

Report  from  Doctor  Geddings 192 

Representation  of,  in  convention 13 

United  States  Pharmacopoeia,  resolution  regarding 30 

Uruguay: 

Report  from  Señor  Requena  Berraudez i 195 

Representation  of,  in  convention 13 

Veloz-Goiticoa,  Señor  Don  Nicolás: 

Delegate  of  Venezuela 13 

Report  fiom 196 

Venezuela: 

National  morbility 212 

Report  from  Señor  Veloz-Goiticoa 196 

Representation  of,  in  convention 13 

Vice-presidents : 

Appointment  of 43 

Nomination  of,  referred  to  advisory  council 22 

Whither,  Señor  Don  Serafín  S.: 

Delegate  of  Ecuador 13 

Report  from 154 

Wood,  Prof.  H.C.: 

Privileges  of  the  floor  extended  to 15 

Remarks  by,  ri  garding  the  United  States  Pharmacopoeia 31 

Woodward,  Dr.  William  C: 

Privileges  of  the  floor  extended  to 15 

Letter  from 29 

Wyman,  Surg.  Gen.  Walter: 

Delegate  of  the  United  States 13 

Opening  remarks  by 7 

President  of  the  convention , 16 

Remarks  by,  at  closing  of  the  convention 97 

Vote  of  thanks  to 88 

Ytla,  Dr.  Joaquin: 

Delegate  of  Guatemala 13 

Report  from 158 

Yellow  fever: 

Additional  articles  relating  to 77 

Mosquito  doctrine,  resolution  confirming 85 

Remarks  on  the  distribution  of  the  mosquito,  by  Doctor  Howard 214 

Report  on,  in  Cuba,  by  Doctor  Guiteras 217 

Resohn  ions  regarding 85 


I  N  I)  I C)  K  . 

Alcivar,  Dr.  Miguel  IJ.:  Pagina. 

Delegado  del  Ecuador 235 

Informo  del 377 

Anderson,  Dr.  J.  F.,  privilegios  de  la  convención  extensivos  al 246 

Apéndice 101 

Aimada  de  los  Estados  Unidos,  Cirujano  General  de  la,  prei:rogativas  de  la  conven- 
ción extensivas  al : 237 

Asociación  de  Banqueros  del  Distrito  de  Columbia,  voto  de  gracias  á  la 308 

Bailhache,  Cirujano  Preston  H.,  prerrogativas  de  la  convención  extensivas  al 237 

Banqueros  del  Distrito  de  Columbia,  Asociación  de,  voto  de  gracias  á  la 308 

Barnet,  Dr.  Enrique  B. : 

Delegado  de  Cuba 235 

Informe  del 335 

Carroll,  Dr.  James: 

Carta  del 251 

Discurso  pronunciado  al  final  de  la  conferencia 315 

Prerrogativas  de  la  convención  extensivas  al 246 

Comisión  de  organización: 

Constituida  como  junta  consultora 245 

Miembros  de  la 238, 247 

(Véase  también  Junta  consultora.) 

Conferencias  sanitarias  internacionales  se  celebrarán  cada  dos  años 239 

Convención  adoptada  por  la  conferencia: 

Acto  de  firmarla 308 

Aprobación 304 

Discusiones 255-283 

Discusión  de  los  artículos  adicionales 297 

Texto 321 

Convención  de  París : 

Descripción  hecha  por  el  Doctor  Geddings 242 

Discusiones  relativas  á  la  adopción  de  la 255-283 

Convocatoria  de  la  convención 227 

Cosmos  Club,  voto  de  gracias  al 307 

Costa  Rica: 

Informe  del  Doctor  UUoa 334 

Representación  de,  en  la  convención 235 

Cuarentenas  marítimas,  resolución  recomendando  que  estén  á  cargo  de  las  autoridades 

nacionales 85 

Cuba: 

Informe  del  Doctor  Barnet 335 

Memoria  del  Doctor  Guiteras  sobre  la  fiebre  amarilla 441 

Ordenanzas  sanitarias 336 

Representación  de,  en  la  convención 235 

Resoluciones  extendiendo  las  felicitaciones  de  la  conferencia  á 305 

455 


456  ÍNDICE. 

Chile:  •  Pagina. 

Informe  del  Doctor  Moore 333 

Representación  ante  la  convención 235 

Delegados,  lista  de 235, 236 

Discurso  del: 

Doctor  Gatewood,  al  final  de  la  conferencia 312 

Doctor  Geddings,  al  final  de  la  conferencia 311 

Doctor  Guiteras,  al  final  de  la  conferencia 310 

Doctor  Johnson,  al  final  de  la  conferencia 313 

Doctor  Medina,  aj  final  de  la  conferencia 314 

Doctor  Moore,  al  final  de  la  conferencia 309 

Doctor  Stiles,  al  final  de  la  conferencia 315 

Doctor  Ulloa,  al  final  de  la  conferencia 310 

Dr.  Wyman — 

Al  final  de  la  conferencia 317 

Alocución  inaugural 229 

Hon.  Gonzalo  de  Quesada,  ministro  de  Cuba 234 

Hon.  Horace  A.  Taylor,  Secretario  Interino  del  Tesoro 233 

Hon.  Williams  C.  Fox — 

Al  final  de  la  conferencia 316 

En  la  inaugm-ación 236 

Presidente  Roosevelt 447 

Secretario  Root 232 

Señor  Joubert,  al  final  de  la  conferencia 415 

Dominicana,  República.     (Véase  República  Dominicana.) 

Doty,  Dr.  A.  il.,  Funcionario  de  Sanidad  del  Puerto  de  Nueva  York,  indicaciones 

sugeridas  por 445 

Ecuador: 

Infomie  de  los  delegados  del 377 

Reglamento  de  la  Estación  Sanitaria 380 

Reglamento  para  la  desinfección  de  buques  y  equipaje 378 

Representación  ante  la  convención 235 

Ejército  de  los  Estados  Unidos,  Cirujano  General: 

Prerrogativas  de  la  convención  exteasivas  al 237 

Voto  de  gracias  al 284 

Epidemias,  resolución  recomendando  que  las  autoridades  nacionales  se  encarguen  de 

combatirlas 305 

Escuela  Médica  Militar,  Presidente  de  la,  prerrogativas  de  la  convención  extensivas  al.  237 
Escuela  Médica  Naval  de  los  Estados  Unidos,  Presidente  de  la,  prerrogativas  de  la 

convención  extensivas  al 237 

Estados  Unidos: 

Del_egados  de,  voto  de  gi-acias  de  los  delegados  hispano-americanos 308 

Farmacopea  de,  resolución  relativa  á  ella 252 

Informe  del — 

Doctor  Fulton 417 

Doctor  Geddings 416 

Observaciones  del  Doctor  Johnson  sobre  la  calificación  etiológica  de  las  enfer- 
medades    441 

Representación  de,  en  la  convención 235 

Farmacopea  de  los  Estados  unidos,  resolución  relativa  á  ella 252 

Fiebre  amarilla:    ;■ 

Artículos  adicionales  relativos  á  la 297 

Declaración  de  Marchoux  y  Simon  sobre  el  modo  de  la  transmisión 292 


ÍNDICE.  457 

Fibre  amarilla — Continued.  Pagina. 

Memoria  do]  Doctor  Guiteras  sobre  la,  en  Cuba 441 

Observaciones  del  Doctor  Howard  sobre  la  distribución  del  mosquito 4.38 

Kesolucioncs  relativas  á  ella 304,  305 

Fox,  Hon.  Williams  C,  Director  de  la  Oficina  de  las  Repúblicas  Americanas: 

Discurso  pronunciado  en  la  inauguración  de  la  conferencia 236 

Discurso  pronunciado  al  final  do  la  conferencia 316 

Voto  de  gracias  al 307 

Fulton,  Dr.- John  S.: 

Delegado  de  los  Estados  Unidos 23-5 

Informe  del 417 

Funcionarios  de  la  convención 22.5 

Gatew^ood,  Dr.  J.  D.: 

Delegado  de  los  Estados  Unidos 23.5 

Discurso  pronunciado  al  final  de  la  conferencia 312 

Miembro  de  la  Comisión  de  organización 247 

Geddings,  Dr.  H.  D.: 

Delegado  de  los  Estados  Unidos 235 

Discurso  pronunciado  al  final  de  la  conferencia 311 

Informe  del 416 

Miembro  de  la  Comisión  de  organización 238 

Observaciones  relativas  á  Convención  Sanitaria  de  París 242 

Goode,  Dr.  Rhett,  Carta  del 248 

Guatemala: 

Informe  del  Doctor  Yela. 381 

Representación  de,  en  la  convención ,  236 

Guiteras,  Dr.  Juan: 

Delegado  de  Cuba 235 

Discu,  so  pronunciado  al  final  de  la  conferencia 310 

Memoria  sobre  la  fiebre  amarilla  en  Cuba 441 

Miembro  de  la  comisión  de  organización 238 

Resoluciones  presentadas  por 264, 304 

Howard,  Dr.  L.  O.: 

Observaciones  sobre  la  distribución  del  Stegomyia  fasciaia 438 

Prerrogativas  de  la  convención  extensi\  as  al 246 

Hunt,  Dr.  Reid,  prerrogativas  de  la  convención  extensivas  al 237 

Informes  de  los  delegados : 

Lectura  de  los 247 

{Véase  también  el  Apéndice,  página  333.) 

Jobnson,  Dr.  H.  L.  E.: 

Delegado  de  los  Estados  Unidos 235 

Discurso  pronunciado  al  final  de  la  conferencia '. .  313 

Observaciones  sobre  la  calificación  etiológica  de  las  enfermedades 441 

Joubert,  Licenciado  Emüio  C. : 

Delegado  de  la  República  Dominicana 236 

Discurso  pronunciado  al  final  de  la  conferencia 415 

Informe  del 414 

Junta  Consultora: 

Comisión  de  organización  constituida  como  tal 245 

Nombramiento  de  los  vice-presidentes,  sometida  á 245 

Kennedy,  Dr.  J.  F.: 

Carta  del 250 

Delegado  de  los  Estados  Unidos ^.  235 


■458  ÍNDICE. 

Pagina. 

Kober,  Dr.  George  M.,  prerreogativas  de  la  convención  extensivas  á 237 

Lavorería,  Dr.  Daniel  Eduardo: 

Delegado  del  Perú 236 

Informe  del 398 

Licéaga,  Dr.  Eduardo: 

Delegado  de  México 236 

Informe  del 384 

Memoria  leída  de  acuerdo  con  el  programa  científico -  -  329 

Miembro  de  la  comisión  de  organización 238 

Presidente  de  la  Tercera  Conferencia  Sanitaria  Internacional 239 

Resolución  concediéndole  la  palabra  para  que  haga  una  memoria  de  interés 

general 239 

Lista  de  los  delegados 235,  236 

Lista  de  los  funcionarios  de  la  convención 225 

Marchoux  y  Simon,  discusiones  relativas  á  la  declaración  hecha  por 292 

McCaw,  Dr.  Walter  D.: 

Delegado  de  los  Estados  Unidos 235 

Discm^o  pronunciado  al  final  de  la  conferencia 312 

Miembro  de  la  comisión  de  organización 238 

Medina,  Dr.  J.  L.: 

Delegado  de  Nicaragua 236 

Discm-so  pronimciado  al  final  de  la  conferencia 314 

Informe  del 397 

Resolución  presentada  por 290 

México : 

Informe  del  Doctor  Licéaga 384 

Memoria  leída  por  el  Doctor  Licéaga,  de  acuerdo  con  el  programa  científico  —  329 

Representación  ante  la  convención 236 

Resolución  felicitando  á  la  República 305 

Moore,  Dr.  Eduardo: 

Delegado  de  ChUe 235 

Discurso  pronunciado  al  final 309 

Informe  del 333 

Miembro  de  la  comisión  de  organización 238 

Nicaragua: 

Informe  del  Doctor  Medina 397 

Representación  ante  la  convención 236 

Oficina  Sanitaria  Internacional,  continuará  como  quedó  constituida 264 

Ordenanzas  sanitarias  de  Cuba 336 

Panamá,  Gobierno  de  la  Zona  del  Canal,  resolución  felicitándolo 305 

Perú: 

Informe  del  Doctor  Lavorería 398 

Representación  ante  la  convención 236 

Prensa  de  Washington,  voto  de  gracias  á  la 308 

Presidente  de  los  Estados  Unidos: 

Discurso  pronunciado  por  el 447 

Voto  de  gracias  al : 307 

Programa  científico 229 

Quesada,  Hon.  Gonzalo  de,  Ministro  de  Cuba: 

Discurso  del 234 

Voto  de  gracias  al 307 

Reglamento  para  la  desinfección  de  buques  y  equipajes  en  el  Ecuador 378 


ÍNDICE.  459 

República  Dominicana:  •  Pagina. 

Informe  del  Señor  Joubert 414 

Representación  ante  la  convención 236 

Requena  Bermudez,  Señor  Don  P.: 

Delegado  del  Uruguay 236 

Informe  del 418 

Resoluciones  adoptarías  por  la  conferencia 239, 252, 264, 304, 307 

Roosevelt,  Hon.  Theodore,  Presidente  de  los  Estados  Unidos: 

Discurso  del 447 

Votode  gi-acias  al 307 

Root,  Hon.  Elihu,  Secretario  de  Estado: 

Discurso  de  bienvenida 232 

Voto  de  gracias  al 307 

Santo  Domingo.     (Véase  República  Dominicana.) 

Servicio  de  Sanidad  Pública  y  Hospitales  Marítimos,  resolución  felicitando  al 30.5 

Sternberg,  Cirujano  General  George  M.,  prerrogativas  de  la  convención  extensivas  á.  237 

Stiles,  Dr.  Ch.  H.  Wardell: 

Discurso  pronunciado  al  final  de  la  conferencia 315 

Prerrogativas  de  la  convención  extensivas  á 237 

Suzuki,  Cirujano  General,  de  la  Armada  Imperial  Japonesa,  prerrogativas  de  la 

convención  extensivas  á 237 

Taylor,  Hon.  Horace  A.,  Secretario  Interino  del  Tesoro: 

Discurso  del 233 

Voto  de  gracias  al 307 

Tercera  Convención  Sanitaria  Internacional,  cuándo  se  celebrará 239 

Ulloa,  Dr.  Juan  J. : 

Delegado  de  Costa  Rica 235 

Discurso  al  final  de  la  conferencia 310 

Informe  del 334 

Resoluciones  presentadas  por 307 

Secretario  de  la  convención 238 

Secretario  permanente  de  la  convención 239 

Voto  de  gracias  al 307 

Uruguay : 

Informe  del  Señor  Requena  Bermudez 418 

Representación  ante  le  convención 236 

Veloz-Goiticoa,  Señor  Don  Nicolás: 

Delegado  de  Venezuela 236 

Informe  del 420 

Venezuela: 

Informe  del  Señor  Veloz-Goiticoa 420 

Morbilidad  nacional 435 

Representación  de,  ante  la  convención 236 

Vice-presidentes : 

Nombramiento  de  los,  sometido  á  la  Junta  Consultora 245 

Nombramiento  de 264 

Tela,  Dr.  Joaquín: 

Delegado  de  Guatemala 236 

Informe  del 381 

Whither,  Dr.  Serafín  S.: 

Delegado  del  Ecuador 235 

Informe  del 377 


46Ü  ÍNDICE. 

Wood,  Profesor. H.C.:  Pagina. 

Observaciones  reía  tivas  á  la  Farmacopea  de  los  Estados  Unidos 252 

Prerrogativas  de  la  convención  extensivas  al 237 

Woodward,  Dr.  William  C: 

Carta  del 251 

Prerrogativas  de  la  convención  extensivas  al 237 

Wyman,  Ciujano  General  Walter  A.:  ' 

Alocución  inaugural 229 

Delegado  de  los  Estados  Unidos 235 

Discurso  pronunciado  al  final  de  la  conferencia 317 

Presidente  de  la  convención 239 

Voto  de  gracias  á 307 

Zona  del  Canal  de  Panamá,  resolución  felicitando  al  gobierno 305 


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